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Results for “Retrognathia”

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At least 19 recordsLinked to original sources

PubMed2005

Severe retrognathia as a risk factor for recent onset painful TMJ disorders among adult females.

OBJECTIVE: To evaluate the importance of severe retrognathia as a risk factor for the development of recent onset painful TMJ disorders among adult females. DESIGN: Case-control study. SETTING: This study was conducted in a large health maintenance organization between 1998 and 1999 [Kaiser Permanente Northwest (KPNW), Portland, OR, USA]. PARTICIPANTS: Adult females with recent onset painful TMJ disorders (n=29) and normal controls (n=104). METHODS: Cases were recruited from the TMD clinic at Kaiser Permanente Northwest (KPNW). Controls were recruited from a dental clinic at KPNW. Case status was determined using a questionnaire; mandibular sagittal position was determined by measuring a research angle on facial photographs. The mean research angle for cases was compared to the mean for controls. Multivariable exact conditional logistic regression analysis was used to examine the demographic characteristics of cases and controls, and to determine the strength of association between recent onset painful TMJ disorders and severe retrognathia. The population attributable risk percentage (PAR%) and the attributable risk percentage (AR%) were calculated to further evaluate severe retrognathia as a risk factor. RESULTS: The mean research angle among cases (67.7 degrees; 95% CI=66.0-69.4) was smaller than among controls (71.6 degrees; 95% CI=70.7-72.5, P<0.001). The odds ratio for the association between case status and the presence or absence of severe retrognathia was elevated (OR=6.3; 95% CI=1.1-47.5, P=0.039). The PAR% and AR%, associated with severe retrognathia, were 13.3 and 84.1%, respectively. CONCLUSIONS: Severe retrognathia is strongly associated with recent onset painful TMJ disorders (OR=6.3). Only a small proportion of these disorders are attributable to severe retrognathia among the total population of adult females (PAR%=13.3%). However, a large proportion of these TMJ disorders are potentially attributable to severe retrognathia among adult females with severe retrognathia (AR%=84.1%).

Adolescent↗

PubMed2006

Sleep-disordered breathing in patients with acquired retrognathia secondary to rheumatoid arthritis.

BACKGROUND: Sleep-disordered breathing (SDB) is associated with a variety of conditions that cause upper-airway narrowing. It was hypothesized that upper-airway narrowing can occur in patients with rheumatoid arthritis (RA) when retrognathia develops secondary to temporomandibular joint (TMJ) destruction. Therefore, the aim of this study was to detect the prevalence of SDB in patients with acquired retrognathia secondary to rheumatoid arthritis and to assess the efficacy of nasal continuous positive airway pressure (nasal CPAP) therapy in patients with SDB. MATERIAL/METHODS: Employed were a questionnaire, lateral cephalometry, and overnight polysomnography in seven women and three men (mean age +/-SD: 50+/-20 years, mean body mass index: 24.2+/-5.7 kg/m(2)) with acquired retrognathia secondary to RA. RESULTS: Three patients had severe obstructive sleep apnea (OSA) with apnea+hypopnea indices (AHI) >60/hour, three had mild obstructive sleep hypopnea (AHI >10/hour), and four had AHI <10/hour. The three patients with severe OSA all had excessive daytime sleepiness and evidence of retrognathia. In these three patients the mean AHI decreased from 72/hour to 3/hour with nasal CPAP therapy. CONCLUSIONS: SDB occurs quite frequently in non-obese patients with acquired retrognathia secondary to RA. The severity of SDB is related to the degree of retrognathia and the presence of daytime sleepiness. Nasal CPAP therapy is effective and well tolerated in these patients.

Adult↗

PubMed2004

Association between mandibular retrognathia and TMJ disorders in adult females.

OBJECTIVE: This study assesses the association between temporomandibular joint (TMJ) disorders and mandibular retrognathia. METHODS: We conducted a case-control study among women, aged 18-70 years, recruited from Kaiser Permanente Northwest Division (KPNW, Portland, OR) and Group Health Cooperative of Puget Sound (GHC, Seattle, WA). Cases (N= 160) were women seeking treatment for TMJ disorders at KPNW and GHC clinics. Controls (N=151) were women without TMJ disorders, selected from among adult female dental hygiene patients at KPNW or GHC enrollees. Case status was determined by questionnaire; mandibular sagittal position (orthognathic, mildly retrognathic, severely retrognathic, or prognathic) was measured using digitized facial photographs. Odds ratios (OR) and associated 95 percent confidence intervals (CI) estimated the magnitude of the association between TMJ disorders and mandibular sagittal position. RESULTS: Women with TMJ disorders were 4.0 times (95% CI=1.5, 10.8) more likely than controls to have severe retrognathia; no association with mild retrognathia or prognathia was seen. Results were similar when cases were restricted to those with recent onset of TMJ pain (OR=6.3; 95% CI=1.8, 21.8). CONCLUSIONS: We found a strong association between TMJ disorders and severe mandibular retrognathia in adult females. In some women this likely resulted from TMJ disorders influencing mandibular development over time. However, among a subset of women, our data support the reverse hypothesis--that severe mandibular retrognathia may influence the development of TMJ disorders. Despite this strong association, abnormal mandibular position contributed only a small portion to the overall rate at which women sought treatment for TMJ disorders.

