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Biomedical subjects

Y Ben-Bassat

Publications and source records attributed to Y Ben-Bassat.

At least 19 recordsLinked to original sources

Periodontal status following surgical-orthodontic alignment of impacted central incisors with an open-eruption technique.

Several factors may affect the outcome of the orthodontic/surgical modality for the resolution of impacted central incisors, but particularly the manner in which the impacted tooth is exposed. The present study aimed to evaluate the post-retention clinical appearance and periodontal status of impacted maxillary central incisors which were exposed and aligned with an open-eruption surgical-orthodontic technique. Twelve subjects (four males, eight females), aged 22 years (range 15-38 years), previously treated for a unilateral impacted central incisor (ICI), were examined 10 years (range 3-25 years) post-retention. A split-mouth method was used for the comparison with the unaffected side. One treated central incisor exfoliated 10 years post-retention, thus the results were based on the remaining 11 patients. Statistically significant differences were found between the affected and control incisors in most of the periodontal parameters measured, although some were small and of minimal clinical importance. The increase in the mesio-labial pocket depth was associated with a highly significant 10 per cent reduction in bone level at this site (P = 0.007). A highly statistically significant increase in crown length (P < 0.001) and a reduction in the width of the attached gingiva (P = 0.005) were seen in these previously impacted teeth. An abnormal gingival contour was present in eight treated incisors and positional relapse in five cases. It is concluded that the convenience of the open-eruption technique must be weighed against the long-term negative aesthetic and periodontal effects on the treated tooth, although the findings of this study should be viewed with caution due to the limited sample size.

Adolescent↗

[A retrospective study of orthodontic treatment of children with clefts].

OBJECTIVES: To evaluate the population of cleft patients treated in a Department of Orthodontics and the types of treatment modalities provided. METHODS: Demographic, cleft related and treatment related data existing in the patients' files were supplemented by questionnaires. Comparisons were conducted among 3 cleft groups: cleft lip (CL), cleft lip and palate (CLP) and cleft palate (CP). RESULTS: The response rate was 36% (n = 152). The distribution of the patients in the 3 cleft groups, the sidedness, the male predominance and association with additional anomalies were similar to the reports in the literature. Most of the patients were the 3rd born (or more) and were of normal birth weight. Consanguity in the cleft families was at least 2.5 times more prevalent than that of the Israeli population and 30% reported on additional cleft in the family. Low birth weight and additional anomalies were found mainly in the CP group. Orthodontic involvement spanned 3 developmental periods: immediate postnatal presurgical treatment, phase I between the ages 6-8 years and full orthodontic treatment at a later age. Up to the age of 5 years only one lip operation was performed for 60% of the lip-affected children and one palate operation for 65% of the palate affected patients. CONCLUSIONS: 1. The distribution of the various cleft-related parameters in this retrospective study was similar to the findings in the literature. 2. The high prevalence of additional anomalies found emphasizes the need for a thorough examination of the cleft babies. 3. Orthodontic treatment was rendered in one and two phase protocols in addition to immediate postnatal pre-surgical intervention.

Age Factors↗

Can maxillary incisor trauma be predicted from cephalometric measurements?

Dental injury is a traumatic event related to many factors, including dentofacial morphology. In a previous study in which we used a logistic regression model, 5 cephalometric variables were defined as being the best predictors of traumatic injury. The purposes of this study were to test the predictive value of the logistic regression analysis results for the occurrence of dental injury in a new patient sample and to compare these results with the outcome based on a visual evaluation of cephalograms. The study population consisted of 2 groups of orthodontic patients: patients with injured incisors (n = 64) and patients with non-injured incisors (n = 90). Cephalometric skeletal, dental, and soft tissue measurements were made. In addition, 6 professional judges visually evaluated all cephalograms. Classification tables were constructed for the results of the logistic regression model and for the assignment of patients according to the visual evaluation of the cephalograms. The percentage of correctly classified patients at the.7 probability level was 62%. Surprisingly, the professional panel rendered an equal predictive value. The relatively inferior performance of both the mathematical model and the "eyeballing" may demonstrate that dentofacial morphology is only partially responsible for susceptibility to trauma.

