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An unusual Class III malocclusion.

A nine year old caucasian boy presented with bilateral double upper central incisors in Class III relationship. In addition 4 showed an abnormal root morphology and path of eruption. The double teeth were retained and the incisor relationship was corrected orthodontically. Following surgical exposure, 4 erupted favourably.

Child↗

The Barry Project--a three-dimensional assessment of occlusal treatment change in a consecutively referred sample: the incisors.

The serial occlusal changes for a consecutively referred sample of malocclusion from a Welsh town are presented. The patients were assigned to one of four treatment regimes (meant to represent those commonly used in the U.K.) and treated to a rigid protocol. Twenty-five per cent of the cases were reviewed by an eight clinician panel. No bias in the original assignments was found although there was considerable interobserver variation. At defined pretreatment, post-treatment, and post-retention stages, records were collected and the study casts quantitatively measured using a reflex metrograph and an occlusal analysis programme. The results found for the overjet, overbite, crown inclination, and crown angulation are presented and discussed.

Analysis of Variance↗

The timing of orthodontic treatment.

The time at which orthodontic treatment should be started remains a matter of conjecture. Anomalies of dental development and functional problems tend to be addressed in the mixed dentition, while definitive treatment tends to be delayed until the late mixed dentition to maximize growth potential and patient compliance. However, some clinicians advocate starting treatment earlier in certain types of malocclusion. In this article, the current concepts of early treatment, both physiological and psychological, will be explored and the relevant indications and contraindications discussed.

Adolescent↗

Supracrestal fiberotomy.

Details of a surgical technique to divide the free gingival and transseptal fibers around rotated teeth that have been corrected orthodontically are outlined. The rationale of the procedure, its applications, indications, and contraindications are discussed. Supracrestal fiberotomy is not a substitute but an adjunct to normal retention procedures.

Anesthesia, Dental↗

Early orthodontic treatment: what are the imperatives?

BACKGROUND: Then authors provide a critical review of the issues involved in determining the appropriate timing of orthodontic treatment. Both single- and two-phase treatments are discussed and guidelines are offered to assist in formulating treatment plans. OVERVIEW: In providing orthodontic care for pediatric patients, clinicians often question whether to begin treatment early--during the primary or early-transitional dentition--or wait until all or most of the permanent teeth are present. The authors review the most current literature (from 1991 to 1999), including several recently completed and ongoing randomized clinical trials, to critically evaluate the effectiveness of each approach. PRACTICAL IMPLICATIONS: The controversy surrounding early vs. late orthodontic treatment is often confusing to the dental community. This article reviews both sides of the issue for orthodontic treatment of Class II and III malocclusions, as well as for the management of Class I crowding and problems in the transverse dimension. Early orthodontic treatment is effective and desirable in specific situations. However, the evidence is equally compelling that such an approach is not indicated in many cases for which later, single-phase treatment is more effective. Therefore, clinicians must decide, on a case-by-case basis, when to provide orthodontic treatment. For many patients, delaying treatment until later in their dental and skeletal development may be advisable.

Adolescent↗

Movements of healthy and periodontally involved teeth measured with laser reflection technique.

The laser reflection method of remote measurement was used to register small tooth movements of upper central incisors from a group of subjects with healthy teeth and another group with periodontally involved teeth. The mobility of the healthy maxillary incisors over a period of 24 hours was well within normal limits. Among orthodontically treated and periodontally involved maxillary incisors relapse was larger sagittally than laterally and largest buccally. This tendency was greatest during the first 5 hours and almost reached its maximum after 1 day. These movements were within the limits of mobility but were not always correlated with mobility or the loss of marginal bone. Furthermore, the relapse was not correlated with the magnitude of orthodontic correction. In this respect, the mean buccal relapse was low, however, individual variations were large. The extent of relapse may be related to the varying intensity of parafunctional habits.

Adult↗

Early bone grafting in complete cleft lip and palate cases following maxillofacial orthopedics. I. The method and the skeletal development from seven to thirteen years of age.

The methods of preoperative orthopedics: a "T-traction" procedure for unilateral clefts and a combined premaxillary pressure and expansion procedure for bilateral clefts and of early alveolar bone grafting: the Nordin's "four-flap" technique, are described in detail. The subsequent effects of treatment according to those methods were studied with roentgencephalometric analysis in cleft patients from 7 to 13 years of age. They were divided into two unilateral and one bilateral complete cleft group, all having been early bone grafted. The unilateral groups were composed of one group of 39 children operated on during the period 1960-65 without preoperative "T-traction", and another group, of 46 children, operated on in 1965-72 after preoperative "T-traction". The bilateral group included 19 children operated on 1960-72 after preoperative orthopedics. The same degree of inhibited development of the facial skeleton as found in another Swedish early bone grafted cleft group was not present in our patients. The development of the skeletal profile in our bone grafted cases, especially those in the "T-traction" group, was well within the limits of non-grafted U.S. cases, but differed from non-clefts.

Adolescent↗

Early bone grafting in complete cleft lip and palate cases following maxillofacial orthopedics. II. The soft tissue development from seven to thirteen years of age.

The subsequent effect of preoperative maxillofacial orthopedics and early bone grafting on the development of the soft tissue profile of the face was studied with roentgencephalometric analysis on cleft patients between 7 and 13 years of age. They were divided into two unilateral and one bilateral complete-cleft group, all having been bone grafted early with the "four-flap" technique. The two unilateral groups were one group of 39 children operated on between 1960 and 1965 without preoperative orthopedics and one group of 46 children operated on between 1965 and 1972 after preoperative orthopedics ("T-traction"). The bilateral group comprised 19 children operated on between 1960 and 1972 after premaxillary retropositioning pressure, combined when necessary, with outward rotation of the lateral maxillary segments. Comparisons of facial growth were made with U.S. non-grafted clefts and with nonclefts. The effect of the preoperative orthopedic management facilitated the subsequent surgical procedure by a narrowing of the cleft and replacement of the deviated maxillary and nasal structures. The results were within limits of the non-grafted cases, with the exception of the soft tissue overlying the subnasal region. The reduced prominence of that region was explained by the primary surgical procedure, which made the lip adherent to the alveolar crest. In comparison with nonclefts, all parameters indicated a reduced growth capacity.

Adolescent↗