There remains a discord among orthodontists regarding the usefulness of a lateral cephalogram radiograph as a part of diagnostic records for treatment planning. Today, orthodontists take diagnostic lateral cephalograms largely based on a personal preference, rather than following any evidence-based approached for determining whether taking the radiograph will affect treatment planning. The aim of this study is to identify patients with the type of malocclusion for which the availability of a lateral cephalogram radiograph will affect the treatment plan. This would prevent patients, whose treatment plan would not benefit from a diagnostic lateral cephalogram, from receiving unnecessary ionizing radiation. The data for this study was obtained from responses to two questionnaires, mailed five weeks apart, to ten orthodontists with clinical experience. Primarily, the orthodontists were required to treatment plan twenty cases, twice, once with full diagnostic records including a lateral cephalogram radiograph and once without. Six orthodontists completed both questionnaires. Based on the data, it was found that for approximately 25% of patients having a lateral cephalogram radiograph does affect treatment planning. These patients present with bilateral, sagittal dental malocclusions, matching significant soft-tissue profile disharmony and at least one arch with a moderate arch length discrepancy. A larger, follow-up study is suggested to further investigate the relationship between malocclusion, lateral cephalogram radiographs, and treatment planning. / Oral Biology

Introduction: Controversy exists over the value of a lateral cephalogram for treatment planning in different malocclusion types. Discord has been found in the literature, and no studies on the matter have focused solely on Class I dental malocclusions. The aim of this study was to elucidate whether treatment decisions of extraction or non-extraction and the perceived need for a lateral cephalogram would change depending on whether a lateral cephalogram was provided or eliminated in the patient record set. Methods: A survey was distributed to a random sample of AAO members. The survey consisted of four different patient record sets, each with a Class I dental malocclusion. Each record set had two versions—one with the lateral cephalogram and one without. The survey had randomization of each version of the record sets so that each record set would be viewed an equal number of times with and without its corresponding cephalogram. Subjects were then asked a series of four questions pertaining to each case: was a cephalogram necessary for treatment planning, treatment of extraction versus non-extraction, retention method, and if records were adequate to treatment plan. Results: In total, 79 orthodontists completed the survey. For all cases combined, record sets viewed with the lateral cephalogram had an increase in the: perceived need for a lateral cephalogram, decision of extraction, and opinion of the records being adequate to treatment plan. All were statistically significant at P ≤ 0.001. For each record set, the difference in perceived need for a lateral cephalogram was statically significant. Conclusions: The use of a lateral cephalogram for diagnosing and treatment planning seems to hold value in Class I dental malocclusions, justifying radiation exposure for this diagnostic record. Additionally, the perceived need for a lateral cephalogram is greater when it is presented with the record sets, demonstrating the diagnostic value this radiograph holds. / Oral Biology

Introduction: The Modified Mallampati Tongue Score (MMT) is commonly used in anesthesiology for the pre-anesthetic assessment of the airway in patients. This score roughly estimates the size and position of the tongue relative to the oral cavity, with higher scores associated with difficult intubation and increased incidence of breathing interferences, such as obstructive sleep apnea. The distance from the tongue base to roof of the mouth decreases from MMT-I to MMT-IV. The tongue shape and position impact the airway patency in the hypopharynx, contributing to changes in craniofacial head posture followed by changes in craniofacial morphology. This present study examines the pattern of associations between the Modified Mallampati Tongue Score positions and 1) the postural relationship of the cranium, hyoid bone, cervical column, and tongue 2) size, shape, and position of the craniofacial components, as depicted in a lateral cephalogram. Methods: This retrospective study was performed on 200 subjects (145 female, 55 male) prior to starting orthodontic treatment. MMT was assessed from one photograph of maximum mouth opening and tongue protrusion. Pretreatment cephalograms were analyzed to evaluate craniocervical posture, resting tongue position, hyoid bone position, or sagittal and vertical skeletal relationships. MMT (I-IV) was also compared to basic demographics (age, gender, race/ethnicity). One-way ANOVA, Chi-square test, and correlation analysis were used for statistical analysis. Probability values <0.05 were accepted as significant. Results: A total of 200 patients (72.5% Female, 27.5% Male, 54% African American), with a mean age of 20 (Range 7-73), were included for the study. MMT-III was most prevalent (34%). MMT was not associated with age, gender, or race/ethnicity. Mean cephalometric measurements of hyoid position (p=0.06-0.03), mandibular position (p=0.006), ANB (p=0.009), and SNB (p=0.023, were shown to have significant differences with MMT. MMT positively correlated with the ANB (p=0.001), Wits (p=0.016), vertical position of the hyoid bone to neck (p=0.004) and mandible (p=0.048); and inversely correlated with the SNB (p=0.003) and Pog:Na-Perp (p=0.045). Conclusion: A higher MMT correlates to a Class II skeletal morphology and extended craniofacial posture. Preliminary results suggest high tongue position influences Class II craniofacial morphology, enhancing maxillary prognathic growth and mandibular deficiency. This indicates that MMT can be a potential predictor of craniofacial growth patterns, strengthening the prognosis and long-term stability of orthodontic treatment. / Oral Biology

No description available.

