PubMed · 4509604
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G Gauthier. [Occlusion concepts].. https://pubmed.ncbi.nlm.nih.gov/4509604/
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The preadjusted orthodontic appliance has improved the efficiency and effectiveness of the orthodontist in achieving good final results for patients in general. However, the orthodontist is limited in achieving excellent final results because of individual patient variation from the prescription of the preadjusted appliance as well as the orthodontist's ability to precisely place the appliance. This article presents a comprehensive system of evaluation of the individual patient to be used during the finishing stage of treatment and a written system of notation that can guide the orthodontist in producing an excellent finished result for each patient. In this system the orthodontist considers multiple aspects of esthetics, occlusion and function, periodontal health and root alignment, and stability. Every feature of these characteristics is examined and desired changes are noted on the "detailing form" resulting in a written plan that guides the orthodontist to achieve excellence in finishing. This written form can also act as a final checklist of obtainment of the goals of orthodontic treatment. This system of finishing can improve the efficiency of the individual orthodontist and assist in communication in multidoctor practices.
The PAR Index was developed to measure treatment outcome in orthodontics. Validity was improved by weighting the scores of some components to reflect their relative importance. However, the index still has limitations, principally due to the high weight assigned to overjet. Difficulties also arise from the application of one weighting system to all malocclusions, since occlusal features vary in importance in different classes of malocclusion. The present study examined PAR Index validity using orthodontic consultant assessments as the 'Gold standard' and clinical ranking of occlusal features and statistical modelling to derive a new weighting system, separate for each malocclusion class. Discriminant and regression analyses were used to derive new criteria for measuring treatment outcome. As a result a new and more sensitive method of assessment is suggested which utilizes a combination of point and percentage reductions in PAR scores. This was found to have better correlations with the 'Gold standard' than the PAR nomogram.
The purpose of this study was to elucidate the influence on masticatory function when the mandibular unilateral distal extension removable partial denture changed the interocclusal distance. The experiments, crushability, the sense of mastication, and the masticatory strokes until swallowing, were conducted, on four subjects, using the denture with the apparatus that enabled to change the interocclusal distance. The results were as follows: The particle size distribution showed that the ratio of small particle (diameter 2.5-4.5 mm) decreased, while that of large particle (more than 5.0 mm) increased, on three of four subjects, and the value of crushability diminished. A reduction of the value of crushability when the interocclusal distance was extended more than 800 microns was found. As for the other subject, no change was recognized on the particle size distribution under experimental condition, and the value of crushability showed no significant change.