Cephalometry↗

The labiogingival notch: an anatomical variation of clinical importance.

BACKGROUND: The labiogingival notch is a developmental phenomenon affecting the maxillary central incisors. Clinically, it can be easily misdiagnosed and improperly treated. Thus, it is important for dentists to recognize this condition. CASE DESCRIPTIONS: The authors describe two cases of misdiagnosed labiogingival notch on a maxillary central incisor. In one case, the notch was misinterpreted as a carious lesion and placement of a restoration was advised. In the second case, external resorption was suspected and forced eruption of the incisor was requested. In both cases, no treatment was needed. CLINICAL IMPLICATIONS: Misdiagnosis of this developmental phenomenon may lead to unnecessary invasive interventions. Because of this, clinicians need to be aware of this clinical variant.

Adolescent↗

Profile of an orthodontic patient at risk of dental trauma.

Increased overjet and inadequate lip coverage of the maxillary incisors are considered significant risk factors in many clinical studies. The purpose of the present study was to examine this issue of dental injury by actual cephalometric measurements in orthodontic patients. Pretreatment cephalograms (taken with lips in repose) of consecutive patients were used. The patients were allotted to two groups Group T (trauma): 56 patients who had injured their maxillary incisors prior to their orthodontic treatment, mean age at the start of treatment 11.9 years (SD = 1.5); and Group C (control): 98 patients with intact maxillary incisors, mean age at the start of treatment 11.6 years (SD = 1.3). Twelve cephalometric landmarks on the soft and hard tissue profile were identified and digitized and the relevant dental, skeletal and soft tissue measurements recorded. The variables in Groups T and C were compared and their predictive values for possible occurrence of trauma were tested by logistic regression analysis. No statistically significant differences between boys and girls were found. Overjet or maxillary incisor exposure or interlabial gap, each as a single variable, could differentiate between the two groups. Logistic regression analysis indicated that only a small percentage (28.7%) of the dependent variable variation (trauma vs control) can be explained by interlabial gap, gender, upper incisor long axis to facial plane (degree), upper incisor long axis to interlabial gap and overjet.

Cephalometry↗

Cortical bone remodeling/tooth movement ratio during maxillary incisor retraction with tip versus torque movements.

The validity of the postulate "bone traces tooth movement" was examined on 40 Angle Cl II cases. It was hypothesized that a 1:1 cortical bone remodeling/tooth movement ratio is preserved during maxillary incisor retraction. The sample was divided into retraction with tip (13 patients), retraction with torque (18 patients), and control (9 patients) groups. Two time point cephalograms were analyzed with two superimposition techniques, SN at S and a newly developed static tooth analysis, with the maxillary left central incisor serving as a reference object. In both retraction with tip and retraction with torque groups, the postulate bone traces tooth movement was not preserved and a bone remodeling/tooth movement ratio of 1:2 and 1:2.35 was obtained, respectively. In retraction with tip movement, the apical one third of the root tipped labially reducing the superior area of labial maxillaris by 19%. However, due to the compensating effect of the retraction movement, no apex approximation to the labial cortical plate occurred (eliminating the hazard of root resorption, dehiscence, or fenestration). In retraction with torque movement, the increase in both superior (28%) and inferior (65%) labial maxillaris areas was indicative for the hazard of root approximation to the palatal cortical bone. It is recommended to use the 1:2 bone remodeling/tooth movement ratio as a guideline to determine the biocompatible range of orthodontic tooth movements. Furthermore, a judicious interplay between the two modes of retraction can prevent major biologic impairments associated with the ratio and can extend the orthodontic range of treatment.

Bone Remodeling↗

Does a secular trend exist in the distribution of occlusal patterns?

The existence of a secular trend in the distribution of occlusal patterns was studied in two generations of children. Study models and demographic data of a sample of 265 children from the previous generation (group A) and recordings of clinical examinations of 988 children from the present generation (group B) served as the data base for this study. Children in whom caries affected the occlusion and those in the deciduous dentition stage were excluded. Thus, occlusal analysis was performed for 102 children in group A and 703 in group B. A dramatic decrease was found in the prevalence of caries affecting the occlusion. No difference existed between the two groups with respect to molar and canine anteroposterior relationships. However, there was a decrease in the prevalence of normal occlusion accompanied by an increase of Class I malocclusion.