Ziel dieser retrospektiven Studie war die Untersuchung verschiedener Wachstumsvorgänge im Ober- und Unterkiefer jugendlicher Patienten, speziell die der retromolaren Räume, am Fernröntgenseitenbild. Für diese Studie wurden insgesamt 305 Fernröntgenseitenbilder der Polikliniken für Kieferorthopädie der Universitätskliniken Leipzig und Dresden mittels der Software OnyxCeph³™ von Image Instruments ausgewertet. Mit dieser Studie konnte gezeigt werden, dass die retromolaren Räume im Alter von 9 – 16 Jahren durchschnittlich annähernd linear und bei beiden Geschlechtern in gleichem Maße zunehmen. Für den mandibulären retromolaren Raum wurde anhand der gewonnenen Durchschnittswerte die vereinfachte Formel Lebensalter + 12 in mm entwickelt. Damit ist eine Einschätzung des retromolaren Platzangebots anhand des Alters möglich. Fast alle vermessenen Strecken korrelieren signifikant mit dem chronologischen Alter, die höchste Korrelation besteht dabei für den retromolaren Raum des Unterkiefers. Neben bereits in anderen Studien zum Zwecke der Altersdiagnostik untersuchten Strecken, wie der Unterkieferlänge, kann zukünftig auch der retromolare Raum zur Altersschätzung anhand des Fernröntgenseitenbildes herangezogen werden. Verschiedene Autoren empfehlen zur Altersschätzung eine Kombination mehrerer Parameter. Mit drei in dieser Studie bestimmten Parametern konnte für beide Geschlechter eine Formel zur Altersschätzung aufgestellt werden. Der Standardschätzfehler beträgt jeweils 1,05 Jahre (Jungen) bzw. 1,28 Jahre (Mädchen).

Aim:To investigate the differences, if any, between tooth-anchored maxillary expansion (TME) and bone-anchored maxillary expansion (BME) in terms of the produced longitudinal dentoskeletal changes -and the stability of these changes- in adolescents with maxillary constriction. Methods:Sixty two suitable subjects were randomly assigned to one of three groups: (1) TME group; (2) BME group; (3) Control group. Lateral cephalograms, posteroanterior cephalograms, and dental casts were obtained at baseline and at three post-expansion time points. Records from all time points were analyzed. Results:There were no clinically significant differences between the TME and BME groups at any data collection time point. Both showed initial increases in dentoskeletal widths and dental tipping which were subsequently largely lost to relapse in the absence of retention. Conclusion:There are no clinically significant differences in the dentoskeletal changes -or the stability of these changes- produced by TME and BME in adolescents with maxillary constriction.

No description available.

Made available in DSpace on 2016-08-03T16:31:01Z (GMT). No. of bitstreams: 1 Geraldo Marchiori.pdf: 2085554 bytes, checksum: 64f4cf5b53c27500df06108f0655da54 (MD5) Previous issue date: 2012-10-04 / The present study consisted of evaluating dental, skeletal and tegumentary changes promoted by fixed orthodontic treatment with two-step retraction anterior, by means of lateral cephalograms. To this end, we selected 14 patients who required extraction of four premolars, all with Class I malocclusion. The anterior retraction was performed by the retraction of canine (prior to incisors bonding) and of incisors. Twelve patients did not use any device for anchoring. Lateral cephalograms were examined at the beginning and end of canine retraction and by the end of the fixed orthodontic treatment. Cephalograms were scanned to obtain cephalometric measurements using the software Radiocef® (RadiomemoryR- Belo Horizonte, Brazil). Data were submitted to analysis of variance and Tukey s test (p<0.05). Results indicated few skeletal changes, except for a slight retraction of the point A, and increase in mandibular length, in lower-anterior and total facial height, and slight mandibularcounterclockwiserotation due to the craniofacial growth. After canine retraction, there was a lingual inclination and retrusion of upper and lower incisors, which remained stable to the upper incisors at the end of the treatment. In the same period,the lower incisors retruded with a slope similar to the initial. Besides that, no significant loss of anchoring was detected. These dental changes resulted in retrusion of upper and lower lips after canine retraction, and the lower lip continued to retract by the end of the treatment. In conclusion, the treatment using two-step retraction anterior did not lead to a significant loss of anchoring, and reduced the facial convexity. / O objetivo do presente estudo consistiu em avaliar as alterações dentoesqueléticas e tegumentares promovidas pelo tratamento ortodôntico fixo com a retração anterior em duas fases, por meio de telerradiografias em norma lateral. Foram selecionados 14 pacientes com idade média de 14,6 anos que necessitavam de extrações dos quatro primeiros pré-molares, todos apresentando má oclusão de Classe I. A retração anterior foi realizada inicialmente pela retração dos caninos (previamente à colagem dos incisivos) e subsequentemente, pelos incisivos. Doze pacientes não utilizaram qualquer dispositivo para ancoragem e dois pacientes utilizaram como ancoragem o Arco Extra-Bucal (AEB) de uso noturno. Foram avaliadas as telerradiografias em norma lateral ao início, final da retração dos caninos e final de tratamento ortodôntico fixo. As telerradiografias foram escaneadas e mensuradas por meio do programa Radiocef® (RadiomemoryR- Belo Horizonte, Brasil). Os dados foram submetidos à Análise de Variância e teste de Tukey (p<0,05). Os resultados demonstraram poucas alterações esqueléticas, exceto por uma retrusão suave do ponto A e aumento do comprimento mandibular, da altura facial ântero-inferior e total e rotação suave anti-horária mandibular devido ao crescimento craniofacial. Após a retração dos caninos, houve uma inclinação para lingual e retrusão dos incisivos superiores e inferiores, que permaneceram estáveis para os incisivos superiores no período final de tratamento. Já os incisivos inferiores neste mesmo período, retruíram mais com uma inclinação semelhante àquela inicial. Além disso, não houve perda de ancoragem de forma estatisticamente significante. Estas alterações dentárias refletiram em retrusão dos lábios superior e inferior após a retração dos caninos, sendo que o lábio inferior continuou a retrair no período final de tratamento. Conclui-se que o tratamento com a retração em duas fases não representou perda de ancoragem estatisticamente significante, além de diminuir a convexidade facial.