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Biomedical subjects

M Limme

Publications and source records attributed to M Limme.

At least 19 recordsLinked to original sources
PubMed2002

[Cephalometric assessment in obstructive sleep apnea and hypopnea syndrome].

Several cephalometric studies have been published to study sleep apnea and hypopnea. The purpose of this review is to provide a clear analysis of the different and apparently contradictory cephalometric results and to describe certain pitfalls of the method. In general, an excessive development of the tongue and soft palate are observed in these subjects, limiting the pharyngeal airway. Bony anomalies include mandibular retrognathism and an excessive anterior ventral development of the skull associated with insufficient anterior growth of the base of the skull. The head is held in extension. These different factors contribute to blocking the upper airway and favor pharyngeal collapse. Cephalometry can be used to identify patients at risk and to propose an apnea/hypopnea index for precise etiological diagnosis and therapeutic decision making.

Cephalometry↗
PubMed2000

[Could mouth breathing lead to obstructive sleep apnea syndromes. A preliminary study].

The aim of this preliminary work is to determine an easy method to diagnose "buccal breather" children and "nasal breather" children. Then, to establish a possible connection with the syndrome of obstructive sleep apnea. 22 children agreed to participate. Clinical, orthophonic, orthodontic, postural and polysomnographical exams have been carried out. The proposed clinical exam turns out to be a good means of diagnosing between buccal breathers and nasal breathers. The aerophonoscope reveals velar inadequacies in buccal breathers. The latter also present osseous discrepancies mainly in the mandible. The polysomnography reveals a higher apnea/hypopnea index and more agitated sleep in buccal breathers. Mandibular lowering movements are more frequent and similar to those of adults suffering from apnea. These elements similar to those encountered in adults suffering from apnea make us think that buccal breathing could be the origin of obstructive sleep apnea, several decades later.

Adolescent↗
PubMed2000

[Indications and implications of surgical maxillary expansion in orthodontic surgery].

Surgically assisted rapid maxillary expansion is an accepted method for correction of transverse skeletal and dental discrepancies. The surgical technique includes a Lefort I osteotomy with medial palatine osteotomy. The maxillary must be totally released to achieve the desired expansion. There are several advantages: bone apposition in osteotomy sites, reduced risk of dental version or extrusion compared with orthopedic care, secondary surgical cure of complex dysmorphism requiring fewer segmentary osteotomies. Finally, we examined skeletal side effects induced by surgically assisted rapid maxillary expansion in the vertical and sagittal dimension of the face.

Adult↗
PubMed1999

Modified bonded bridge space maintainer.

The premature loss of primary teeth can create the need for space maintenance and restoration of function. This article presents a fixed bonded space maintainer, which allows space to be maintained with economy of dental tissues.

Child, Preschool↗
PubMed1997

[Orthodontic contribution in sleep apnea].

This study details the role that the orthodontist can play, when faced with sleeping obstructive apneas and snoring phénomena. Of special importance are knowledge of cranio-facial growth, radiographic exam and cephalometric analysis: they mainly help to understand all the aspects of this specific syndrome, and reveal the interest for a neuro-orthodontic or a neuro-surgical orthodontic approach.

Adult↗
PubMed1995

[The decision to extract in orthodontics].

Serial extractions of premolars are submitted, in the present state of the contemporary orthodontics, in opposition to the non-extraction treatments (maxillary expansion, molar distancing...). The choice depends on many parameters including the severity and the nature of the malocclusion, the age and the morphological type of the patient and also the "orthodontic philosophy" relating to the techniques used by each orthodontist. The indications and contraindications of these teeth removals are explained showing the benefits and the disadvantages in different cases. "Orthodontics extractions" of other teeth (2nd bicuspid, 1st and 2nd molar, incisor) are also discussed.

Bicuspid↗
PubMed1993

[Non-obstructive etiology of mouth breathing].

Besides nose obstruction other etiological factors can be advanced to explain the development of oral respiration: malformation of the face (Binder's syndrome, Bimler's microrhinodysplasia, Apert's and Crouzon's syndrome); alterations or deviations of the tongue (Robin's syndrome, macroglossia, ankyloglossia); lip closure problems.

Child↗
PubMed1993

[Orthognathic and orthodontic consequences of mouth breathing].

There is a large controversy about the causal relations between dento-facial deformities and mouth-breathing habits. Some postural and morphological changes during long-term adaptation to oral respiration are evoked: opening of the bite with a lowered postural position of the mandible, reduction of upper arch width, downward and backward rotation of the mandible, increased lower facial height and changes in the inclination of the lower and upper incisors. It seems that the altered postural position of the tongue and of the mandible, needed for oral ventilation, could, by soft-tissue stretching, change the growth pattern of the face.

Adolescent↗
PubMed1993

[Orthodontic studies in mouth breathing].

The diagnosis of dental malocclusions and skeletal deformities associated with an oral mode of breathing, requires a comprehensive orthodontic examination. The importance of dental occlusion and the skeletal morphology is stressed. Lateral sliding of the mandible when the centric occlusion shows the first contact in a cusp-to-cusp relationship; unilateral or bilateral cross-bite, due to the underdevelopment of the maxillary; the sagittal relationship of the jaws (class 1, 2 or 3); a vertical excess of the anterior facial height with postero-rotation of the mandible and open bite context. Cephalometric analysis provides a better understanding of facial architecture and allows a quantitative and qualitative appreciation of dento-skeletal dysmorphism.

