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Biomedical subjects

David M Sarver

Publications and source records attributed to David M Sarver.

14 recordsLinked to original sources
PubMed2006

Long-term efficacy of reverse pull headgear therapy.

OBJECTIVE: To add to the data for long-term reverse pull headgear (RPHG) outcomes and further explore possible variables that could be predictors of long-term failure. MATERIALS AND METHODS: Cephalometric radiographs of 41 Class III malocclusion children treated with RPHG (face mask) were evaluated before and immediately after treatment; at 5 years posttreatment; and, for 18 patients, at 10 years posttreatment. Patients were assigned to success or failure groups according to positive or negative overjet at the longest available recall. RESULTS: Seventy-five percent of the patients maintained positive overjet, whereas 25% outgrew the correction. In a stepwise discriminant analysis, a large mandible and vertical positioning of the maxilla and mandible so that mandibular growth would be projected more horizontally were the major indicators of unfavorable later mandibular growth. Patients who experienced downward-backward rotation of the mandible during RPHG treatment were more likely to be categorized in the failure group. The age at which treatment began had no effect on long-term success and failure for patients younger than 10 years, but the percentage of successful treatment decreased after that age. CONCLUSIONS: When RPHG treatment is used for all but the most obviously prognathic children to correct anterior cross-bite in the early mixed dentition, positive overjet is maintained long-term in 70%-75% of cases, whereas 25%-30% of cases relapse into reverse overjet mainly because of increased horizontally directed and often late mandibular growth. Up to age 10, the time at which RPHG treatment began does not appear to be a major factor in long-term success in maintaining positive overjet.

Age Factors↗
PubMed2006

Use of the 810 nm diode laser: soft tissue management and orthodontic applications of innovative technology.

Innovative technologies such as the diode laser have provided considerable benefit to dental patients and professionals. Facilitating efficient cutting of tissue and subsequent coagulation, the soft tissue laser enhances tissue healing and can reduce postsurgical complications. Due to the conservative nature of treatment accomplished with the laser this technology is very useful in orthodontic procedures. The diode laser is utilized in both esthetic enhancement of the smile, and treatment management of soft tissue issues that impede efficient orthodontic treatment. Its clinical application will be illustrated in a series of orthodontic cases.

Esthetics, Dental↗
PubMed2003

Dynamic smile visualization and quantification: part 1. Evolution of the concept and dynamic records for smile capture.

The "art of the smile" lies in the clinician's ability to recognize the positive elements of beauty in each patient and to create a strategy to enhance the attributes that fall outside the parameters of the prevailing esthetic concept. New technologies have enhanced our ability to see our patients more dynamically and facilitated the quantification and communication of newer concepts of function and appearance. In a 2-part article, we present a comprehensive methodology for recording, assessing, and planning treatment of the smile in 4 dimensions. In part 1, we discuss the evolution of smile analysis and review the dynamic records needed. In part 2, we will review smile analysis and treatment strategies and present a brief case report.

Cephalometry↗
PubMed2003

Dynamic smile visualization and quantification: Part 2. Smile analysis and treatment strategies.

The "art of the smile" lies in the clinician's ability to recognize the positive elements of beauty in each patient and then create a strategy to enhance the attributes that fall outside the parameters of the prevailing esthetic concept. New technologies have enhanced our ability to see our patients more dynamically and facilitated the quantification and communication of newer concepts of function and appearance. In a 2-part article, we present a comprehensive methodology for recording, assessing, and planning treatment of the smile in 4 dimensions. In part 1, we discussed the evolution of smile analysis and reviewed the dynamic records needed. In part 2, we review smile analysis and treatment strategies and present a brief case report.

Aging↗
PubMed2003

Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances.

In this cephalometric investigation, we compared the long-term effects of an initial phase of rapid maxillary expansion and facemask (RME/FM) therapy followed by comprehensive edgewise therapy with the effects of growth in untreated, matched controls. The treated sample consisted of 34 patients who underwent RME/FM treatment before the pubertal growth spurt (average age, 8 years 3 months at the beginning of treatment). At the final observation period (average age, 14 years 10 months), all patients were in decelerative growth phases as determined by the cervical vertebral maturation (CVM) method. After the first 10 months of active treatment, significant favorable changes in both the maxillary and the mandibular skeletal components were noted. The forward movement of the maxilla was 1.8 mm greater than in the controls, mandibular projection was reduced by almost 3 mm, and the relative sagittal intermaxillary discrepancy improved by 4.3 mm, as measured by the Wits appraisal. During the posttreatment period, the treated and untreated Class III subjects generally grew similarly, although the skeletal relationship of the maxilla to the mandible remained unchanged in the RME/FM group, whereas the controls had an increased skeletal discrepancy of 3.0 mm. Over the long term, there was a slightly greater increase in midfacial length (1.6 mm) in the treatment group than in the controls. Similarly, the distance from Point A to nasion perpendicular decreased by 1.2 mm in the treated group. The overall increase in mandibular length was 2.4 mm less in the RME/FM group than in the controls, and mandibular projection relative to nasion perpendicular was 3.0 mm less in the treated group. The change in the Wits appraisal was substantial between groups (6.1 mm), with an improvement in the intermaxillary relationship in the treated group (3.4 mm); the Wits appraisal worsened (-2.7 mm) in the untreated controls. No clinically significant differences were observed between the groups in the vertical dimension. Overjet increased significantly in the treated group relative to the controls (4.4 mm), whereas the molar relationship decreased significantly (-3.9 mm). It appears that the favorable skeletal change observed over the long term is due almost entirely to the orthopedic correction achieved during the RME/FM protocol. During the posttreatment period that includes the pubertal growth spurt, craniofacial growth in RME/FM patients is similar to that of untreated Class III controls. Aggressive over-correction of the Class III skeletal malocclusion, even toward a Class II occlusal relationship, appears to be advisable, with the establishment of positive overbite and overjet relationships essential to the long-term stability of the treatment outcome.

Age Factors↗
PubMed2002

The predictability of maxillary repositioning in LeFort I orthognathic surgery.

Our ability to predict the outcome of any orthognathic procedure relies on the surgeon's ability to accurately reproduce the desired skeletal movements and on our understanding of the soft tissue changes associated with those movements. The purpose of this retrospective study was to evaluate the surgical accuracy of maxillary repositioning by comparing the objectives obtained from cephalometric prediction tracings with the actual skeletal changes achieved during maxillary and maxillomandibular procedures. The sample consisted of 46 patients from the files of 1 orthodontist. Presurgical and immediately postsurgical cephalometric radiographs were digitized, and the original surgical prediction was reproduced with Dentofacial Planner (Dentofacial Software, Toronto, Ontario, Canada) software. Vertical and horizontal measurements to several skeletal landmarks were used to assess the differences between the predicted maxillary position and the actual maxillary postsurgical position. Statistical differences were found for some measurements, particularly those related to the vertical placement of the posterior maxilla. Three variables were evaluated for their effect on the surgical discrepancies. The 2 surgeons with the most patients were evaluated and found to have differences in the direction of discrepancies but not the amount (absolute values). Significant differences were also found when evaluating surgical complexity (single-jaw vs bimaxillary procedures) and the direction of movement (impaction vs advancement) in direction only. To assess the overall fit of individual predictions, we calculated an average discrepancy for each patient; 80% of the actual results fell within 2 mm of the prediction, and 43% fell within 1 mm of the prediction.

Adult↗