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Biomedical subjects

D R Joondeph

Publications and source records attributed to D R Joondeph.

17 recordsLinked to original sources

Eruption of mandibular third molars after second-molar extractions: a radiographic study.

The purpose of the present study was to analyze the posteruptive contact relationship and inclination of mandibular third molars after extraction of second molars and to determine whether predictors could be formulated for the dental relationships observed. In all, 140 mandibular quadrants were evaluated from 95 sets of panoramic radiographs taken at the time of second molar extraction (T1) and at the time of final evaluation (T2). For analysis of a consecutive sample of patients, a subsample of 25 sets of radiographs from all the patients who had received such treatment during one calendar year was also quantified. Subjective evaluation indicated that 46% of the sites examined had satisfactory tooth contact relationship between the first and third molars at T2. Third-molar impaction was found in 4% of the sites in the subsample of 25 consecutively treated patients. Measurements of crown axis inclination revealed that the third molar invariably erupted into a mesially tilted position. The first molar showed only minor distal tipping between T1 and T2. Inclination of the third molar bud at the time of second molar extraction was not found to be a useful predictor for posteruptive third molar position. The clinical significance of these results and the need for studies regarding a rationale for mandibular second molar extraction are discussed.

Adolescent

A comparison of apical root resorption during orthodontic treatment in endodontically treated and vital teeth.

The purpose of this study was to determine whether vital and endodontically treated incisors exhibit a similar severity of apical root resorption in response to orthodontic treatment. Forty-three patients who had one or more endodontically treated incisors before orthodontic treatment and who exhibited signs of apical root resorption after treatment were studied. In each patient the vital contralateral incisor served as a control. Vital incisors resorbed to a significantly greater degree than endodontically treated incisors (p less than or equal to 0.05). When patients were separated by gender, control teeth in males exhibited a statistically significant increase in resorption over control teeth in females. No significant differences were apparent between males and females when endodontically treated incisors were compared.

Adolescent

A long-term study of the relationship of third molars to changes in the mandibular dental arch.

The purpose of this study is to determine the relationship of third molars to changes in the mandibular dental arch. The sample for this study consisted of four groups and subgroups. The groups consisted of premolar extraction treated, nonextraction treated with initial generalized spacing, nonextraction treated, and serial extraction untreated subjects. The subgroups were divided into persons who had mandibular third molars that were either impacted, erupted into function, congenitally absent, or extracted at least 10 years before postretention records. The mean postretention time interval was 13 years, with a range of 10 to 28 years. The mean postretention age was 28 years 6 months, with a range of 18 years 6 months to 39 years 4 months. Two-way analysis of variance with repeated measures was used to compare the changes over time (before treatment, at end of active treatment, and after retention) of groups and third molar subgroups. With time, mandibular incisor irregularity increased while arch length and intercanine width decreased. The eruption patterns of mandibular incisors and first molars were similarly dispersed in all groups studied. The findings between the subgroups in which mandibular third molars were impacted, erupted into function, congenitally absent, or extracted 10 years before postretention records revealed no significant differences between any of the subgroups for the parameters studied. No significant differences in mandibular growth were found between the third molar subgroups; this suggests that persons with third molars erupted into satisfactory function do not have a significantly different mandibular growth pattern than those whose third molars are impacted or congenitally missing. In the majority of cases some degree of mandibular incisor crowding took place after retention, but this change was not significantly different between third molar subgroups. This finding suggests that the recommendation for mandibular third molar removal with the objective of alleviating or preventing mandibular incisor irregularity may not be justified.

Adult

Long-term evaluation of root resorption occurring during orthodontic treatment.

The present study was undertaken to evaluate the long-term status of teeth that had undergone root resorption during active orthodontic treatment. A total of 100 patients who exhibited root resorption during appliance therapy were recalled at a mean period of 14.1 years (SD 0.4) after treatment. At those examinations full-mouth sets of periapical radiographs were taken and tooth mobility evaluated. Pretreatment, posttreatment, and long-term periapical radiographs were examined and compared for changes in root length and contour with time. At each stage scores were given on a scale from 0 to 4, depending on the degree of resorption. The maxillary incisors were affected more frequently and to a greater degree than the rest of the teeth during active treatment. The long-term evaluation showed no apparent changes after appliance removal except remodeling of rough and sharp edges. Hypermobility was observed in only two instances.

