Maturational changes of the normal occlusion: A 40-year follow-up.

INTRODUCTION: In this study, we aimed to evaluate the changes in dental arch dimensions, tooth size, and incisor crowding in subjects with normal occlusion over a 40-year period. METHODS: A sample of 82 white subjects with normal occlusion evaluated in adolescence and early adulthood was recruited for a third evaluation in their sixth decade of life. The final sample included dental casts of 22 subjects (12 men, 10 women) obtained at mean ages of 13.3, 17.8, and 60.9 years. The following variables were measured on the digital casts: mesiodistal tooth size; clinical crown height; arch length, width, and perimeter; palatal depth; crowding; overjet; overbite; and curve of Spee. Interphase changes were evaluated using repeated measures analysis of variance, followed by Tukey tests (P <0.05). RESULTS: Increases of clinical crown height in the posterior teeth and incisor crowding were found. Decreases of mesiodistal tooth size, mandibular intercanine width, arch length, arch perimeter, overbite, and curve of Spee were observed. Palatal depth increased from 13 to 17 years of age. No changes were observed for overjet. CONCLUSIONS: Subjects with normal occlusion had changes in tooth size and alignment, overbite, and arch dimensions from adolescence to late adulthood.

Dentoskeletal changes induced by the Jasper jumper and cervical headgear appliances followed by fixed orthodontic treatment.

UNLABELLED: INTRODUCTION The objective of this controlled clinical study was to compare the dentoskeletal effects of the Jasper jumper with those of cervical headgear, when both are used with edgewise appliances to correct Class II Division 1 malocclusion. METHODS: Lateral cephalograms of 75 patients were divided into 3 groups of 25. The control group included untreated Class II children with an initial mean age of 11.82 years (range, 9.35-14.84 years); they were followed without treatment for a mean period of 1.95 years (range, 0.90-3.95 years). The Jasper jumper group had an initial mean age of 11.86 years (range, 9.45-14.94 years); they were treated for a mean period of 1.96 years (range, 0.93-3.98 years). The cervical headgear group had an initial mean age of 12.29 years (range, 9.95-15.24 years); they were treated for an average of 1.88 years (range, 0.95-3.95 years). Comparison of the initial measurements showed that the 3 groups were similar at pretreatment, thus allowing direct comparisons. Analysis of variance (ANOVA) and the Tukey test were applied for comparison of the groups. RESULTS: Different appliances yielded specific effects on several components (skeletal and dentoalveolar) evaluated. Anterior maxillary growth was significantly restricted by the cervical headgear. Mandibular growth was similar in all 3 groups, although it was slightly greater in the Jasper jumper group. The experimental groups had similar improvements in maxillomandibular relationshipd. The pattern of craniofacial growth was not significantly different between groups. The most significant effect on the maxillary dentoalveolar component was retrusion of the maxillary incisors by the cervical headgear. The effects observed for the Jasper jumper group were primarily related to the mandibular dentoalveolar component, including labial tipping and protrusion of the mandibular incisors, and mesial movement and extrusion of the mandibular molars compared with the control group. CONCLUSIONS: The headgear appliance corrected the Class II malocclusion mostly by anterior maxillary restriction and maxillary dentoalveolar effects. Correction of the Class II malocclusion with the Jasper jumper appliance was largely due to mandibular dentoalveolar effects rather than skeletal effects.

Sagittal, vertical, and transverse changes consequent to maxillary molar distalization with the pendulum appliance.

INTRODUCTION: The purpose of this study was to evaluate the skeletal and dental changes in patients who underwent distalization of their maxillary molars with pendulum appliances. METHODS: The sample consisted of 31 patients (initial mean age, 14.58 years) with Angle Class II molar relationships and all permanent teeth up to the second molars. The maxillary molars were distalized with pendulum appliances for a mean period of 5.87 months. Lateral cephalograms, 45 degrees oblique radiographs, and dental casts were obtained before and after distalization. Changes produced by the pendulum appliance were analyzed with paired t tests. RESULTS: Maxillary first molar distalization accounted for 63.5% of the space opening; mesial movement of the maxillary first premolars contributed 36.5% of the space. The mean space opening on lateral cephalograms was 7.25 mm, and the rate of molar movement was 1.23 mm per month. The mean distalization of the maxillary molars was 4.6 mm, with a mean distal crown tipping of 18.5 degrees The maxillary molars experienced expansion, with a smaller effect on the first molars than on the second molars. The pendulum appliance produced symmetrical expansion, with a rate of 1.04 mm per month on the right and 1.10 mm per month on the left. CONCLUSIONS: The pendulum appliance is effective for distalization of the maxillary molars and the establishment of a Class I molar relationship in a relatively short time. However, caution is needed to control collateral effects, including mesial movement of the first premolars and distal tipping of the molar crowns.

Treatment effects produced by Fränkel appliance in patients with class II, division 1 malocclusion.

The purpose of this investigation was to evaluate the dentoalveolar and skeletal cephalometric changes produced by the Fränkel appliance in individuals with a Class II, division 1 malocclusion. Lateral cephalograms of 44 patients of both sexes were divided in two groups of 22 each. The control group was comprised of untreated Class II children with an initial mean age of eight years and seven months who were followed without treatment for a period of 13 months. The Fränkel group had an initial mean age of nine years and was treated for a mean period of 17 months. Lateral cephalometric headfilms of each patient were obtained at the beginning and end of treatment. The Fränkel appliance produced no significant changes in maxillary growth during the evaluation period, while a statistically significant increase in mandibular length was observed. The maxillomandibular relationship improved mostly because of an increase in mandibular length. In addition, there were no statistically significant differences in the craniofacial growth direction between the Fränkel and the control group, both showing a slight downward rotation of the palatal plane. The Fränkel appliance produced a labial tipping of the lower incisors and a lingual inclination of the upper incisors as well as a significant increase in mandibular posterior dentoalveolar height. It was concluded that the main effects of the Fränkel appliance during this time period were mostly dentoalveolar with a smaller but significant skeletal mandibular effect.

Open-bite orthodontic-surgical treatment in the Klippel-Trenaunay-Weber syndrome: a case report.

We describe the orthodontic treatment of a patient with Klippel-Trenaunay-Weber syndrome (KTWS) who received orthodontic treatment that included rapid palatal expansion and orthognathic surgery. There is no report in the literature with this orthodontic treatment protocol, that was considered successful. The pros and cons of this approach as well as the risks involved are discussed.