Adolescent↗
PubMed1993

[Orthodontic treatment in mouth breathing].

Patients with severe alterations of the maxillary growth pattern, due to long term predominant oral respiration, primarily need orthopaedic appliances, rather than common orthodontic mechanics. In cases of maxillary transversal deficiency, rapid expansion is indicated to recover an adequate width. Such treatment improves the ability for nasal ventilation. When the maxilla is sagittally underdeveloped, a facial mask is used to protract the entire maxilla. Other ways of treatment include oral screens, partial glossectomy, myofunctional therapy and respiratory gymnastics. Finally orthodontic treatment can be planned to correct irregularities of the teeth and residual malocclusions.

Activator Appliances↗
PubMed1993

[Physiology of craniofacial development].

This topic summarizes basic principles of the development and the postnatal growth of the craniofacial skeleton. The different stages involved in the progressive ossification of facial bones are exposed: the intramembranous ossification, the endochondral (intracartilagenous) ossification and the changes (remodelling and relocation) associated with periosteal and endosteal membranes.

Adolescent↗
PubMed1992

[Guidance of tooth eruption in the support areas using proximal grinding].

This article brings a description of a procedure for interproximal slicing. When persistence of the second deciduous molar occurs, the premolar is likely to be blocked in his eruption, while the canine is guided out of the dental arch; in these conditions it might be necessary to perform a slicing mesially of the second deciduous molar. Beforehand one should check for the posterior tooth-size and eruption pattern or sequence of each quadrant.

Bicuspid↗
PubMed1992

[Space maintenance following the premature loss of temporary teeth].

Despite contemporary techniques, we still don't have the ability of saving all deciduous teeth in their place on the dental arch until the time of physiological loss. A premature loss of temporary teeth interferes with the harmony of the adult dentition. The principal consequence of this premature loss is crowding, caused by migration of the adjacent teeth. This article ames to guide our policies in the decision making process whether or not maintaining space, in causes of premature loss of one or more deciduous teeth.

Child↗
PubMed1991

[Obstructive sleep apnea syndrome: the orthodontist's viewpoint].

Obstructive sleep apnea syndrome (OSAS), previously called Pickwickian syndrome is usually associated with obesity, excessive daytime sleepiness and ventilation troubles. These patients are heavy snorers and present a typical craniofacial morphology. Among several characteristics is retrognathic lower maxillary. Functional orthodontic appliances are proposed to help these patients, in order to open the superior airway and allow a better ventilation.

Facial Bones↗
PubMed1991

[Orthodontic consequences of mouth-breathing].

Mouth breathing habits are frequently associated with orthodontic problems. In the nasal area, the lack of ventilation leads to an underdevelopment of the maxilla: lateral and sometimes anterior cross bites appear. In the buccal area, the want of maintaining the mouth opened induces a new postural position of the mandible which alters the pattern of growth of the mandible ("long face"). The functional context of the buccal praxis is also altered: low or protruded tongue, deviant swallowing, troubles of speech.... The treatment of this pathological context needs a pluridisciplinary approach where the otorhinolaryngologist, the dentist, the orthodontist and the speech pathologist have to play an important role. In the orthodontic fields, we have to carry out an orthopedic treatment (rapid maxillary expansion, facial masks,...) to normalize the growth of the maxilla before the orthodontic treatment.

Child↗
PubMed1991

[Therapeutic maxillary expansion].

The purpose of this study was to assess the effects of rapid maxillary expansion on nasal airflow studies and mouth breathing habit. 15 children aged from 5 to 12 years underwent rapid palatal expansion for orthodontic abnormalities. Otolaryngologic evaluation, computerized active anterior rhinomanometric measurements and oral myo-functional disorder examination were obtained before treatment, 2 months after expansion and after a retention period of approximately 10/12 months. Based on this multidisciplinary judgment and confirmed by the rhinomanometric values two groups could be distinguished: a group of predominantly mouth breathers where the nasal airway resistance had an average decrease of 34% and a group of predominantly nasal breathers where the nasal airway resistance had an average decrease of less than 5%. From the initial 8 predominantly mouth breathers before treatment only 2 remained clinically unchanged. From these results it was concluded that for the 15 children involved in this study rapid maxillary expansion affected the nasal airway patency in a way tailored to the initial deficiency and had a significative effect on the respiratory mode.

Airway Resistance↗
PubMed1991

[Evaluation of speech therapy and rehabilitation exercises in mouth-breathers].

Mouth breathing induces a low rest posturing of the tongue and tongue thrusting in many cases. This disturbs the development of the oral functions. The first stage of the reeducation is nose breathing's rehabilitation in order to "liberate" the tongue. Nasal breathing cannot be taught exteriorly . It's a result of the physical well-being. It's important to observe the mouth breathers and understand their needs. The second stage of the reeducation concerns the tongue moving tonicity and suppleness. Every exercise relies on the proprioceptive control that makes the child aware of each motion of the tongue. The next stages will be the recovering of the different functions as the rest tongue posture, swallowing, chewing. The use of phonation (lingual alveolar speech sounds) will facilitate the automatism of the new functions, because the children feel the elevation of the tongue.

Child↗