Adolescent↗

PubMed1979

Correlation between mandibular retrognathia and induction of cleft palate with 6-aminonicotinamide in the rat.

A single injection of the niacin antimetabolite 6-aminonicotinamide (6-AN) late in gestation produces cleft palate in the rat. In order to achieve an understanding of the mechanism of induction of cleft palate, craniofacial growth and palate development were studied in Sprague-Dawley rats after treatment with 6-AN on day 15 of gestation. The rats were maintained on a high niacin diet (95 ppm) and subjected to three different teratogenic levels of 6-AN. The first group was injected with 8 mg/kg, the second was fasted and injected with 8 mg/kg and the third was treated with 16 mg/kg. The lowest teratogenic dose, 8 mg/kg, produced mild mandibular retrognathia on day 16, delayed shelf elevation a few hours and resulted in small rostral and small caudal clefts of the secondary palate. The moderate dose, 8 mg/kg with fasting, produced more severe mandibular retrognathia, delayed shelf elevation about 24 hours and resulted in 37% full clefts and 63% partial clefts of the palate. The highest teratogenic dose, 16 mg/kg, produced severe mandibular retrognathia, delayed shelf elevation by more than 24 hours and resulted in 100% full clefts of the palate. In each 6-AN group, the most severe mandibular retrognathia was present between days 16 and 17, the critical time for palate closure in the rat. Treatment with 6-AN also produced abnormality of the epithelial cells of the palate, the toothbuds and the nasal septum. Molar and incisor toothbuds were small and malformed, and the epithelial surfaces of the palate and the soft tissue nasal septum did not fuse.

6-Aminonicotinamide↗

PubMed2002

The fetal mandible: a 2D and 3D sonographic approach to the diagnosis of retrognathia and micrognathia.

OBJECTIVE: To define parameters that enable the objective diagnosis of anomalies of the position and/or size of the fetal mandible in utero. DESIGN: Fetuses at 18-28 gestational weeks were examined by two- and three-dimensional ultrasound. The study included normal fetuses and fetuses with syndromes associated with known mandible pathology: Pierre Robin sequence or complex (n = 8); hemifacial microsomia (Treacher-Collins syndrome, n = 3); postaxial acrofacial dysostosis (n = 1). Fetuses with Down syndrome (n = 8) and cleft lip and palate without Pierre Robin sequence or complex (n = 18) were also studied. Retrognathia was assessed through the measurement of the inferior facial angle, defined on a mid-sagittal view, by the crossing of: 1) the line orthogonal to the vertical part of the forehead at the level of the synostosis of the nasal bones (reference line); 2) the line joining the tip of the mentum and the anterior border of the more protruding lip (profile line). Micrognathia was assessed through the calculation of the mandible width/maxilla width ratio on axial views obtained at the alveolar level. Mandible and maxilla widths were measured 10 mm posteriorly to the anterior osteous border. RESULTS: In normal fetuses, the inferior facial angle was constant over the time span studied. The mean (standard deviation) value of the inferior facial angle was 65.5 (8.13) degree. Consequently, an inferior facial angle value below 49.2 degree (mean - 2 standard deviations) defined retrognathism. All the fetuses with syndromes associated with mandible pathology had inferior facial angle values below the cut-off value. Using 49.2 degree or the rounded-up value of 50 degree as a cut-off point, the inferior facial angle had a sensitivity of 1.0, a specificity of 0.989, a positive predictive value of 0.750 and a negative predictive value of 1.0 to predict retrognathia. In normal fetuses, the mandible width/maxilla width ratio was constant over the time interval studied. The mean (standard deviation) value was 1.017 (0.116). Consequently, a mandible width/maxilla width ratio < 0.785 defined micrognathism. Mandible width/maxilla width ratio values were below this cut-off point in eight and in the normal range in four fetuses with syndromes associated with mandible pathology. CONCLUSIONS: Retrognathia and micrognathia are conditions that can be separately assessed. The use of inferior facial angle and mandible width/maxilla width ratio should help sonographic recognition and characterization of fetal retrognathic and micrognathic mandibles in utero.

Cephalometry↗

PubMed2006

Bilateral TMJ disk displacement induces mandibular retrognathia.

Unilateral non-reducing TMJ disk displacement has been shown to retard mandibular growth on the ipsilateral side, with facial asymmetry a sequela. We hypothesized that bilateral affliction would impair mandibular growth bilaterally, generating mandibular retrognathia. Non-reducing TMJ disk displacement was surgically created in 10 growing New Zealand White rabbits. Ten additional rabbits served as a sham-operated control group. Facial growth was followed in serial cephalograms, with tantalum implants, during a period corresponding to childhood and adolescence in man. The results verified that bilateral non-reducing TMJ disk displacement retarded mandibular growth bilaterally, the extent corresponding to mandibular retrognathia in man. Maxillary growth was also retarded, but to a lesser degree. Growth impairment fluctuated over time, the most striking retardation occurring during periods of general growth acceleration. This should be taken into consideration when orthodontic treatment, aimed at stimulating mandibular growth, is initiated in adolescent individuals with non-reducing TMJ disk displacement.

