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Biomedical subjects

Mladen M Kuftinec

Publications and source records attributed to Mladen M Kuftinec.

8 recordsLinked to original sources

Unusual intraosseous transmigration of a palatally impacted canine.

Intraosseous migration of impacted teeth across the midline to the opposite side of the jaw is a rare dental anomaly of unknown etiology. Transmigration of an impacted mandibular canine through the symphysis to the contralateral side of the arch has been documented. Transmigration of an impacted maxillary canine across the midpalatal suture to the opposite side of the maxilla has not been previously observed and is reported here for the first time.

Adolescent↗

Condyle-fossa modifications and muscle interactions during herbst treatment, part 1. New technological methods.

Changes in the condyle, the glenoid fossa, and the muscles of mastication were investigated in subjects undergoing continuous orthopedic advancement of the mandible with a Herbst-block appliance. The total sample consisted of 56 subjects and included 15 nonhuman primates (in the middle mixed, early permanent, and permanent dentitions), 17 human Herbst patients in the early permanent dentition, and 24 human controls from the Burlington Growth Center. The 8 nonhuman primates in the middle mixed dentition were the focus of this study. Mandibular advancement was obtained progressively in 5 animals by adding stops to the telescopic arms of fixed functional Herbst appliances with occlusal coverage; activations of 5.0 mm, 7.0 mm, and 8.0 mm were achieved. Two primates served as controls, and the third was a sham control. Two experimental animals and the 2 controls also wore surgically implanted electromyographic electrodes in the superior and inferior heads of the lateral pterygoid muscles and in the superficial masseter and anterior digastric muscles. Changes in condylar growth direction and amount were assessed with the Björk method from measurements made on serial cephalometric tracings superimposed on metallic implants. Undecalcified sections, treated with intravenous tetracycline vital staining, were viewed with fluorescence microscopy to examine histologic changes in the condyle and the glenoid fossa. New bone formation in the fossa associated with continuous mandibular protrusion was quantified by using computerized histomorphometric analysis of decalcified histological sections and polarized light. The unique combination of permanently implanted electromyographic electrodes, tetracycline vital staining, and histomorphometry represents a significant technological advancement in methods and materials. Together, they demonstrated different muscle-bone interaction results for functional appliances than those reported in previous studies. In Part 1 of this study, we describe and discuss the techniques used in this research and give a brief overview of the findings; in Part 2 (to be published next month), we offer a more in-depth discussion of the results and the implications of our findings.

Animals↗

Condyle-fossa modifications and muscle interactions during Herbst treatment, Part 2. Results and conclusions.

Herbst appliances were activated progressively in growing nonhuman primates, and the results were compared with primate and human controls. The methods and materials of this research are explained in Part 1 of this study. The results are discussed here in Part 2. All experimental subjects developed large super Class I malocclusions, the result of many factors including posterior movement of the maxilla and the maxillary teeth, an increased horizontal component of condylar growth, and anterior displacement of the mandible and the mandibular teeth. The growth modification measured in the glenoid fossa was in an inferior and anterior direction. Restriction of the downward and backward growth of the fossa observed in the control subjects might additionally contribute to the overall super Class I malocclusion. Clinically, these combined effects could be significant at the fossa. The restriction of local temporal bone (fossa) growth cannot be observed clinically; thus, these results might also clarify some Class II correction effects that cannot be explained with functional appliances. Differences in the area and maximum thickness of new bone formation in the glenoid fossa and in condylar growth were statistically significant. The bony changes in the condyle and the glenoid fossa were correlated with decreased postural electromyographic activity during the experimental period. Results from permanently implanted electromyographic sensors demonstrated that lateral pterygoid muscle hyperactivity was not associated with condyle-glenoid fossa growth modification with functional appliances, and that other factors, such as reciprocal stretch forces and subsequent transduction along the fibrocartilage between the displaced condyle and fossa, might play a more significant role in new bone formation. These results support the growth relativity concept.

Animals↗

Intrabony migration of impacted teeth.

Intrabony migration of impacted teeth is a rare dental anomaly, which occurs only in the permanent dentition of the lower jaw. The teeth involved in this phenomenon are the mandibular lateral incisor, canine, and second premolar. Migration of the lateral incisor is usually in a distal direction, resulting in transposition with the canine. Migration of the canine is most frequently in a mesial direction, resulting in transmigration across the mandibular symphysis to the opposite side of the dental arch. The second premolar most often migrates distally, sometimes past the gonial angle and as far as the coronoid process. Surgical and orthodontic treatment options are presented for the three intrabony migrating teeth.

Bicuspid↗

Early detection and prevention of mandibular tooth transposition.

Distal migration of the mandibular permanent lateral incisor happens rarely and it can be discovered radiographically in the early mixed dentition. If unattended, the tooth may erupt ectopically, usually distal to its normal anatomical position and occlusal to the developing first premolar, and it can become transposed with the permanent canine. Early detection and immediate interceptive removal of the retained deciduous lateral incisor and canine, followed by uprighting the ectopic lateral incisor to its normal anatomical position in the arch, will intercept the problem and prevent the developing transposition.

Bicuspid↗