International journal of orthodontics最新文献

This article introduces a new appliance for the orthopedic correction of craniofacial disorders. The development of a remoldable craniomandibular (RCM) appliance is the result of four years of clinical research. The remoldable craniomandibular appliance is designed as an inexpensive and time efficient method of arriving at a differential diagnosis for some patients with temporomandibular joint related headache. In addition, clinical observation indicates that it may be helpful in treatment for patients suffering from internal derangement of the temporomandibular joint. Although no specific claims for the appliance are being made at this time, research studies currently designed and implemented may be able to confirm the potential for this appliance. Independent studies are encouraged.

Fixed orthodontic appliances increase the number of retention areas, resulting in increased possibilities for the accumulation of dental plaque. In addition, there is a risk of direct mechanical irritation. In spite of good toothcleaning most orthodontic patients develop generalized moderate gingivitis or an edematous type within one to two months after the placement of the fixed orthodontic appliances. Since the gingival changes represent a reaction to the bacterial plaque products rather than to the orthodontic forces; the only way to control them is by effective oral hygiene. Braces and banded teeth have many tiny recesses that a toothbrush and other cleaning aids have difficulty reaching. For good oral hygiene, these should be kept free of food debris. Water irrigating devices irrigates these hard-to-clean areas to remove food and other debris. Pulsating jets of water very gently lift the free gingiva to rinse out crevices. The water irrigator also pulses into areas between teeth and gums to flush out trapped food and debris. Water irrigating devices cannot by any means be regarded as substitutes for more effective plaque-removing methods, such as tooth-brushing and flossing; rather, they should be considered as an adjunct to the total oral hygiene program.

Anthropologists have shown that the external covering made up of integument, adipose tissue, connective tissue, and muscle does not always distribute itself in a uniform, orderly manner. There are great variations in the amount and distribution of these soft-tissue elements. Therefore, a facial profile analysis that is limited to measurements on the hard skeletal structure would not appear to conform to the standards of accuracy if an assessment of the soft-tissue profile were required. The purpose of this investigation is to provide an understanding of the changes which occur in the soft-tissue profile during the orthodontic treatment concurrent with normal growth and development. At the present time, it is not possible to devise a set rule for differentiating a desireable from an undesireable soft-tissue facial profile. However, this should not prohibit the presentation of some reference material as an aid in the diagnosis and practice of orthodontics. In many instances evaluations of facial esthetics seem to be singularly influenced by the orthodontist's concept of a pleasing face. At present, the accomplishment of soft-tissue profile changes by dental movement is limited so it is very important to rely on proper timing of the orthodontic treatment through the pubertal growth period to achieve optimal profile changes.

The efficiency of Angle class II correction using functional orthopedic appliances is well accepted in the literature. However, there are controversial views as to whether dentoalveolar processes, growth alteration or jaw displacement predominates. This study was therefore designed to clarify the mode of action in class II treatment using Bimler's "GebiBformer". Cephalometric radiographs taken in 146 patients before and after treatment were analysed (mean age at beginning of treatment: 9.2 years). In these patients, Angle class II of one premolar width was successfully corrected during a mean 4.2 years of treatment. Matching data of 100 patients, who had undergone functional jaw orthopaedics because of class I malocclusion served as comparison group. According to cranio-facial growth type, the patients were subdivided in to three subgroups. Statistical analyses were performed using the t-test. The results indicate, that point A develops posteriorly relative to the nasion in the class II group and anteriorly in the class I group. The length of the maxilla develops equally in the groups compared. The sagittal discrepancy between upper and lower jaw deminishes significantly in treated class II patients. The B point comes only slightly more anteriorly in the class II group than in the control group. Shape and length of the mandible showes similar development in the two groups. In correcting class II with the "GebiBformer", changes in the craniofacial pattern take place. However, class II correction cannot be attributable to skeletal changes alone. It can only be explained by additional dentoalveolar changes.

The orthodontic profession has assumed much of the responsibility for the improvement in function of the teeth and jaws. Since function is closely associated with overbite, the correction of vertical overbite discrepancies comprises a major part of clinical orthodontics. This investigation was undertaken to describe the movements that teeth undergo during the correction of excessive overbites and to correlate these movements to the change in overbite. A total of 87 cases were selected from the records of the Indiana University School of Dentistry, Department of Orthodontics. The selected cases had an excessive pre-treatment overbite of 4.0 mm or more as seen cephalometrically and a satisfactory post-treatment result. In addition, they were clinically determined to be post-pubertal, indicating essentially no growth potential during the treatment period. Pre and post-treatment tracings of the cephalograms were made and measurements collected from the tracings. Superimpositions were prepared of the pre and post-treatment radiographs and the general trends that appeared were noted. The change in overbite was correlated to tooth movements of the Class II Division 1 correction using the Pearson test of correlation coefficients. The results indicate that the tooth movements most commonly seen in treatment to reduce excessive overbite occur mainly in the mandibular arch. In Class II Division 1 cases, the change was significantly correlated to the reduction in vertical height of the mandibular incisor and to the increase in the angulation of the mandibular incisor to the mandibular plane. Not all measurements recorded were significantly correlated to the change in overbite.(ABSTRACT TRUNCATED AT 250 WORDS)

Orthognathic surgical corrections of deformities and defects are performed to establish normal functional relationships between osseous, muscular, and contiguous structures. At times, aesthetics will be improved, but this psychosocial improvement is an additional benefit as long as correction of the functional aspects of the skeletal deformity constitutes the criteria for surgical intervention.