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Biomedical subjects

J L Vaden

Publications and source records attributed to J L Vaden.

At least 19 recordsLinked to original sources
PubMed1999

A longitudinal cephalometric study of postorthodontic craniofacial changes.

Although the orthodontist focuses great efforts on diagnosis and treatment of the patient, less attention is paid to posttreatment changes that occur because of relapse and continued growth, especially over the long term. This cephalometric study describes 36 patients who were recalled x = 5.5 years after treatment and again x = 14.4 years after treatment. Most linear dimensions increased significantly from the end of treatment to first recall (ca. 16 to 21 years), presumably as a result of continued adolescent growth, but few changes achieved significance thereafter (ca. 21 to 30 years). Arch relationships (eg, ANB, NAP, AOBO, Y-axis) continued to improve after treatment, probably as a result of late growth of the mandible producing a more orthognathic profile. There was little change from first to second recall in any of the variables. Results suggest that if relapse occurs, it is likely to be evident soon after treatment and diminish thereafter and that continued craniofacial growth generally augments the orthodontic correction.

Adolescent↗
PubMed1998

Postorthodontic dental changes: a longitudinal study.

The conventional adolescent orthodontic patient is treated during a phase of active growth, but growth of the skeletodental complex continues after treatment and into adulthood at a much slower pace. Selection of orthodontic diagnostic and treatment regimens that produce stable and esthetic dental relationships is a continual endeavor for the orthodontic specialist. Patients should be recalled for long periods of time and the results evaluated. The present longitudinal study was completed on 36 individuals, all of whom had received comprehensive orthodontic treatment. Dental changes were assessed from cephalograms for the in-treatment period (ca. 12 to 15 years of age), posttreatment to first recall (0 = 22 years of age), and first to second recall period (0 = 30 years of age). There was considerable change in the absolute locations of the teeth, but, in reality, these changes are almost wholly attributable to growth of the bony reference structures, not dental changes per se. Growth proceeded at a very slow pace after the first recall (ca. 22 to 30 years of age ). Dental relationships, eg., FMIA, IMPA, 6L angulation, exhibited no systematic change after treatment.

Adolescent↗
PubMed1998

Nonsurgical treatment of the patient with vertical discrepancy.

Conventional orthodontic treatment of the patient who has excessive anterior facial height is difficult. Many times, the patient is presented only a surgical-orthodontic option. However, some "orthodontics only" options are available. These options can generally give the patient acceptable facial balance and a good functional occlusion. The two keys are differential diagnosis and a carefully monitored force system. Conventional treatment of two patients with high angle facial dimension will illustrate these concepts.

Adolescent↗
PubMed1997

Relapse revisited.

Rather little is known about the changes in orthodontic treatment results exceeding a decade after treatment. The purpose of this study was to quantify changes in tooth relationships in a series of cases (n = 36) at 6 years and again at 15 years after treatment. The rate of change decreased with time, supporting the contention that most "relapse" occurs soon after treatment; continued change generally cannot be distinguished from normal aging processes that occur, regardless of whether a person had been treated orthodontically. There were minor, but statistically significant, associations between increased incisor irregularity ("relapse") and parasagittal growth of the jaws. Greater irregularity occurred when mandibular growth exceeded that of the maxilla, decreasing overjet and crowding the lower incisors within the containing arch of the maxilla. Overall, relapse tended to be less in these cases treated by a single experienced specialist that in university-based samples treated by multiple, orthodontic residents.

Adolescent↗
PubMed1996

Straight talk about extraction and nonextraction: a differential diagnostic decision.

At one stage or another, orthodontics is usually a space management procedure, particularly during the correction of a Class I or Class II malocclusion. Orthodontists use space that is available or create space to correct malocclusions. There are anterior, posterior, lateral, and vertical dimensions of the dentition and its supporting structures. If the muscular balance is normal, the clinician should try to respect these dimensions. The orthodontic clinician should not be an extractionist or a nonextractionist. Rather, the clinician should use differential diagnostic skills and artistic ability to arrive at the most appropriate treatment outcome for each patient.

Decision Making↗
PubMed1996

The Tweed-Merrifield philosophy.

Charles Tweed's concepts have been simplified, enhanced, and expanded by Levern Merrifield. Merrifield's ideas have augmented Tweed's to give orthodontics the Tweed-Merrifield philosophy. Adherence to the philosophy allows the orthodontic specialist to define objectives for the face, the skeletal pattern, and the teeth, and to diagnose and treat a malocclusion to efficiently reach these predetermined objectives.

Cephalometry↗
PubMed1996

Alternative nonsurgical strategies to treat complex orthodontic problems.

