PubMed Health⌕ Search

Biomedical subjects

J S Casko

Publications and source records attributed to J S Casko.

11 recordsLinked to original sources
PubMed2000

Evaluation of profile esthetic change with mandibular advancement surgery.

Our purpose was to investigate the impact of mandibular advancement surgery on profile esthetics and to attempt to define guidelines that could be of value to the clinician in predicting profile esthetic change. The sample consisted of 34 patients who had been treated with a combination of orthodontics and mandibular advancement surgery without genioplasty. Initial (pretreatment) and final (posttreatment) cephalometric radiographs of each patient were used to produce silhouette images and to quantify skeletal changes that occurred with surgery. The images were displayed randomly to lay persons and orthodontic residents who were asked to score the esthetics of each profile. On average, after mandibular advancement surgery, B point moved forward 5.0 mm (SD = 2.6 mm) and downward 4.7 mm (SD = 3.1 mm), and the ANB angle decreased 3.0 degrees (SD = 1.6 degrees ) Graphical analysis and results of paired t tests revealed that for patients with an initial ANB angle >/= 6 degrees, a consistent improvement in profile esthetics was seen following surgery (P </=.001). This represented, on average, about a 45% improvement in esthetics. For patients with an initial ANB angle < 6 degrees, an improvement in profile esthetics after surgery was seen about half the time but poorer esthetics were equally likely. These results underscore the importance of using the ANB angle as a skeletal guideline when deciding whether to treat patients with mandibular advancement surgery. If improved profile esthetics are a desired outcome, an initial ANB angle of at least 6 degrees is recommended.

Adult↗
PubMed1998

Prediction of mandibular growth rotation: assessment of the Skieller, Björk, and Linde-Hansen method.

The purpose of this investigation was to assess the method proposed by Skieller, Björk, and Linde-Hansen in 1984 to predict mandibular growth rotation. Our sample consisted of 40 randomly selected, untreated, adolescent subjects representative of the patient population generally encountered in orthodontic practice. The four independent variables identified in the Skieller study as having the highest predictive value (mandibular inclination, intermolar angle, shape of the lower border of the mandible, and inclination of the symphysis) were identified on initial lateral cephalograms. The proposed regression equations were applied and predicted mandibular rotations obtained. Final lateral cephalograms made 6 years after the initial profile radiographs were superimposed and actual mandibular rotation recorded. The observed and predicted rotations were compared and regression analyses performed to determine the amount of variability in observed values accounted for by the four variables individually and in combination. Only 5.6% of the variability in mandibular growth rotation could be accounted for using the four variables individually. Only 9% of the variability could be accounted for with a combination of the variables. In addition, we performed a Monte Carlo analysis, which mirrored the Skieller analysis but used random numbers instead of actual cephalometric data, to determine if the Skieller results may simply have capitalized on chance. Using the same forward stepwise selection procedure with a rejection level of P >.1, we found after 5000 simulations that a mean of 84% and a median of 94% of mandibular growth rotation variability could be accounted for using meaningless data in the Skieller analysis. This result was comparable to the Skieller value of 86%. In conclusion, information derived from pretreatment lateral cephalograms using the Skieller, Björk, and Linde-Hansen method does not permit clinically useful predictions to be made in a general population relative to the direction of future mandibular growth rotation.

Cephalometry↗
PubMed1997

Genioplasty strategies for anterior facial vertical dysplasias.

The influence of anterior mandibular height is often overlooked when planning treatment of facial vertical excess or deficiency. Although treatment decisions tend to focus primarily on Le Fort I maxillary osteotomies, genioplasty remains a useful adjunctive surgical procedure. Components of anterior facial vertical dysplasia are reviewed, and six genioplasty strategies are described.

Bone Transplantation↗
PubMed1995

Intrusion anchorage potential of teeth versus rigid endosseous implants: a clinical and radiographic evaluation.

The purpose of this study was to compare the intrusion anchorage potential of teeth to osseointegrated titanium implants. Titanium implants were surgically placed unilaterally in a healed mandibular fourth premolar extraction site in eight adult mongrel dogs. The implants were surgically uncovered 3 months later and second stage abutments with soldered edgewise brackets secured. Edgewise brackets were also placed on the ipsilateral third premolars and on the contralateral third and fourth premolars. Segmental edgewise arch wires were placed between the implant and the third premolar and between the contralateral third and fourth premolars. Intrusion arch wire bends (v-bends) just mesial to the implant and the fourth premolar brackets were adjusted to apply a 50 to 60 gm intrusive force to the third premolars, bilaterally. Seven weeks later this force was increased to approximately 100 gm. Force levels were monitored biweekly for a total period of 16 weeks. Superimposition of initial and final periapical radiographs with bone markers demonstrated that for each dog the implant remained immobile and the third premolar on the implant anchor side was intruded in a curved path. On the contralateral side of the arch the dental anchor (fourth premolar) underwent an adverse reactive tip-back movement, and the third premolar was not intruded. We conclude that rigid endosseous implants are superior to dental anchorage for orthodontic intrusion of teeth and offer a potential means to intrude anterior teeth in adult patients with missing posterior teeth.

Animals↗
PubMed1989

Treatment of a dental deep bite in a patient with vertical excess and excessive gingival display.

The purpose of this report is to demonstrate the importance of developing an individualized treatment plan and treatment mechanics based on the patient's specific dental, skeletal, and profile problems. A case report is presented outlining the diagnosis and treatment planning for a patient who had a 100% deep bite combined with vertical facial excess and an excessive maxillary gingival display.

Cephalometry↗
PubMed1984

Dental and skeletal variation within the range of normal.

The cephalometric radiographs of 79 patients with untreated ideal occlusions were evaluated. The means, standard deviations, modes and ranges for 10 of the most popular cephalometric measurements were recorded. While the means for many of the measurements are close to those reported by previous studies, the ranges vary widely. Correlation coefficients were used to identify and evaluate dental and skeletal adaptations associated with these variations. These closely resemble those proposed by Steiner, although showing a somewhat greater degree of variation. While profile evaluation was not a basis for inclusion in this study, a subjective evaluation revealed no patient having extremely poor or unattractive profiles. While it appears reasonable to use mean relationships as an initial goal of treatment in the growing patient, an understanding of limitations, natural adaptation and normal variation should provide additional help in diagnosing and treatment planning. This can be especially important in adult patients. Ranges recorded for individual skeletal relationships can also provide a rough guide in helping the clinician differentiate between those patients who can be treated orthodontically and those who might need supplementary surgical correction for skeletal deformities. As in any system of diagnosis, the information provided in this study must be adapted and modified on the basis of individual patient needs as it is integrated into a comprehensive diagnosis.

Adult↗