Adolescent↗

Lower molar and incisor displacement associated with mandibular remodeling.

The purpose of this study was to quantify the amount of alveolar modeling at the apices of the mandibular incisor and first molar specifically associated with appositional and resorptive changes on the lower border of the mandible during growth and treatment. Cephalometric data from superimpositions on anterior cranial base, mandibular implants of the Björk type, and anatomical "best fit" of mandibular border structures were integrated using a recently developed strategy, which is described. Data were available at annual intervals between 8.5 and 15.5 years for a previously described sample of approximately 30 children with implants. The average magnitudes of the changes at the root apices of the mandibular first molar and central incisor associated with modeling/remodeling of the mandibular border and symphysis were unexpectedly small. At the molar apex, mean values approximated zero in both anteroposterior and vertical directions. At the incisor apex, mean values approximated zero in the anteroposterior direction and averaged less than 0.15 mm/year in the vertical direction. Standard deviations were roughly equal for the molar and the incisor in both the anteroposterior and vertical directions. Dental displacement associated with surface modeling plays a smaller role in final tooth position in the mandible than in the maxilla. It may also be reasonably inferred that anatomical best-fit superimpositions made in the absence of implants give a more complete picture of hard tissue turnover in the mandible than they do in the maxilla.

Adolescent↗

Occlusal traits in a group of school children in an isolated society in Jerusalem.

The prevalence of occlusal features in 939 children, aged 6-13 years, belonging to an ultra-orthodox community of Jewish Ashkenazi descent living in Jerusalem was studied clinically. Sexual dimorphism was found for overjet, overbite, and habit practising. About one-quarter of the sample exhibited some degree of occlusal mutilation due to caries, thus creating a 'caries-affected' subgroup, the rest forming the 'caries-free' subgroup. In the latter set, normocclusion was scarce (7.4 per cent), Class I being the most frequent malocclusion (49.1 per cent). Caries had a significant effect on the symmetry of bilateral occlusal relationships, lower dental midline deviation, and on crowding/spacing conditions in the mixed dentition stage (except for the maxilla in late mixed dentition). The low prevalence of normocclusion can be attributed to genetic background, environmental influences and the definition attached to normal occlusion.

Adolescent↗

Skeletal and functional effects of treatment for unilateral posterior crossbite.

Unilateral posterior crossbite (UPXB) is a common malocclusion, frequently presenting a lower midline deviation, accompanied by Class II subdivision relationships in final closure and a very high prevalence of the reverse sequencing (RS) pattern of jaw movement. These features often persist even after the elimination of the crossbite. The purpose of the present study was to examine in detail the morphologic, skeletal, and functional effects of the treatment for this malocclusion category. The experimental group consisted of 24 children in the mixed dentition stage with UPXB who were treated with removable expansion plates and a control group of 10 age-matched children with normal occlusion. Longitudinal follow-up revealed a stable dental maxillary arch expansion of at least 1.5 mm but a complete elimination of crossbite in only 50% of the cases. The frequent persistence of Class II subdivision relations and lower midline deviation that were not due to functional mandibular shift was striking. The pretreatment posteroanterior (P-A) cephalograms indicated reduced facial and maxillary widths. After treatment, the achieved maxillary width increase was greater than expected with normal growth. Longitudinal assessment of the mandibular movement response revealed by the electrognathograph showed a high prevalence of RS, which was reduced after treatment. In conclusion, (1) a higher than expected prevalence of skeletal transverse aberrations at the maxillary and zygomatic levels were found in the UPXB group; (2) the removable expansion appliance induces transverse growth of the maxilla; and (3) an inherent pattern of jaw movement is characteristic to the UPXB and does not change significantly with orthodontic treatment.

Case-Control Studies↗

Partitioning the components of maxillary tooth displacement by the comparison of data from three cephalometric superimpositions.