Adolescent

Long-term periodontal status of labially erupted canines following orthodontic treatment.

Periodontal status was studied at the mesiobuccal, midbuccal and distobuccal aspects of contralateral pairs of canines in 22 postorthodontic patients aged 30 to 51 years with a mean time of 26.4 years (SD, 5.6) out of active treatment. The pretreatment models showed one canine erupting severely to the labial ("ectopic") with a contralateral canine in good arch alignment (control). None of the patients experienced relapse of the "ectopic" canine in a labial direction, and none had missing teeth, malalignment, overhanging restorations or open tooth contacts adjacent to the canines evaluated. Periodontal parameters were examined using a Michigan #0 probe with Williams markings. A nonstandardized light force was used and the measurements were rounded to the nearest millimeter. The results demonstrated statistically significant differences between the canines in probing attachment and bone levels (mean, 0.75; SD, 0.92; P less than 0.01) and width of attached gingiva (mean, 0.50; SD, 1.07; p less than 0.05) at the midbuccal aspects. The reason for these differences could only be speculated upon.

Adult

Anterior open-bite malocclusion: a longitudinal 10-year postretention evaluation of orthodontically treated patients.

Long-term response of the anterior open-bite malocclusion was evaluated in forty-one white subjects who had undergone orthodontic treatment and were out of retention a minimum of 9 years 6 months. The purpose of the study was threefold: (1) to make cephalometric comparisons between a sample of open-bite patients and a sample with normal cephalometric standards, (2) to evaluate treatment and posttreatment changes that occurred in treated open-bite patients, and (3) to search for predictors and associations of value. Changes occurring across time in the open-bite patients were analyzed by computer means using pretreatment, posttreatment, and long-term cephalometric radiographs and dental casts. An analysis of subgroups was reviewed to compare dentoalveolar and skeletal relationships of both stable and relapse groups. More than 35% of the treated open-bite patients demonstrated a postretention open bite of 3 mm or more, with the relapse subgroup demonstrating across-time, less mandibular anterior dental height, less upper anterior facial height, greater lower anterior facial height, and less posterior facial height. Neither the magnitude of pretreatment open bite, mandibular plane angle, nor any other single parameter of dentofacial form proved to be a reliable predictor of posttreatment stability.

Adolescent

Perceptions of facial profile and their influence on the decision to undergo orthognathic surgery.

Eighty patients, who had previously been evaluated by an oral surgeon and an orthodontist as requiring orthognathic surgery, completed questionnaires rating their perceptions of their own profiles. Half of the patients had decided to undergo surgical correction of their jaw deformities, while the other half had decided against surgical treatment. In addition, booklets containing pretreatment photographs of all 80 patients were mailed to 37 oral surgeons, 46 orthodontists, and 43 lay persons. These three groups of evaluators rated the patients' profiles, using the same rating scales that the patients had used. Cephalometrically, the two patient groups were statistically the same in all skeletal and soft-tissue measures except for ANB (mean difference = 1.8 degrees) and soft-tissue AN-pogonion (mean difference = 2.4 degrees). Differences in these dimensions were considered in subsequent data analyses. Results of this study support the following conclusions: In spite of the fact that surgical treatment may be recommended by dental specialists and indicated by cephalometric measurements, self-perceptions of profile are more important in the patient's decision to elect surgical correction; the perception by others that the profiles of patients deciding against surgery are closer to ideal may have some influence on their decision against surgical correction of their jaw deformities; oral surgeons and orthodontists evaluate facial profiles similarly, but surgeons are more likely to recommend surgical correction; lay persons are more likely to rate an individual's profile as being normal than are dental specialists in orthodontics and oral surgery; in contrast, individuals perceive their own profiles differently than orthodontists, oral surgeons, and lay persons, particularly with respect to the mandibular and dentoalveolar dimensions.

Adolescent

Second premolar serial extraction.

Serial extraction of mandibular second premolars should be considered if they are impacted or in cases with moderate arch length deficiency combined with an absence of dentofacial protrusion. The favorable dental changes associated with this approach greatly minimize future orthodontic treatment complexity and time.

Anodontia