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[Applied phoniatry. V. Speech defects due to abnormalities of jaw and dentition (author's transl)].

Dysgnathia (jaw and tooth anomaly, tooth misspacing, macillodento-facial anomaly) influences to a certain degree the development of defects of articulation especially sigmatism. Other factors, such as mild motor system inco-ordination and hearing defects, besides dysgnathia, are frequently observed. Speech therapy is necessary preceding as well as together with the maxillofacial treatment. The dental, prosthodontic and maxillofacial prostheses may likewise interfere with enunciation, but this will disappear spontaneously within 2 weeks or will be compensated for. If necessary the prosthesis will have to be altered.

Hearing Disorders

An orthodontic study of temporomandibular joint disorders. Part 1: Epidemiological research in Japanese 6-18 year olds.

Malocclusion is considered one of the etiological factors of temporomandibular joint disorder (TMD). The purpose of this study was to investigate the prevalence of TMD and the relationship between TMD and the type of occlusion. The sample consisted of 7337 Japanese children, 6-18 years old, 3219 boys and 4118 girls. TMD symptoms were recorded as well as the type of occlusion in children with TMD. The prevalence of TMD overall was 12.2%. The prevalence increased with age and was slightly higher in girls (13%) than in boys 11.1%. This difference was not statistically significant. Joint sound as the only symptom was more common in younger subjects. TMD symptoms seemed more complicated with age when pain and abnormal jaw movement combined with sound. Joint sound was the most common symptom (89.3%), followed by the combination of sound and pain (2.2%). The incidence of other symptoms was under 1%. In subjects with TMD, 24.9% exhibited crowding, 20.1% had excessive overjet, 6.8% deep bite, 6.3% edge-to-edge bite, 5.6% anterior crossbite, 5.4% open bite, and 3.8% posterior crossbite. Morphologically normal occlusion was observed in 27.1%. In this study, many subjects with TMD had malocclusions. Early treatment may be important in the prevention of severe TMD. Although those with morphologically normal occlusions were included, a more detailed study concerning other causes of TMD is needed also.

Adolescent

Nocturnal electromyographic evaluation of myofascial pain dysfunction in patients undergoing occlusal splint therapy.

Twenty-five patients with symptoms of myofascial pain and abnormal jaw function were treated with use of a full arch maxillary occlusal splint. The level of nocturnal activity of the masseter muscle was monitored as were symptoms before, during, and after occlusal splint therapy. A decreased nocturnal EMG level during treatment was noted for 52% of the patients. A return to pretreatment EMG levels after removal of the splint was noticed in 92% of the patients; in 28% no change was shown and in 20%, an increase was shown in nocturnal EMG levels. The splint was most likely to reduce nocturnal EMG levels in patients with least severe symptoms.

Adult

[The discriminatory force of 3 sagittal measurement relations of the jaw bases].

The angle ANB relates the apical base not only to each other but also to point nasion and the profile. Furthermore, it is influenced by prognathism and inclination of the maxillo-mandibular complex. Both the angle AB/Occlusal plane and the "Wits" appraisal are based on elements within the maxillo-mandibular complex and not influenced by structures outside this complex. Cephalograms of 4 groups of 25 cases each comprising ideal occlusion, class-II/1, class-II/2 and class-III malocclusions were collected. Angle ANB, angle AB/Occlusal plane and "Wits" appraisal in 10 variations using points A and B according to Downs, As and Bs according to Herren and the occlusal plane using Incsup., Incinf. and Incinter and the molar point Mo (Hügli) were determined. By means of a discriminant analysis the discriminatory power of these variations were calculated. Variations using the points As and Bs and point Mo gave better results in separating 100 cases according to their relation of the apical bases. The results of the stepwise discriminant analysis reveal a high percentage of "right" classification. It is possible to draw borderlines in the continuum of values, allowing with high probability a classification of each case according to Angles classification when more than one measurement is utilized.

Cephalometry