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PubMedDate not supplied

[Psychological aspects of orthodontic treatment].

Psychical factors are often contributory determinants of success or failure of treatment. The orthodontist should therefore dispose of basic psychological knowledge to give his patients help in an entire sense. The psychosocial impact of malocclosion should represent a major factor in the decision to obtain treatment, because what is most important in terms of psychosocial response to malocclusion is not the absolute degree of disfigurement that results from malocclusion, but rather how the individual perceives and evaluates the esthetic effects of these dentofacial problems and their orthodontic correction.

Esthetics, Dental↗
PubMed2001

Morphological parameters as predictors of successful correction of Class III malocclusion.

The aim of the study was to assess pre-treatment cephalometric parameters and measurements of the size of the apical bases as predictors of successful orthodontic correction of Class III malocclusions. Pre- and post-treatment lateral cephalograms and study models of 80 completed Class III subjects were examined to obtain 23 cephalometric parameters taken mainly from the analyses of McNamara and Schwarz, and to measure the size of the apical bases. Success of occlusal correction was evaluated as the percentage change of peer assessment rating score during treatment, which was used as the dependent variable in multivariate statistical analyses testing the predictive value of the parameters assessed. No improvement in the Class III skeletal pattern occurred during treatment and the treatment effects were confined to dentoalveolar changes. With the exception of the percentage midfacial length/mandibular length ratio, the net sum of maxillary and mandibular length differences, the mandibular ramus height/mandibular body length ratio and the gonion angle, most cephalometric parameters of pre-treatment craniofacial morphology assessed were poor predictors of successful correction of Class III malocclusions. Assessment of the size relationship of the maxillary and mandibular apical bases was the strongest predictor of occlusal correction achieved and may serve as a valuable diagnostic addition in the prediction of successful treatment outcome.

Age Factors↗
PubMed2006

The role of orthodontics in implant dentistry.

Orthodontic treatment of partially edentulous patients is difficult, especially if a significant number of teeth are missing. With loss of teeth, adjacent or opposing teeth usually tip, drift or over-erupt leaving spaces that are not optimal for replacement of missing teeth. Orthodontic correction of these spatial relationships will aid prosthetic replacement of the missing teeth, function, hygiene and aesthetics. Orthodontists rely on teeth to provide the anchorage to correct malocclusions. With patients with an intact dentition dental anchorage is usually adequate to facilitate tooth movement. In some partially edentulous patients however, insufficient anchorage may present to correct the malocclusion. In these patients implants can provide additional anchorage. At times, osseointegrated implants can also be used to support restorations after completion of orthodontic therapy if treatment planning is precise. The use of implants for orthodontic anchorage requires an interdisciplinary approach and precise planning to achieve optimal results.

Alveolar Bone Loss↗
PubMed1976

Preorthodontic guidance and the corrective mixed-dentition treatment concept.

A concept of corrective orthodontic treatment starting at an earlier age than usual has been discussed and illustrated. Realignment of terminology has been prosposed to give a clearer picture of the circumstance of malocclusion and its need for correction at an early age. A group of 300 patients treated in three categories were compared as to length of treatment time. Three groups of twenty-five patients treated correctively after preorthodontic guidance in the mixed dentition and only in permanent dentition were analyzed cephalometrically. The following conclusions can be reached: 1. Corective mixed-detition orthodontic treatment is a valid, safe, and reliable peocedure. 2. It encompasses both preorthodontic guidance and full-banded orthodontic treatment. 3. Current terminology is confusing and controversial...

Attitude of Health Personnel↗
PubMed1988

Appliance selection. Treatment objectives and esthetic concerns.

The adaptability of modern orthodontic appliances to meet the esthetic needs of the adult patient while satisfying the treatment goals agreed upon has been shown. Some of the treatments cited could be accomplished by the general practitioner, while other modalities should be handled by the orthodontist. The outstanding advances in orthognathic surgical technique provide the patient with additional options for orthodontic corrections of malocclusions while reducing the time needed to wear braces. Proper planning and interaction among the dental disciplines can greatly enhance a patient's final outcome. It behooves all clinicians to look at all the options available in treating the adult so these patients can benefit most from our services.