Animals↗

PubMed1985

The postcondylar cartilage graft--an evaluation of an alternative surgical method for the treatment of retrognathia.

Postcondylar cartilage grafts were used for 6 years to advance the mandible surgically in adolescent patients with retrognathia. Thirty-seven subjects were treated; of these, 30 were followed for more than 1 year and have been analyzed. Relapse occurred in 9, caused mainly by displacement of the graft. In the stable group temporomandibular joint changes were studied. Progressive calcification of the graft occurred and a normally functioning joint was established in the advanced position. Improvements in surgical technique--in particular, the fixation of the graft--produced consistent stability in the later cases.

Adolescent↗

PubMed1987

Lower premolar extraction/removable plastic Herbst treatment for mandibular retrognathia.

The patient was a 12-year-old girl with a Class I malocclusion characterized by maxillary arch width constriction, dental crowding, and mandibular retrognathia. Treatment goals related to the chief compliant were anterior mandibular repositioning, maxillary arch expansion, and dental alignment. Because the preexisting overjet was minimal and prevented adequate anterior repositioning of the mandible, lower first premolar extraction was recommended to increase the overjet and allow greater anterior repositioning. Treatment was divided into four stages: (1) extraction of mandibular first premolar teeth, alignment, space closure, and an increase in the overjet, (2) anterior mandibular repositioning with a removable plastic Herbst appliance, (3) arch alignment and detailing of the occlusion with full fixed appliances and a tooth positioner, and (4) retainers. At the end of treatment, the patient had an acceptable dental alignment with a Class III molar relationship and an improvement in facial appearance.

Activator Appliances↗

PubMed2006

Comparison of mandibular rami width in patients with prognathism and retrognathia.

PURPOSE: The purpose of this study was to assess the ramus thickness in skeletal Class III and Class II patients. METHODS: Forty patients were evaluated using computed tomography scanning. RESULTS: Compared with the Class II patients, the mandibular ramus of Class III patients was thinner. The ramus thickness in retrognathic patients was 8.84 mm and the ramus thickness in prognathic patients was 7.80 mm. CONCLUSION: The ramus is thinner in patients with prognathism than in those with retrognathia.

Adolescent↗

PubMed1989

Maxillonasal dysplasia, mandibular retrognathia and cleft palate.

The present paper describes the craniofacial form of subjects with maxillonasal dysplasia and reports its occurrence in two siblings who also have cleft palate and mandibular retrognathia. Maxillonasal dysplasia and a cleft deformity may be illustrative of a field effect of a teratogen on developing midface components or even suggestive of a possible inherited etiology.

Cephalometry↗

PubMed1977

Our experience with sagittal split osteotomy for retrognathia.

Twenty-six cases which had been operated upon for retrognathia are reviewed. Most of these patients were unmarried, young individuals, and the improvement in their self-image and appearance was the major benefit from the surgical procedure: a lesser number felt the improvement in their bite and function was more important. Relapse, weakness of the lower lip, and numbness of the lower lip were the 3 most common complications. They occurred with sufficient frequency to encourage us to find a surgical approach with less morbidity for this problem of skeletal asymmetry. Perhaps a "C" cut (as champion;ed by Hinds), a forward block of the mandible with cartilage (as described by Trauner), or a vertical cut of the ramus with the posterior fragment notched into the anterior fragment (Mehnert), would yield results with fewer undesirable effects.

Adolescent↗

PubMed1989

[Comparison of treatment of mandibular retrognathia by functional regulators and activators].

A tele-roentgenological longitudinal examination in 46 patients suffering from mandibular retrognathia analysed over a period of 2.35 years the development within the range of their facial skeleton. 24 patients had been treated by the regulator of function acc. to Fränkel, 20 patients by means of activators. Compared with the activator-treated group, the group treated by regulators of function offered an improved sagittal development of the lower jaw, an increased forward rotation of the lower jaw and a stable development of the lower region of incisors.

Activator Appliances↗

PubMed1977

Retrognathia and sleep apnea. A life-threatening condition masquerading as narcolepsy.

The association of sleep apnea with daytime hypersomnolence without obesity, and its potentially lethal cardiopulmonary sequelae, make it crucial that this condition be distinguished from narcolepsy. A patient with retrognathia who had been diagnosed as a narcoleptic for 15 years had the primary complaint of excessive daytime sleepiness. Sleep laboratory evaluation showed severe hypoxemia and a mean of 366 upper airway obstructions per night. The patient was treated with a tracheotomy; this resulted in relief of the sleep-related upper airway obstructions, hypoxemia, and hypersomnolence.

Airway Obstruction↗

PubMed2006