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PubMed1991

Overbite and overjet characteristics of refined diagnostic groups of temporomandibular disorder patients.

Overbite and overjet were studied as continuous variables to examine for any relationship to diagnostic groups of temporomandibular disorders (TMD) compared with symptom-free controls. This avoided the bias of arbitrary definitions of normal and abnormal for these occlusal variables and also avoided the masking effect of studying symptoms rather than diagnostic entities. Incisal overbite in primary osteoarthrosis (OA) was shifted toward the minimal and open bite ranges as compared with the controls (p less than 0.02). Open bite occurred in only the two OA classes studied and in a few cases with myalgia only but was absent in the symptom-free controls. Overbite in myalgia was slightly skewed to the lower range. Deep bite was not more common in the myalgia, disk displacement (with or without reduction), or the OA groups. Increased overjet characterized OA groups, especially when there was a history of derangement (p less than 0.004), but did not characterize the other diagnostic groups. Except for open bite, overbite and overjet characteristics as isolated variables did not distinguish TMD patient groups. It is hypothesized that open bite in OA can be the result of joint changes rather than a predisposing occlusal cause.

Adult↗
PubMed1992

Patterns of incisor root resorption before and after orthodontic correction in cases with anterior open bites.

External root resorption is a frequent iatrogenic consequence of orthodontic treatment, particularly in the maxillary anterior teeth. Since resorption also occurs is a normal function of aging and since altered behaviors such as bruxism and chronic nailbiting accelerate resorption even in the absence of treatment, it was hypothesized that the long-term orthopedic forces of tongue thrusting leading to anterior open bites would also enhance the rates of clastic activity. In a series of 32 adolescents with open bites, the roots of permanent maxillary central incisors were significantly shorter and exhibited higher modal grades of periapical resorption than a matched series with deep bites before treatment. The open bite group also had less facial bony support for these teeth. Both series experienced discernible resorption during full-banded treatment but to comparable extents so that, after active treatment, the open bite series continued to possess significantly greater degrees of resorption. Consequently, the oral forces leading to apertognathia are themselves destructive of root integrity and merit early recognition and interception.

Adolescent↗
PubMed1992

Longitudinal study of signs of temporomandibular disorders (TMD) in orthodontically treated and nontreated groups.

This study measured the prevalence and incidence of signs of temporomandibular (TM) disorders in both a group undergoing orthodontic treatment in the University of Florida graduate orthodontic program and a control group. A questionnaire pertaining to the patients' reports of signs and symptoms of TM disorder and a clinical examination were administered by a trained dental examiner. Data collection sessions occurred at baseline (before treatment) and at 12-month intervals to 24 months. Data were also collected for the control group at the same time intervals. There were 102 patients (43 boys, 59 girls) mean age 15.3 years. An untreated control group of 41 nonorthodontically treated subjects mean age 16.2 years was used. The incidence of TM signs for the treatment group and control group were not significantly different. Preliminary results are in agreement with the contention that orthodontically treated patients are not more likely to develop TM signs while undergoing treatment. Results underscore the changing, inconstant, and ephemeral nature of TM signs in many persons over the course of time.

Adolescent↗
PubMed1992

A static occlusal analysis based on ideal interarch and intraarch relationships.

Study models were visually assessed to quantify the number of ideal tooth relationships actually present relative to the potential total. Both intraarch and interarch relationships were used to generate an ideal tooth relationship index (ITRI). Index scores were generated for the entire dentition, which could be divided into anterior, posterior, interarch, and intraarch relationships. Index scores were determined at various time intervals so the longitudinal changes could be studied. Treated orthodontic cases (n = 92) showed an initial total ITRI score of 26% that increased to 52% at the end of orthodontic treatment and continued to improve to 59% during the retention and postretention periods. Anterior segment scores were higher (64%) than posterior segment scores (44%). The intraarch relationships of the anterior segment registered the highest (75%), whereas the lingual cusp relationships of the posterior segment had the lowest scores (35%). Various types of malocclusions exhibited different ITRI scores before treatment but responded equally to treatment showing similar improvement in scores at the end of treatment and the posttreatment period.