Adult↗
PubMed2001

Radical correction of secondary nasal deformity in unilateral cleft lip patients presenting late.

It is universally acknowledged that correction of a cleft lip nasal deformity continues to be a difficult problem. In developing countries, it is common for patients with cleft lip deformities to present in their early or late teens for correction of severe secondary lip and nasal deformities retained after the initial repairs were carried out in infancy or early childhood. Such patients have never had the benefit of primary nasal correction, orthodontic management, or alveolar bone grafting at an appropriate age. Along with a severe nasal deformity, they present with alveolar arch malalignments and anterior fistulae. In the study presented here, a strategy involving a complete single-stage correction of the nasal and secondary lip deformity was used. In this study, 26 patients (nine male and 17 female) ranging in age from 13 to 24 years presented for the first time between June of 1996 and December of 1999 with unilateral cleft lip nasal deformity. Eight patients had an anterior fistula (diameter, 2 to 4 mm) and 12 patients had a secondary lip deformity. An external rhinoplasty approach was used for all patients. The corrective procedures carried out in a single stage in these patients included lip revision; columellar lengthening; repair of anterior fistula; augmentation along the pyriform margin, nasal floor, and alveolus by bone grafts; submucous resection of the nasal septum; repositioning of lower lateral cartilages; fixation of the alar cartilage complex to the septum and the upper lateral cartilages; augmentation of nasal dorsum by bone graft; and alar base wedge resections. Medial and lateral nasal osteotomies were performed only if absolutely indicated. The median follow-up period was 11 months, although it ranged from 5 to 25 months. Overall results have been extremely pleasing, satisfactory, and stable. In this age group (13 years of age or older), it is not fruitful to use a technique for nasal correction that corrects only one facet of the deformity, because no result of nasal correction can be satisfactory until septal deviations and maxillary deficiencies are addressed along with any alar repositioning. The results of complete remodeling of the nasal pyramid are also stable in these patients because the patients' growth was nearly complete, and all the deformities could be corrected at the same time, leaving no active deforming vector. These results would indicate that aesthetically good results are achievable even if no primary nasal correction or orthodontic management had been previously attempted.

Adolescent↗
PubMed2003

Predictive value of morphologic parameters for successful correction of Class II Division 2 malocclusion.

The aim of this study was to assess the predictive value of pretreatment cephalometric parameters and apical base size for successful correction of Angle Class II Division 2 malocclusion. Pretreatment lateral cephalograms and pretreatment and posttreatment study casts of 96 subjects with Class II Division 2 malocclusions were examined to obtain 23 cephalometric parameters and to measure the size of the apical bases. Success of occlusal correction was evaluated as the percentage of change of peer assessment rating scores during treatment; percentage of change was the dependent variable in multivariate statistical analyses used to test the predictive value of the assessed parameters. Cephalometric parameters of pretreatment craniofacial morphology were insignificant as predictors of successful orthodontic correction of the malocclusions. Maxillary apical base size was the strongest predictor of occlusal correction and might serve as a valuable diagnostic predictor of successful treatment outcome.

Cephalometry↗
PubMed1999

A longitudinal cephalometric study of postorthodontic craniofacial changes.

Although the orthodontist focuses great efforts on diagnosis and treatment of the patient, less attention is paid to posttreatment changes that occur because of relapse and continued growth, especially over the long term. This cephalometric study describes 36 patients who were recalled x = 5.5 years after treatment and again x = 14.4 years after treatment. Most linear dimensions increased significantly from the end of treatment to first recall (ca. 16 to 21 years), presumably as a result of continued adolescent growth, but few changes achieved significance thereafter (ca. 21 to 30 years). Arch relationships (eg, ANB, NAP, AOBO, Y-axis) continued to improve after treatment, probably as a result of late growth of the mandible producing a more orthognathic profile. There was little change from first to second recall in any of the variables. Results suggest that if relapse occurs, it is likely to be evident soon after treatment and diminish thereafter and that continued craniofacial growth generally augments the orthodontic correction.

