A postero-anterior cephalometric evaluation of adult open bite subjects as related to normals.

Reduced nasal airflow can be the result of enlarged adenoids, hypertrophic turbinates, severely deviated nasal septum, or even narrow nasal cavities. The question of whether the width of the nasal cavity may influence certain facial dimensions examined on the postero-anterior cephalometric X-ray was evaluated through the study of two different groups of subjects. Possible intercorrelations between some other frontal dimensions were also examined in these subjects. The first group consisted of 15 males and 22 females aged from 17 to 25 years diagnosed as having an anterior open bite of at least 2 mm. The second group consisted of 20 males and 16 females aged from 19 to 25 years with a normal Class I skeletal and dental pattern. Postero-anterior cephalometric X-rays were taken for all individuals and the following dimensions were measured: facial width, nasal width, maxillary width, mandibular width, nasal height, and lower facial height. Statistical analysis was performed for the primary linear measurements as well as for certain ratios. Nasal height and lower facial height were found to be significantly increased in both males and females of the open bite group. The ratios of nasal width to lower face height, as well as nasal width to nasal height, were found to differ significantly only between open bite and normal females, being higher in the latter group.     

Frontal cephalometric study of dentofacial morphology in children with bilateral clefts of lip, alveolus and palate

The transverse dentofacial morphology of 36 children with bilateral cleft lip, alveolus and palate was studied by means of a frontal proportional cephalometric analysis at the ages of three, eight and twelve years. Comparison of the variables of the cleft group was made with the normal dimensions as obtained from the Bolton cephalometric templates. The results indicated that the BCLP group presented characteristics and significant differences from the normal in the dimensions of the nasal septum width and the mandibular intergonial width as they are both related to the interorbital width, the maxillary intermolar width as it is related to the mandibular intermolar width and the maxillary width as it is related to the mandibular intergonial width at all three ages. The maxillary base and intermolar widths, although significantly different at the ages of three and eight years, showed no significant deviation from normality at the age of twelve years. Following orthodontic treatment between the ages of seven to twelve years, the maxillary intermolar width of the treated subgroup was significantly larger than in the untreated subjects.     

Okklusion,Kiefergelenke und kieferorthopädische Behandlung

Zusammenfassung Für die Okklusion und den Gelenkbereich sind Zuordnungsnormen existent. Dies ist im Seitenzahnbereich die Höcker-Fossa-Relation, im Frontzahnbereich die Zuordnung der Unterkiefer-Inzisalkanten zu der Nullpunktlinie der palatinalen Konkavitäten im Oberkiefer und im Gelenkbereich die physiologische Kondylenposition. Letztere läßt sich im Pantogramm durch den Wendepunkt der von der Achse bei sagittaler Grenzführung gezeichneten Kurve präzisieren, in Übertragung aber auch im Röntgenbild ermitteln.Ziel der kieferorthopädischen Behandlung sollte die physiologische Zuordnung von Seitenzähnen, Frontzähnen und Gelenken sein. Das vorgestellte Funktionsmodell gibt Hilfestellungen bei der Behandlung auf ein funktionelles Optimum hin.Die Gelenke sind bei der Behandlung wie ein eigenes terminales Okklusionspaar zu betrachten. Ihre korrekte Einstellung läßt sich bisher nur durch Röntgenbilder und durch die pantographische Aufzeichnung darstellen.

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Summary We are convinced that there is a relation between the occlusion and the temporomandibular joint. In the molar region the correlation is known as the cusp-fossa relationship. In the incisor region the corresponding structures are the mandibular incisor tips and the palatal concavities of the upper incisors. We have designated the correlation in the TMJ-region as the physiological condyle position, which can be identified in the sagittal pantogram by the turning point of the traced sigmoid curve. Similarly this position can be shown by our method on the TMJ-radiograph.The aim of orthodontic treatment should be a physiological positioning of molars, incisors and joints. The functional model presented above can render assistance in achieving a functional optimum in treatment.The temporomandibular joints must be regarded in treatment as additional occluding points. Up to now their correct positioning has been visible only through the use of TMJ-radiographs and pantographic tracings.