Adolescent↗
PubMed1993

Maxillary incisor crown-root relationships in different angle malocclusions.

The long axis of the maxillary incisor root is not always identical to that of the crown. Instead, there is appreciable variation in the crown-root angle, generally with the crown torqued lingual to the root axis. In orthodontic cases assessed before and at the end of full-banded treatment, the crown-root angle was significantly deflected in the Class III molar relationship series, notably so in moderate to severe cases where the maxillary incisors are constrained lingual to the lower arcade. Apical root resorption was not significantly associated with the crown-root angle before or after comprehensive orthodontics. Cephalometric predictors of the amount of deflection of the crown-to-root axis were localized to intertooth relationships (overjet, interincisal angle). It is proposed that the large collum angles in Class III cases develop during tooth eruption when the maxillary incisors are trapped within the lower arch; this torques the crown of the maxillary incisor but leaves the unmineralized portion of the root free to develop as if the crown were still in its prior, more procumbent orientation.

Adolescent↗
PubMed2005

A comparison of providers' and consumers' perceptions of facial-profile attractiveness.

INTRODUCTION: The purpose of this study was to evaluate the perception of facial attractiveness in profile digital photographs that were incrementally altered to produce different combinations of mandibular anteroposterior positions and lower anterior facial heights. The specific aims were to determine whether there is concordance between providers and consumers in their perceptions of facial attractiveness, and to evaluate whether interactions of the anteroposterior and vertical dimensions and the magnitude of these interactions influence perception of facial attractiveness. METHODS: Profile digital photographs and cephalograms of 3 men and 3 women were used. The position of the jaw was altered incrementally with Dolphin imaging equipment (Dolphin Imaging and Management, Chatsworth, Calif), and booklets were created. One hundred raters (50 laypersons, 25 oral surgeons, 25 orthodontists) scored the profiles on a visual analog scale. All images were duplicated to test intrarater reliability. Factorial ANOVA with repeated measures and the Tukey-Kramer post-hoc test for multiple comparisons were used to test for differences in facial attractiveness. The level of significance was set at .05 (P = .05) for all analyses. RESULTS: Intrarater reliability was good (ICC = 0.71), and general concordance was found between providers and consumers in their perceptions of facial attractiveness. Interactions of the anteroposterior and vertical dimensions and the magnitude of change in each dimension influence the perception of facial attractiveness. CONCLUSIONS: The results suggest that preferences of facial attractiveness by laypersons, orthodontists, and oral surgeons in central Ohio are generally in agreement. This information might assist clinicians in treatment planning and making recommendations.

Adolescent↗
PubMed2006

A novel method for the 3-dimensional simulation of orthognathic surgery by using a multimodal image-fusion technique.

INTRODUCTION: The aim of this study was to establish a novel method for simulating orthognathic surgery in 3-dimensional (3D) space. METHODS: This system mainly consists of 6 procedures: (1) reconstruction of a virtual skull model (VS) from presurgical computed tomography scans; (2) reconstruction of virtual dentition models from 3D surface scanning of dental casts occluded at presurgical and postsurgical intercuspal positions (VD1 and VD2, respectively); (3) reconstruction of a preliminary fusion model of VS and VD1 by an initial intermodality registration; (4) reconstruction of another preliminary fusion model of VS, VD1, and VD2 by a second intramodality registration; (5) repositioning of bony segments by a third intramodality registration and reconstruction of final fusion models at presurgery and postsurgery; and (6) 3D analysis of the movement of bony segments. To test this system, 2 patients with severe skeletal deformities, who had undergone presurgical orthodontic treatment, were used as models. Registration accuracy was determined by the root mean squared distance between the corresponding fiducial markers in a set of 2 images. RESULTS AND CONCLUSIONS: The sum of the root mean squared error of the 3 registration processes was less than 0.4 mm in both patients. This simulation system could be used to precisely realize the presurgical and postsurgical occlusal relationships and craniofacial morphology of a patient with severe skeletal deformities, and to quantitatively describe the movement of a given anatomical point of bony segments. It is assumed that there could be significant benefits in sharing visual and quantitative 3D information from this simulation system among orthodontists and surgeons.