Adolescent↗
PubMed2002

Orthodontic finishing after TMJ disk manipulation and recapture.

Orthodontic treatment has as its goal in most patients to achieve a cosmetic and functional result. There are functional goals for all orthodontic treatment and in some few cases the functional outweigh the cosmetic; an example would be a cleft-palate case. Orthodontic finishing to a specific condylar position is not routinely a goal of orthodontic care. The reason for this is that only patients who have pain, dysfunction and a negative change in quality of life from their temporomandibular apparatus need this tangential type of treatment. Research has shown that most patients suffering from a temporomandibular disorder (TMD) have displacement of the temporomandibular disk(s). Research has shown that when the mandibular condyle is repositioned to the Gelb 4/7 position that the temporomandibular joint disk is recaptured to a normal position between 85% and 96% of the time. The Gelb 4/7 position has been equated to the physiologic position of the mandibular condyle in the glenoid fossa. TMJ condyle repositioning to the physiologic position has been correlated to disk recapture proven by magnetic resonance imaging (MRI). A case is shown in which a displacement without reduction is manipulated into reduction and maintained with orthodontic correction. TMJ disk displacement without reduction is usually preceded by TMJ disk displacement with reduction. Pumping of the upper joint compartment can assist in reducing the TMJ disk displacement without reduction. Magnetic resonance imaging before and after the manipulation and after orthodontic treatment are shown. A detailed method of orthodontic finishing that maintains a specific condylar position and TMJ disk recapture is shown.

Adolescent↗
PubMed1989

[Functional appliances. Possibility of correction of a class II malocclusion].

In this article the most common types of functional appliances are briefly presented. This overview might enhance the understanding of functional therapy by the general practitioner. Timing of treatment with functional appliances should be individualized by the occurrence of pubertal growth spurt. The overall clinical effect must be regarded as a combination of skeletal and dento-alveolar changes. Some clinical tips are demonstrated for appropriate application. Indications and contra-indications are generally examined. It definitely can be concluded that functional appliances constitute specific method of therapy among orthodontic corrective procedures for class II malocclusions.

Activator Appliances↗
PubMed2001

Skeletal and dento-alveolar stability after surgical-orthodontic treatment of anterior open bite: a retrospective study.

The aim of this investigation was to assess skeletal and dento-alveolar stability after surgical-orthodontic correction of skeletal anterior open bite treated by maxillary intrusion (group A) versus extrusion (group B). The cephalometric records of 49 adult anterior open bite patients (group A: n = 38, group B: n = 11), treated by the same maxillofacial surgeon, were examined at different timepoints, i.e. at the start of the orthodontic treatment (T1), before surgery (T2), immediately after surgery (T3), early post-operatively (+/- 20 weeks, T4) and one year post-operatively (T5). A bimaxillary operation was performed in 31 of the patients in group A and in six in group B. Rigid internal fixation was standard. If maxillary expansion was necessary, surgically assisted rapid palatal expansion (SRPE) was performed at least 9 months before the Le Fort I osteotomy. Forty-five patients received combined surgical and orthodontic treatment. The surgical open bite reduction (A, mean 3.9 mm; B, mean 7.7 mm) and the increase of overbite (A, mean 2.4 mm; B, mean 2.7 mm), remained stable one year post-operatively. SNA (T2-T3), showed a high tendency for relapse. The clockwise rotation of the palatal plane (1.7 degrees; T2-T3), relapsed completely within the first post-operative year. Anterior facial height reduction (A, mean -5.5 mm; B, mean -0.8 mm) occurred at the time of surgery. It can be concluded that open bite patients, treated by posterior Le Fort I impaction as well as with anterior extrusion, with or without an additional bilateral sagittal split osteotomy (BSSO), one year post-surgery, exhibit relatively good clinical dental and skeletal stability.

Adolescent↗
PubMedDate not supplied

[Orthodontic treatment and periodontal problems. 2].

The Authors intend to show the relationship existing between orthodontic treatment and periodontal disease. Particularly they evaluate the effects produced by the orthodontic correction of the position of the teeth and, moreover, they suggest a clinical approach in order to prevent and treat mucogingival disease.

