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Tomasz Gedrange

Publications and source records attributed to Tomasz Gedrange.

10 recordsLinked to original sources
PubMed2006

The influence of craniofacial growth in a case of transverse facial cleft.

This report presents the case of a female patient bearing a right-side transverse facial cleft. She has received interdisciplinary treatment since birth. At regular intervals, dental casts were made, and profile and full-face photographs, lateral and postero-anterior cephalograms were taken during the course of orthodontic treatment and maxillofacial surgery. We evaluated her diagnostic records with the intent of documenting the effects of growth and therapy on the skeletal structures of the facial cranium and on occlusion, and to show the influence on facial esthetics. Her facial morphology and occlusion were manifest at birth and in the primary dentition. The maxilla and mandible deviated from the midsagittal plane toward the cleft side, with the mandible considerably more affected, revealing a markedly posterior position. The lateral skeletal deviation of both jaws increased slightly during growth, yet the midline deviation of the dental arches and malocclusion clearly worsened. The increasing deviation was not obvious in full-face photographs. Especially in the primary and mixed dentition, the mandible shifted to the anterior, which was visible in both the lateral cephalograms and profile photographs. On the whole, however, no noteworthy alteration in the character of the craniofacial morphology occurred by the time growth was complete, despite functional jaw-orthopedic and maxillofacial surgical treatment consisting of two distraction osteogenesis procedures.

Adolescent↗
PubMed2006

Influence of examiner differences on KIG-classification when assessing malocclusions.

OBJECTIVE: Indication systems such as the German KIG system (Kieferorthopädische Indikationsgruppen = Orthodontic Indication Groups) presuppose the objective assessment of underlying malocclusions. In this survey, we aimed to investigate the degree of agreement among the findings of several examiners in the assessment of different malocclusions and their classification according to the KIG system. SUBJECTS AND METHODS: Calibrated examiners assessed in the clinical evaluation and on plaster models orthodontic malocclusions in 180 adults (aged 20-49, 64 male, 116 female) from the population-based Study of Health in Pomerania (SHIP). Clinical examination was carried out by an experienced orthodontist, and the plaster models were also analysed by an examiner experienced in orthodontics. To compare inter- and intra-individual model examiners, we had two examiners with differing orthodontic experience carry out additional analyses of 60 of the 180 models (29 male, 31 female). RESULTS: The examiner differences yielded various KIG classifications and hence different assessments (i. e., whether KIG case-costs should be borne by health insurance). The comparison "clinical examination versus model analysis" revealed differences regarding 16.7% of the study participants in the assessment of whether the expense would be borne by the statutory health insurance fund. At 5.0-8.3%, the number of participants whose assessments had differed was much smaller in the inter-individual comparison of model-examiners and was smallest (at 3.3-6.7%) when comparison was made between intra-individual assessments (by a sole examiner). With regard to overall malocclusion assessment, the greatest examiner differences were again revealed when comparing the clinical examination with the model analysis (median kappa 0.57). The model-examiner comparison revealed larger differences among examiners with less orthodontic experience (median kappa 0.61 and 0.62) than the comparison between examiners with orthodontic experience (median kappa 0.70). CONCLUSIONS: There can occasionally be considerable examiner differences in the classification of participants according to orthodontic indication groups and hence varying assessments of whether such persons are KIG cases or not. Various means of data collection (clinical evaluation-plaster models) in the assessment of malocclusions by multiple examiners and by those with little orthodontic experience may negatively influence agreement among examiners.

Female↗
PubMed2006

The face-physiognomic expressiveness and human identity.

The facial structure develops through the harmonious interaction of bones, mandibular and cervical joints, masticatory, facial and cervical muscles, connective and fatty tissue as well as tracts of conduction. The face represents the personal identity. Ten basic types of faces exist, although they are difficult to classify. No face is symmetrical (biological variance). The expressions are generated by muscles and tension of the elastic facial skin and enable the face to be an organ of expression. The cranial position supports and influences the expression. Certain diseases change the expression in such typical ways that diagnosis and prognosis of some diseases may be concluded from it.