Patients whose vertical discrepancies are best corrected with both orthodontics and surgery can be placed into two distinct categories. The first category is the group of patients who have short posterior facial heights in conjunction with excessive anterior facial heights. The second category is the group of patients who have the opposite problem, i.e., excessive posterior facial heights and decreased anterior facial heights. Both of these types of malocclusions can best be treated with a combination of orthodontics and surgery. Alternative treatment for these "outer limits" patients require a thorough differential diagnosis, selection of appropriate force systems, and an understanding that nonsurgical treatment will result in compromises. Although these compromises must be accepted these patients can expect treatment results that are esthetically pleasing, highly acceptable for the teeth and supporting tissues, functional, and reasonably stable if a careful differential diagnosis is followed with treatment that uses precise space management with sequential directional force application.

Adolescent↗
PubMed1995

Adult versus adolescent Class II correction: a comparison.

The interest of the adult patient in orthodontics has increased as the demographics of the specialty of orthodontics has changed. There are major intreatment and posttreatment differences in Class II malocclusion correction between the adolescent and the adult. This article outlines the differences--and the similarities--between adolescent and adult Class II malocclusion correction. The differences and similarities are illustrated with case reports of a representative adolescent from the adolescent group and a representative adult from the adult group.

Adolescent↗
PubMed1994

Clinical ramifications of posterior and anterior facial height changes between treated and untreated Class II samples.

Some clinicians have suggested that one primary difference between successful and unsuccessful Class II treatment outcomes is the relative change of anterior and posterior facial heights. Successfully treated cases are claimed to exhibit greater increases in posterior facial height (PFH, articulare to gonion) than in the anterior facial height (AFH, menton to palatal plane). This conjecture was tested here by recalling a treated Class I sample and a treated Class II sample and by comparing the differences found in these samples to an untreated Class II sample at the same ages. The PFH/AFH ratio increased significantly more in the treated Class I and Class II samples during the active phase of treatment than in the untreated Class II sample at the same ages. During the years from posttreatment to recall (mean = 6 yrs), there was a significant increase in the PFH/AFH ratio in the treated Class II sample due to a greater increase in PFH than AFH. This ratio continued to improve after all appliance therapy had been discontinued, and it did not occur in the treated Class I sample nor in the untreated Class II sample. The conclusion was that the patient with a Class II malocclusion, if treated, continues to change favorably over time. This favorable change, in turn, helps maintain the Class II correction.

Adolescent↗
PubMed1994

Differential diagnostic analysis system.

This article links clinical research to fundamental orthodontic concepts to give the clinician a workable differential diagnosis system. The clinical research, conducted by the Charles Tweed Foundation, attempted to establish a "profile" for the Class II malocclusion correction, which, because of certain characteristics, was destined to failure. The Cranial Facial Dental Analysis integrates this clinical research with the total space analysis to give the clinical orthodontist a useful tool for differential diagnosis.

Cephalometry↗
PubMed1994

Effects of patient age on postorthodontic stability in Class II, division 1 malocclusions.

The increase in the proportion of adults in the typical orthodontic practice merits closer scrutiny of the treatment differences involved in adult vis-à-vis adolescent patients. Orthodontic treatment in the adolescent relies heavily on growth; in the adult, the practitioner must reposition teeth within the nongrowing arches. This difference may create the potential for greater postretention relapse in the adult; alternatively, continued growth in the subadult might detract from stability of the case. Two samples of Class II, Division 1 cases, all treated by one specialist, were examined an average of 5 years out of treatment. One group had been treated during adolescence (approximately 12 years of age), the other in adulthood (approximately 28 years). The orthodontic corrections were stable in both groups, but for different reasons: Posttreatment changes in the bony and dental structures of the adults were minimal. Bony changes (i.e., continued midface and mandibular growth) were appreciable in adolescents, and this growth--notably growth of the mandible--compensated for unfavorable drift of the dental elements (primarily mesial shift of the maxillary molar) after treatment. In sum, orthodontic corrections in adults were found to be at least as stable as those in the conventional adolescent patient.

Adolescent↗
PubMed1994

Posttreatment stability in adult and adolescent orthodontic patients: a cast analysis.

Orthodontic treatment of adults differs in many ways from that of the conventional adolescent patient. Adults are essentially nongrowing and have lower turnover rates of alveolar bone. These and other factors may affect the posttreatment stability of adult dentitions. This study compared the stability of orthodontic outcomes in matched samples of adolescents (about 13 years of age) and adults (about 30 years old) at an average of 5 years out of treatment. Analysis disclosed few differences between age groups; both exhibited considerable stability. Regarding key treatment considerations--such as midline alignment, incisor overbite and overjet, incisor irregularity, and molar relationship--both groups changed to equivalent degrees (and very little on average). Although minor differences were found (eg, arch length decreased more in adults), treatment changes in this sample of adults were at least as stable as those in the adolescents for all clinically relevant variables.

Adolescent↗