Adult↗
PubMed2005

A comparison of craniofacial morphology in patients with and without facial asymmetry--a three-dimensional analysis with computed tomography.

This study intended to evaluate the morphological characteristics of the cranial base and maxillomandibular structures of facial asymmetry in adult patients, so as to determine whether mandibular asymmetry is a result of primary mandibular deformity or if it is influenced by cranial base deformity. Forty-two adult patients with dentofacial deformity were placed into two groups according to the deviation of the chin: Asymmetry group (n = 24) and Non-asymmetry group (n = 18). They were compared with three-dimensional (3D) CT reformatted images using a 3D visualization and analyzing program. The differences between the two groups, the correlation between the cranial base and maxillomandibular asymmetry were evaluated statistically. The degree of cranial base asymmetry in the Asymmetry group was not statistically different from the Non-asymmetry group. The asymmetric condyle position was found to be associated with skull base characteristics. The 3D position of the condyle and cranial base, however, was not closely related with mandibular asymmetry. The results showed that the cranial measurement variables were not the dominant factors that determined the degree of facial asymmetry. It seems that the mandibular skeletal factors itself, functional or intrinsic asymmetric growth potential, compensate or aggravate the influence of cranial asymmetry during the growth period.

Adult↗
PubMed2004

Skeletal relapse after mandibular advancement and setback in single-jaw surgery.

PURPOSE: The aim of this study was to identify contributing factors to skeletal relapse by analyzing cephalometric changes after bilateral sagittal split ramus osteotomy. PATIENTS AND METHODS: This study included 60 consecutive patients who underwent either mandibular advancement (30 patients) or setback surgery (30 patients). There were 36 women and 24 men (mean age, 23 years). The radiographs of these patients taken immediately before operation, at 1 week, and 14 months postoperatively were studied. To analyze the influence of hyper- and hypodivergent facial patterns on the surgical outcome, the patients were divided into 3 groups according to the mandibulo-nasal plane angle. The position of the maxilla was also taken into account. RESULTS: Measured at B-point, skeletal relapse was 1.3 mm (30%) after mean advancement of 4.4 mm and 0.8 mm (12%) after setback of 6.0 mm. The magnitude of the surgical movement correlated with skeletal relapse. However, the correlation was not linear. Advancement of greater than 7 mm is associated with an increased tendency to relapse (r=0.52), but setback of more than 12 mm with a decreased tendency (r=-0.95). The retrognathic patients with a high mandibulo-nasal plane angle (hyperdivergence) had 30% higher relapse rate. Patients with hypodivergent facial patterns had less relapse in both advancement and setback surgery. CONCLUSION: Skeletal relapse was affected by magnitude of surgical movement and different facial patterns according to the mandibulo-nasal plane angle; however, influences of both factors were different between mandibular advancement and setback.

Adolescent↗
PubMed1997

Mid-facial growth following functional cleft surgery.

The stigmata of lip and palate clefting are well recognized, but recently it has been thought that these may be exacerbated by the surgical repair. Functional repair, however, with re-establishment of muscle continuity may result in less disruption to normal facial growth. This study examines mid-facial growth in 10 consecutive children aged 6.5 years with complete unilateral cleft lip and palate who had undergone functional repair. Outcomes were compared with non-cleft children and children who had undergone non-functional surgery.

Adult↗
PubMed1997

Effect of primary surgery for cleft lip and palate on mid-facial growth.

Surgery for cleft lip and palate is known to have an effect on growth and development of the mid-face. This paper studies the outcomes in 34 consecutive 10-year-old patients with unilateral cleft lip and palate. Clinical observations of the importance of both surgical technique and the influence of cranial base morphology on maxillo-mandibular position are discussed.