Face↗
PubMed2006

Intrauterine growth restriction induces increased capillary density and accelerated type I fiber maturation in newborn pig skeletal muscles.

AIMS: Humans with low birth weight exhibit evidences of vascular dysfunction. Recent findings indicate a microvascular rarefaction in skeletal muscles soon after postnatal development in rats suffered by intrauterine protein restriction. METHODS: To examine the effects of intrauterine growth restriction on capillary density, muscle fiber distribution and accompanying muscular and systemic circulation immediately after birth, studies were conducted on 1-day-old anesthetized normal weight (n = 7) and intrauterine growth restricted (n = 6) piglets. Cardiac output and hind limb muscle blood flow were measured by colored microspheres. Counting of type I fibers and skeletal capillary numbers was done by immunohistochemical staining. RESULTS: Increased proportion of type I fibers and capillary density was found in the flexor digitalis superficialis and gastrocnemius medialis (P < 0.05) in newborn IUGR piglets. Furthermore, a marked correlation was shown between capillary density and type I fiber fraction for all flexor muscles studied (P < 0.05). Moreover, cardiac output and muscular blood flow were markedly increased in IUGR piglets (P < 0.05). Correspondingly, total peripheral resistance, as well as vascular resistance, of hind limb flexors appeared significantly decreased (P < 0.05). CONCLUSIONS: Compromised intrauterine environmental conditions leading to fetal growth restriction provokes coordinated structural and functional adaptation of skeletal muscles.

Animals↗
PubMed2006

Partial- or full-mouth examination assessing the dental and prosthetic status among elderly individuals.

The aim of this study was to determine whether half-mouth examinations accurately reflect the dental and prosthetic status of the entire mouth. Samples of 1,830 adults aged 55- 79 years were examined. The rate of agreement between half- and full-mouth examinations was estimated using weighted and unweighted Kappa values comparing findings of each tooth bilaterally. A power analysis was performed to estimate the number of subjects representing complete dental recordings within a certain power. Subjects showed unweighted Kappa values from 0.34-0.96. Weighted Kappa values ranged from 0. 74-0.99. A power analysis for unweighted Kappa scores computed that.findings from 122-335 individuals were necessary to equal the results obtained using complete dental recordings.

Aged↗
PubMed2005

Myosin heavy chain protein and gene expression in the masseter muscle of adult patients with distal or mesial malocclusion.

The aim of this study was to determine the amount of myosin heavy chain (MyHC) proteins and MyHC mRNA in muscles of patients with different positions of the mandible. Ten adult patients for orthognathic surgery were divided into two groups: distal and mesial malocclusion. The mRNA expression of two MyHC isoforms of the anterior and posterior part of the right and left side of the human masseter muscle was analysed with a competitive RT-PCR assay. An exogenous template that includes oligonucleotide sequences specific for sarcomeric MyHC isoforms (1 and 2x) was constructed and utilized as competitor. Different isoforms of the MyHC protein were identified by Western blot analysis. In the total mRNA pool of the masseter muscle, the MyHC 1 mRNA level was 25.5 +/- 7.6% and the MyHC 2x mRNA was 2.5 +/- 1.2%. The anterior part of the masseter muscle from patients with distal occlusion contained more type 1 and 2x MyHC mRNA, as compared to patients with mesial occlusion (P < 0.05). No difference in the protein distribution was observed. The differences in mRNA expression may be caused by the enforced stress of the masticatory muscle in distal occlusion because of the disadvantageous pivot.

Adult↗
PubMed2004

Rapid maxillary expansion with palatal anchorage of the hyrax expansion screw--pilot study with case presentation.

