Mandibular excursions and maximum bite forces in patients with temporomandibular joint disorders.

PURPOSE: This study evaluated mandibular motion and bite force in patients with temporomandibular joint disorders after joint surgery. PATIENTS AND METHODS: Maximum voluntary mandibular motion, maximum excursion during mastication, and maximum bite force were examined in 25 female patients before temporomandibular joint surgery. Their pretreatment performance was compared with that at 6 weeks, 6 months, and 1 year after surgery, and with performance of 26 normal female volunteers. RESULTS: Before surgery, all of the patients' movements and bite forces were smaller than those of controls. One year after surgery, maximum interincisal opening increased significantly, but lateral excursion and protrusion remained unchanged. Maximum bite forces increased significantly and nearly reached control levels. CONCLUSIONS: Patients with severe restriction in temporomandibular joint function exhibit general improvements in some mandibular movements and in maximum bite force after surgical treatment.

Cephalometric analysis of profile nasal esthetics. Part III. Postoperative changes after isolated superior repositioning.

In part I of this study, a method for the objective evaluation of profile nasal esthetics was presented and applied to establish normative values for young adult white males and females. Male and female nasal profile esthetics were found to be virtually identical. In part II, the data from the preoperative lateral cephalograms of 13 young adult white female patients with vertical maxillary excess (VME) were compared to the normative data established for females in part I. Results showed a distinct nasal profile in patients with VME. In this part of the study, the postoperative lateral cephalograms of the 13 female patients from part II were analyzed after surgical correction of their vertical maxillary dysplasia to determine if returning the maxilla to a more normal position effected similar changes in nasal profile esthetics. All patients had superior repositioning of the maxilla for which the magnitude of movement was greatest in the superior direction, with the mean movement being 2.3 mm superiorly. The results revealed that surgical correction of VME effected normalization of most of the nasal profile esthetic characteristics.

Cephalometric analysis of profile nasal esthetics. Part II. Patients with vertical maxillary excess.

In part I of this study, a method for the objective evaluation of profile nasal esthetics was detailed, and normative values for males and females were presented. In part II, identical methodology was applied to the preoperative lateral cephalograms of 13 female patients with vertical maxillary excess to determine how the nasal profile esthetics of these patients varies from the norm. This data was compared to the normative data established for females in part I. Results determined that patients with vertical maxillary excess have increased nasal length caused by a more superiorly positioned soft tissue nasion, decreased thickness of soft tissue at rhinion, increased nasal form angle, and increased absolute nasal tip angle related to an increased inclination of the cranial base, increased forward projection of the anterior nasal spine (tip support), and decreased incidence of supratip break. These findings suggest a characteristic appearance similar to the type II nasal characteristic (aquiline form) established in part I.