Using roentgenographic cephalograms from a sample of subjects with metallic implants, appropriately superimposed tracings were used to distinguish developmental and treatment-associated displacements of the maxillary central incisor and first molar associated "local" changes within the periodontium from "secondary" changes which reflect sutural and appositional growth at more distant osseous loci. Tracings were superimposed on anterior cranial base (ACB), on the maxillary implants only (IMP_MAX), and according to the best fit of maxillary anatomic structures without reference to the implants (A_MAX). Using the IMP_MAX superimposition, one could measure total local displacement at any landmark taking into consideration the effects of all appositional and resorptive changes on the superior and anterior surfaces of the palate, whereas using the A_MAX superimposition one could measure local displacement without consideration of surface appositional and resorptive changes. If the second of these measurements were subtracted from the first, the result would be a direct measurement of the effects of surface appositional and resorptive changes as they are expressed at that particular landmark. This strategy has enabled us to quantify and report the amount of accommodation which occurs at the location of each dental landmark in association with the resorptive and appositional changes which occur through time on the superior and anterior surfaces of the hard palate.

Adolescent↗

Functional and morphological-occlusal aspects in children treated for unilateral posterior cross-bite.

Morphological and functional aspects were investigated in children with unilateral posterior cross-bite (UPXB) before and after treatment. Sixty-five patients with Class I malocclusion with UPXB in the mixed dentition stage (mean age 8.8 +/- 1.6 years) served as the experimental group and 10 children of comparable age, with normocclusion or very mild Class I malocclusion (without UPXB) served as controls. The morphological aspects were examined on a longitudinal basis while the functional recordings, by means of a sirognathograph, were performed in a cross-sectional fashion. Complete elimination of cross-bite was maintained in 61 per cent and was accompanied by a dramatic reduction in the prevalence of functional mandibular displacement. However, the prevalence of mandibular midline deviation related to the maxillary midline as recorded in the intercuspal position was not affected. In addition, the high prevalence of Class II subdivision relationships which accompanied the UPXB in the intercuspal position was resolved in 50 per cent of the cases only. The sirognathographic recordings of the masticatory pattern showed a very high prevalence of a 'reverse sequencing' type pattern before treatment which was significantly lower following the elimination of UPXB, but still notably higher when compared with the controls. Reasons for these results are suggested and possible inter-relationships between the morphological and functional aspects are discussed.

Child↗

Mandibular remodeling measured on cephalograms. 1. Osseous changes relative to superimposition on metallic implants.

We report the results of a study aimed at quantifying remodeling of mandibular surfaces in a sample of growing children who represent those usually treated by orthodontists in the mixed and early adult dentition. The sample, 31 patients with metallic implants of the Björk-type, was monitored at annual intervals between 8 1/2 and 15 1/2 years of age. (Maxillary remodeling changes for the sample have been reported earlier.) The present article reports findings concerning changes at condyle, gonion, menton, pogonion, and point B as identified on lateral cephalograms. Data are reported in the Frankfort plane frame of reference with the cephalograms from different time points superimposed on the metallic implants. Mean displacement at condyle was larger than that at any other landmark and was similar in magnitude and direction to the observations of Björk when the difference in orientation of the vertical axis in the two studies is taken into account. The mean displacement of gonion was in an upward and backward direction at an angle of approximately 45 degrees to the Frankfort plane. Mean displacements at menton and pogonion were in a downward and backward direction but were very small. Mean displacement at point B was somewhat greater than that of menton and gonion, oriented in an upward and backward direction. Individual variation for most of the parameters measured was sufficiently large to warrant the inference that caution should be used when mean values are applied to the analysis of individual cases.

Adolescent↗

Mandibular remodeling measured on cephalograms: 2. A comparison of information from implant and anatomic best-fit superimpositions.