BACKGROUND: Rapid maxillary expansion (RME) with the appliance fixed at the crowns of the first premolars and molars leads not only to transversal expansion but also to tipping of the anchorage teeth and a risk of increased tooth mobility as well as of root and bone resorptions. These disadvantages were to be avoided by fixing the transversal screw directly to the hard palate. MATERIAL AND METHOD: Following preliminary experimental work to determine the extent to which the hard palate could be loaded with orthodontic implants, two female patients were treated for extreme transverse maxillary deficiency using a Hyrax expansion screw fixed on one side with an implant with the following dimensions: length 4.0 mm, diameter 3.5 mm, abutment diameter 5.00 mm (EO implant, Straumann, Freiburg i. Br., Germany), and on the other side with a bone screw between the roots of the second premolars and the first molars. Presurgical osteotomy according to Glassmann was followed immediately by loading, i. e. by expansion through activation of the screw several times per day. Additional anterior guidance of the right and left maxilla was provided by crossed segmented archwires and a tension coil spring for space opening in the incisor region. After adequate expansion by 8.0 mm and correction of the position of the buccal teeth, the Hyrax expansion screw and the osteosynthesis screw were removed. The implant served as orthodontic anchorage for a molar-to-molar transpalatal bar aimed at preventing relapse. RESULTS AND CONCLUSIONS: The tooth axis inclination measured on cut sections of the plaster casts made at the beginning and end of treatment was largely without transversal discrepancies. Direct fixing of the transversal screw in the palatal arch prevents buccal tipping of the posterior teeth, especially in patients with a small apical base. Compared with other direct procedures involving osteosynthesis plates, this technique offers adequate guiding stability and is minimally invasive.

Adult↗
PubMed2004

Muscle influence on postnatal craniofacial development and diagnostics.

The postnatal craniofacial development is determined by exogenous and endogenous factors that may result in morphological and functional muscle changes and influence the dentoskeletal region in terms of a physiologic or dysgnathic development. Using functional appliances, efforts are made to treat skeletal malocclusions through targeted exercise and to prevent an undesirable development of the dentition and the craniofacial structures. However, the success of the treatment and the stability of the outcome are not always adequate. To illustrate the treatment processes, clinically relevant measures for diagnosing muscle function and morphology have been developed in recent years. Electromyographic investigations and bite-force measurements show an excessively high variability and the histologic examinations applied to date are restricted in their suitability for analysis of the human masticatory muscles. Animal experimental studies have meanwhile succeeded in simulating functional jaw orthopedics and in demonstrating muscle remodeling processes at the genetic level. Despite some invasiveness, the time and the small quantity of muscle tissue involved permit molecular biological measuring in the orofacial system.

Animals↗
PubMedDate not supplied

Do bivariate and multivariate cephalometric analyses lead to different results concerning the skeletal cause of postnormal occlusion?

In most cephalometric studies on the craniofacial pattern of untreated Class-ll-malocclusion subjects mean values were bivariately compared with the mean values of subjects with normal occlusion or Class I malocclusion, or with standard values. A multivariate approach, which does not merely compare two variables at a time but which analyses several skeletal variables at once, is lacking. The objective of the present study was in a first step to bivariately compare the sagittal and vertical skeletal pattern of Norwegian untreated postnormal occlusion patients with Class I children and in a second step to compare the results of the bivariate analysis with the results of a multivariate analysis on the same subjects. Previous studies showed in the majority of cases a retropositioned mandible rotated to the posterior with an indefinite positioned maxilla. A bivariate comparison of 138 Norwegian subjects with Class II/1 malocclusion and 80 children with Class I occlusion from the same region (mean age of both 9 years) confirmed the posterior position of the mandibles. However, a multivariate analysis (harmony-box-concept) of the same subjects yielded a different result. Simultaneously taking the sagittal and vertical position of both jaws and the cranial base flexure angle (NSBA) into consideration, the comparison of the two groups demonstrated a forward positioned maxilla as the skeletal cause of the Class II/1 malocclusion. The mandibles were on average normal positioned instead of retropositioned relative to other skeletal structures of the viscerocranium. Apparently standard bivariate tests and multivariate analysis methods may lead to different results which also have to be considered by the functionally treating orthodontist.

Cephalometry↗