Epithelial Attachment↗
PubMed1994

[The diagnosis and treatment of congenital facial asymmetries in childhood. A clinical study].

Following a brief discussion of etiology, pathogenesis, and diagnosis of congenital facial asymmetries, a new interdisciplinary treatment concept encompassing the disciplines of orthodontics, maxillo-facial surgery, and pedaudiology is set forth. This concept calls for the surgical reconstruction of the mandibular ramus and of the temporo-mandibular joint already in childhood in those cases in which functional jaw orthopedics has already begun at an early age. Thereafter the occlusal plane can be corrected orthodontically. Six patients were treated according to this concept. Two years nine months after surgery favorable results were observed in relation to occlusion and mandibular growth. Because, however, long term results are still outstanding, the results obtained until now and the treatment concept remain the subject of ongoing critical study.

Child↗
PubMed1988

Relationship between the development of skeletal mesio-occlusion and posterior tooth-to-denture base discrepancy--its significance in the orthodontic reconstruction of skeletal Class III malocclusion.

The purpose of this paper is to explain the relationship between the development of Skeletal Class III malocclusion and the posterior discrepancy. Four cases which had severe Skeletal Class III malocclusion and had experienced unsuccessful orthodontic correction are presented to evaluate the causative factors of Skeletal Class III malocclusion. The forward displacement of the mandible was associated with inferiorely positioned maxillary molars and/or superiorly positioned mandibular molars caused by the "squeezing out" effect of posterior discrepancy, which provides a less steep maxillary occlusal plane in the denture frame. Perhaps continuous forward displacement of the mandible induces vertical condylar elongation which establishes the characteristics of Skeletal Class III malocclusion. A new approach to the orthodontic treatment of skeletal Class III malocclusion was achieved by the control of the occlusal plane with four second molars extraction in order to eliminate the posterior discrepancy.

Adolescent↗
PubMed1991

Patient characteristics and treatment variables associated with apical root resorption during orthodontic treatment.

Multivariate analysis of patient characteristics and clinical variables was carried out with the maximum single maxillary incisor apical root resorption for each patient as the dependent variable. Root lengths were measured in standardized intraoral radiographs from 485 consecutively treated patients, 11.5 to 25 years of age. The correlation matrix revealed a complex pattern of positive and negative associations between the six pretreatment and seven treatment variables. Variables found to contribute significantly to apical root resorption were overjet, history of trauma to maxillary incisors before initiation of treatment, time of treatment with rectangular arch wires, time of treatment with Class II elastics, lip/tongue dysfunction, and/or history of finger-sucking habits persisting beyond the age of 7 years, and impacted maxillary canines to be corrected orthodontically. Clinical application of an open activator was significantly correlated with overjet but negatively correlated with apical root resorption, with the use of rectangular arch wires and/or Class II elastics, and with total banding time.

Adolescent↗
PubMed1990

Veterinary orthodontics.

Orthodontic correction for dogs in both practical and beneficial. We have treated several dogs in our practice and have developed a manageable, fully fixed technique for solving various malocclusions. The case presented herein was a pseudo Class III malocclusion with all incisors in crossbite and an anterior open bite.

Animals↗
PubMed1995

Communication in orthodontic treatment planning: bioethical and informed consent issues.

Orthodontic treatment planning is an interactive process in which the patient or parent and the orthodontist serve as co-decision makers. As in most partnerships, there is a natural tension between the orthodontist and the patient because of differences in their frames of reference. The orthodontist generally is influenced more by the objective findings (the problem list), whereas patients are guided more by subjective issues related to their perceived needs, desires, and values. The art of careful probing and listening to the patient as part of the treatment planning process is an essential skill. One of the most difficult situations in contemporary orthodontics is presented by the patient with a jaw discrepancy for which the alternative treatments are orthodontic camouflage through dental compensation or surgical-orthodontic correction. Computer imaging to simulate the probable treatment outcomes can facilitate communication about these alternatives by eliminating misconceptions. Full disclosure and the consideration of all viable treatment alternatives have great benefits from a risk management standpoint, in addition to their bioethical merits.

Adolescent↗