[The French School of Dentistry (II). Its history and vicissitudes].
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Biomedical subjects
Publications and source records attributed to A Coutand.
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Proprioceptive sensibility from stimulation of muscle, ligament articular and vestibular receptors plays a determining role in the regulation of tone, of the resting position of the mandible, of head posture and of the closure pathway of the mandible. Studies conducted on temporomandibular joints of fetuses and adult subjects failed to demonstrate the specialized corpuscles (a fact previously noted by Ramfjord) in the temporomaxillary joint capsule, described typically in other joints. In contrast, however, histology showed a particularly rich population of muscle receptors adjacent to this joint, this being only one of several particular characteristics.
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Physiological mesiodistal inclinations of the permanent first molars are now well recognized. These inclinations can be measured without difficulty on a lateral teleradiographic image of the head. Several cases are reported where anatomical normality of articulation of the molars did not correspond with physiological normal limits.
During childhood and adolescent years, the buccal musculature characteristics as well as the anatomical relation between the lips and the incisors, change. The consequence of these maturation phenomena is the retroclination of the incisors. In certain cases, this results in a decrease of the dental arches' length which is sufficient to create those belated dental malpositionings due to lack of space.
Teleradiographic recordings were employed to compare growth of maxillary skeleton and changes in dental systems. Facial growth occurs at a constant rate during the period when growth in stature is firstly slowed, and then accelerates with the approach of puberty. Growth rates of different parts of the skeleton are not parallel and the face is not involved in the prepubertal acceleration in statural growth. In contrast, puberty affects the adaptation of the dental system to its maxillary insertion bases by its action on buccal musculature.
What should be done about the child who sucks his thumb? If the child has no dento-maxillary deformity, he should be left to suck his thumb. In the presence of deformities, it would seem wise not to interfere before the age of 6 or 7 years. Firstly, the majority of thumb suckers abandon this behavior spontaneously between 3 and 7 years, and secondly it is only at the age of 6 years that the milk teeth begin to be replaced by the adult dentition. An early intervention has the risk of being ineffective or even of reinforcing the habit and leading to other problems. After 7 years, the child with deformities should be examined and in the absence of an psychological contraindication, "invigoration psychotherapy" should be undertaken in order to put a stop to the thumb sucking habit. Finally, when the 8 year old continues to suck his thumb despite psychotherapy by the psychologist or the stomatologist, the advice of a child psychiatrist must be sought in order to determine whether the symptom which the habit represents should be disturbed or not.
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The musculature of the lips contributes to oro-facial muscular equilibrium. Labial topography at rest is extremely variable, as there may be gaping of the lips with a short upper lip and associated protrusion of the upper alveolar process, as well as on the contrary an upwardly displaced stoma leading to incarceration of the upper dental arch by the lower lip and retrocession of the laveolar process (stoma syndrome). Anomalies at rest justify surgical treatment.
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