This study quantifies the differences in the perceived pattern of mandibular remodeling when two different methods are used to superimpose roentgenographic images of the mandible. Lateral cephalograms for a group of subjects with metallic implants of the Björk type were superimposed twice; first on the metallic implants and then independently on mandibular anatomic structures according to a common "best fit" rule. In this article, we compare the between-superimposition differences in the perceived displacements of condyle, gonion, menton, pogonion, and Point B. Mean differences between the two superimpositional techniques were smaller than had been anticipated. For the 7-year time interval between 8.5 and 15.5 years, the largest mean differences between methods were 2.70 mm in the horizontal direction at condyle, 1.90 mm in the vertical direction at condyle, and 1.52 mm in the vertical direction at gonion. None of the other between-superimposition differences had a mean value in excess of 1 mm. The individual case variability between the two methods was, however, quite considerable, a finding that we believe has bearing on the confidence that can be placed in individual case analyses in clinical orthodontics. A preliminary attempt has been made to represent and discuss the magnitude of this problem.

Adolescent↗

Cephalometric pattern of Jewish East European adolescents with clinically acceptable occlusion.

Knowledge of the normal dentofacial patterns of various ethnic groups is important for clinical and research purposes. The objective of this study was to describe the dentofacial pattern of one Jewish ethnic group and to compare it with accepted standards for other white populations. Lateral cephalometric radiographs of 18 children of Jewish East European origin with clinically acceptable permanent occlusion, ages 11 to 13 years, were used. A computer-aided cephalometric analysis was performed, and the mean values and standard deviations for the various cephalometric variables were obtained. When compared with some classical standards, it was found that this ethnic group tended toward a mild skeletal Class II, a convex profile, and a more vertical direction of growth. These features appeared in persons selected on the basis of a clinically acceptable occlusion, suggesting the existence of dental compensations. Understanding these natural accommodations of the dentition to skeletal variations can be clinically useful when establishing treatment goals.

Adolescent↗

The influence of orthodontic treatment on previously traumatized permanent incisors.

The reaction of previously traumatized teeth to orthodontic force application was investigated. Four groups of children were examined: group T comprised 56 children who encountered trauma to their maxillary incisors; group O comprised 29 orthodontic patients with intact incisors; group TO comprised 28 previously traumatized orthodontic patients; and group C served as the control group (n = 26). Orthodontic treatment was restricted to tipping movement executed only by means of removable appliances. Groups T, O, and TO were followed up longitudinally by means of clinical and radiographic examinations. In most of the cases the reported trauma occurred to teeth with completed roots and affected the crown only. Group TO presented the highest, though relatively moderate, prevalence of root resorption (27.8 per cent) and was followed by groups O and T (6.7 and 7.8 per cent, respectively) while in the control group no resorption was observed. Electrical pulp testing revealed the highest prevalence of loss of tooth vitality in group TO (7.3 per cent) in which the highest prevalence of pulp obliteration was also found. It can be concluded that the combination of trauma with orthodontic tipping renders the teeth more susceptible to complications, especially to root resorption and loss of vitality.

Adolescent↗

Appearance of a labial notch in maxillary incisors: a population survey.

A labiogingival notch appearing on the enamel of maxillary central incisors seems to be a potential factor for compromised gingival and dental health. The objective of the survey was to describe the phenomenon and its prevalence in a random Israeli population. One thousand eight hundred eighty children with fully erupted permanent incisors were clinically examined. The appearance of the labiogingival notch on the enamel surface of the maxillary central incisors was determined. Two depth categories of the phenomenon were distinguished by probing. The possible differences in the prevalence of the labial notch appearance, between the sexes as well as between the right and left sides, were statistically evaluated. The prevalence between the right and left sides, were statistically evaluated. The prevalence of the labial notch on at least one incisor in the population examined was 6.5% (5.1% unilaterally and 1.4% bilaterally). No significant difference between the sexes regarding the appearance of this phenomenon was found. The shallow notch was similarly distributed between the right and left sides in both sexes. However, the deeper malformations appeared significantly more on the left side in boys (P less than 0.05) and in girls (P less than 0.01). The gingivae tended to follow the enamel contour; however, only in few cases was gingival inflammation or incipient caries diagnosed. It was concluded that the labio-gingival notch is not a rare phenomenon, and it should be given special attention to prevent possible damage to the dental and gingival tissues.

Anthropology, Physical↗