Cephalometry↗
PubMed1985

The inverted L osteotomy for treatment of skeletal open-bite deformities.

Numerous surgical procedures have been proposed for the correction of the skeletal open-bite deformity. Mandibular ramus procedures have not been uniformly successful due to the amount of observed relapse in both the horizontal and vertical dimensions. The authors studied 20 patients who underwent correction of an open-bite deformity using the inverted L ramus osteotomy technique. Results indicated that this procedure may have more stability in both the horizontal and vertical dimensions than previously reported ramus procedures.

Adolescent↗
PubMed2000

For four sixes.

This article reviews the literature on orthodontic treatment involving extraction of first molars and highlights many of the clinical considerations when treating such cases. Case reports illustrate the potential problems and indicate some solutions.

Adolescent↗
PubMed1996

Comparison of malocclusion in preschool black and white children.

Previous research confirms ethnic and gender differences among children with malocclusions. A limited amount of information is available on preschool children. With an increasing interest in the early recognition of malocclusion and a corresponding emphasis on preventive procedures, more information on preschool children may prove to be useful. This study compared ethnic and gender differences for Angle's classification, anterior crossbite, and posterior crossbite. The sample consisted of 238 children, 3 to 5 years of age; 99 of the children were black and 139 were white. The acquired data were tested with chi(2). The results indicate significant racial differences in occlusal patterns and little or no gender difference.

Black People↗
PubMed1997

On the management of extraction sites.

Extraction sites may be needed to achieve specific orthodontic goals of positioning the dentition within the craniofacial complex. The fundamental reality that determines the final position of the dentition, however, is the control exercised by the clinician in closure of the extraction sites. A specific treatment objective may require the posterior teeth to remain in a constant position anteroposteriorly as well as vertically, while the anterior teeth occupy the entire extraction site. Another treatment objective may require the reverse, or any number of purposeful alternatives of extraction site closure. An appliance system developed over time, which provides this control, is described. The system takes advantage of aspects of continuous arch therapy that provides constant, positive orientation of the anterior and posterior groups of teeth to each other in three-dimensional space across an extraction site, combined with aspects of the segmented arch technique that permit definable and predictable force systems to be applied to these teeth. Consequently, the clinician has the ability to forecast treatment outcomes with confidence.

Bicuspid↗
PubMed1996

A comparative study of two arbitrary face-bow transfer systems for orthognathic surgery planning.

The relative reproducibility of two widely used arbitrary face-bow transfer systems, the Denar Slidematic and the Dentatus type AEB, was assessed for use in orthognathic surgery planning. A novel method was also developed to determine any variation in three-dimensional spatial position and orientation of the maxillary cast. This envelope of movement enabled realistic comparisons to be made for each face-bow system, operator, and skeletal type. The overall face-bow/articulator procedure showed poor reproducibility. However, the Denar Slidematic face-bow was better (P < 0.001) than the Dentatus type AEB standard face-bow, and the errors were higher in the anteroposterior and lateral directions than the vertical direction. There was no significant difference between operators for each system.

Analysis of Variance↗
PubMed1994

Cephalometric alterations following facial advancement surgery. 2. Clinical and computerised evaluation.

Part 1 of this investigation identified an established patient cohort whose treatment is best suited to combined surgical-orthodontic correction of dento-facial deformity. This is as opposed to the attempted correction of the problem by an orthodontics-only or a surgery-only approach. Experienced surgeons will subjectively assess facial aesthetics and devise surgical treatment objectives in terms of the beneficial soft tissue improvements derived from dento-skeletal manipulation. None the less, traditional and soft tissue cephalometric parameters remain a guideline in the diagnostic phase of treatment. Part 2 of this investigation compared pre and postoperative clinical and computerised evaluations of patients diagnosed as having combined mid and lower dento-facial deficiency with Class 1 dento-skeletal parameters.

Cephalometry↗