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Résumé Il existe des normes structurelles correspondantes entre l'occlusion et l'articulation temporomandibulaire; à savoir dans les zones latérales d'arcades la relation cuspide-sillon, dans le segment antérieur l'arête des incisives inférieures glissant le long des faces palatines des incisives supérieures jusqu'à la ligne d'arrêt et au niveau de l'articulation la position physiologique du condyle. Cette corrélation s'établit dans le plan sagittal du pantogramme par l'existence d'un point tournant du tracé sigmoïde; on peut transposer cette position dans l'image radiographique.Le but d'un traitement orthodontique est de coordonner physiologiquement les segments latéraux et antérieur d'arcades et l'articulation temporo-mandibulaire. Des moulages fonctionnels préétablis nous aident à obtenir la meilleure fonction au cours du traitement.On doit considérer la double articulation temporo-mandibulaire comme une occlusion finale. Seuls la radiologie et les tracés pantographiques permettent de juger de la position correcte des condyles dans leurs fosses glénoïdes.

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In memoriam Herrn Prof. Dr.G. Müller von seinen ehemaligen Schülern und Mitarbeitern.     

Healing of onlay mandibular bone grafts covered with collagen membrane or bovine bone substitutes: a microscopical and immunohistochemical study in the sheep

The objective of this study was to evaluate the role of collagen membrane and Bio-Oss coverage in healing of an onlay graft to the mandible. Twelve adult sheep each received an onlay bone graft (experiment 1), bone graft+Bio-Gide (experiment 2), and bone graft+Bio-Oss/Bio-Gide (experiment 3) on the lateral surface of the mandible. The animals were euthanized at 4, 8, 12 or 16 weeks after surgery, and findings were analysed by routine microscopy and immunohistochemistry for proliferation (Ki67) and apoptotic (Caspase-3) markers. Grafts were fully incorporated in all specimens. Pronounced resorption was observed in experiment 1. Minimal loss of graft volume was seen in experiment 2 specimens without membrane displacement. A remarkable increase in the augmented region of the mandible was observed in experiment 3. A high number of osteoclasts were expressed within the grafts during the early healing period, and thereafter declined markedly. Osteoblasts within the grafts expressed a moderate level of Ki67 at 8 weeks, which thereafter declined markedly. The strongest expression of Caspase-3 on the bone surface was observed after 16 weeks. In conclusion, the effect of collagen membrane coverage on bone graft volume maintenance was dependent on membrane stability during healing. An autogenous bone graft covered with Bio-Oss particles resulted in a remarkable increase in augmented lateral surface of the mandible. The late stage of bone graft healing was associated with a high apoptotic induction pathway of osteoblasts lining the surfaces of the new bone, demonstrated by strong positive Caspase-3 immunoreactivity.     

Surgical correction of pseudoankylosis and microgenia: report of case.

The coronoid process was fused to the zygomatic buttress and posterior aspect of the maxilla, resulting in a restricted mandibular opening. In addition to the functional limitation, the patient also had a skeletal deformity of microgenia. A coronoidectomy released the extracapsular ankylosis and restored normal mandibular function, and an augmentation genioplasty corrected a contour deficient chin.     

Retention of dowels subjected to tensile and torsional forces.

This investigation measured the maximal tensile and torsional forces sustained by four different designs of dowels. 1. Under tensile force, the threaded screw-in dowels were significantly more retentive than the unthreaded dowels. 2. Under torque, both the threaded screw-in and serrated dowels were significantly more retentive than the smooth-sided dowels.     

Disodium clodronate in the treatment of diffuse sclerosing osteomyelitis (DSO) of the mandible

Diffuse sclerosing osteomyelitis (DSO) of the mandible is a chronic condition, the cause of which is not known. Jaw pain, occurring irregularly, is a typical symptom. The aim of the study was to assess the effectiveness of disodium clodronate for relieving pain in patients with DSO. Disodium clodronate is a bisphosphonate used to treat diseases of bone and calcium metabolism. Ten DSO patients experiencing pain received disodium clodronate or placebo intravenously on a randomized double-blind basis. Both minimum (300 mg) and maximum (900 mg) doses were well tolerated. Disodium clodronate administration did not result in better immediate pain relief than placebo administration. However, 6 months after treatment there was a statistically significant difference in pain intensity between the groups, with the disodium clodronate group experiencing significantly less pain.     

Predictability of treatment outcome in patients with myofascial pain-dysfunction (MPD) syndrome.

Responses to the Minnesota Multiphasic Personality Inventory (MMPI) were used to develop a 29-item scale designed to predict the treatment outcome of 135 patients with Myofascial Pain-Dysfunction (MPD) Syndrome. The results suggested that a single scale to predict treatment outcome would be ineffective due to the absence of consistent personality differences in MPD patients.