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Richardson S, Ramakrishnan M, Banerjee P, Mobarak FA. Stepladder plating following lower subapical and genioplasty procedure in patients with bimaxillary protrusion having short chin: A technical note. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Pupulim DC, Henriques JFC, Freitas KMS, Fontes FPH, Fernandes TMF. Class ii treatment effects with fixed functional appliances: jasper jumper vs. forsus fatigue resistant device. Orthod Craniofac Res 2021; 25:134-141. [PMID: 34219381 DOI: 10.1111/ocr.12515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/28/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to compare cephalometric changes of Class II malocclusion patients treated with Jasper Jumper and Forsus, associated with fixed appliances. METHODS The sample consisted of 62 individuals divided into 3 groups: group 1 included 22 subjects with a mean initial age of 12.39 years, treated with Jasper Jumper associated with fixed appliances for a mean period of 2.43 years; group 2 included 19 subjects with a mean initial age of 12.43 years, treated with Forsus associated with fixed appliances for a mean period of 3.54 years; and group 3 included 22 Class II malocclusion untreated subjects at a mean age of 12.14 years, followed for a mean period of 1.78 years. Intergroup comparison was performed with one-way ANOVA, followed by Tukey test. RESULTS Both treated groups had similar dentoskeletal changes: restrictive effect on the maxilla; clockwise rotation of the occlusal plane; mild increase in lower anterior facial height; limitation on the vertical development of the maxillary molars; labial tipping and intrusion of the mandibular incisors; extrusion of mandibular molars; improvements of the maxillomandibular relationship, overjet, overbite, molar relationship; and retrusion of the upper lip. The mandibular incisors exhibited greater protrusion in group 1 compared to the other groups. In addition, group 2 presented mild protrusion of the lower lip, and groups 1 and 3 showed mild retrusion. CONCLUSION The Jasper Jumper and Forsus appliances were effective and showed similar changes in the treatment of Class II malocclusion.
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Affiliation(s)
- D C Pupulim
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - J F C Henriques
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - K M S Freitas
- Department of Orthodontics, Ingá University Center Uningá, Maringá, Paraná, Brazil
| | - F P H Fontes
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - T M F Fernandes
- Department of Orthodontics, University of North Parana (UNOPAR), Londrina, Paraná, Brazil
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Abdulwhab A, Ku JH, Alfawaz F, Park JH, Kook YA. Adjunctive surgery after total arch distalization to optimize esthetics. APOS TRENDS IN ORTHODONTICS 2020. [DOI: 10.25259/apos_43_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This case report presents surgically assisted orthodontic treatment for an adult patient due to labial exostosis, prominent malar, and unesthetic chin. Her treatment was total arch distalization with modified C-palatal plate for maxillary arch and miniscrews for mandibular arch. In addition, she was treated with alveoloplasty, malarplasty, and genioplasty to improve the consistency of her profile. The total treatment duration was 28 months.
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Affiliation(s)
- Ahmad Abdulwhab
- Department of Orthodontics, Catholic University of Korea, Seocho-Gu, Seoul, Korea,
| | - Ja Hyeong Ku
- Department of Orthodontics, Catholic University of Korea, Seocho-Gu, Seoul, Korea,
| | - Fawaz Alfawaz
- Department of Orthodontics, Catholic University of Korea, Seocho-Gu, Seoul, Korea,
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, A.T. Still University, Arizona, United States,
| | - Yoon-Ah Kook
- Department of Orthodontics, Catholic University of Korea, Seocho-Gu, Seoul, Korea,
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Evrard A, Tepedino M, Cattaneo PM, Cornelis MA. Which factors influence orthodontists in their decision to extract? A questionnaire survey. J Clin Exp Dent 2019; 11:e432-e438. [PMID: 31275515 PMCID: PMC6599705 DOI: 10.4317/jced.55709] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/01/2019] [Indexed: 12/03/2022] Open
Abstract
Background To evaluate the relative influence of different criteria in the choice between extraction and nonextraction treatment in current orthodontics, and to assess how the percentage of extractions has evolved over time. Material and Methods Pre-treatment records (panoramic radiograph, lateral cephalogram, study casts and photographs) of fourteen cases in permanent dentition (adult or adolescent) with class I molar relationship and moderate anterior crowding were evaluated by 28 orthodontists. For each case, each orthodontist filled out a questionnaire reporting his treatment plan proposal (extraction or nonextraction) and the importance of specific parameters in his decision-making process, using categorical scales. Orthodontists practicing for more than 15 years were also asked to compare this decision with the one they would have taken at the beginning of their professional career. Results The two most important factors in the decision-making were the soft tissue profile and the amount of crowding. The least important factor was the presence of third molars. In cases of nonextraction treatment, the lack of space was managed mostly by dental expansion and stripping. Twenty percent of the case evaluations revealed extraction(s) decisions. Among the orthodontists practicing for more than 15 years, the current extraction rate reached 24%, whereas the same orthodontists reported they would have extracted in 39% of the cases in the past. Conclusions The present study suggests that soft tissue profile has a higher impact than traditional criteria such as cephalometric measurements in the extraction decision. This is associated with a decreased extractions rate compared to the past. Key words:Orthodontics, extractions, survey, treatment planning.
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Affiliation(s)
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Paolo M Cattaneo
- Associate Professor, Section of Orthodontics, Department of Dentistry and Oral health, Aarhus University, Faculty of HEALTH, Aarhus, Denmark
| | - Marie A Cornelis
- Associate Professor, Section of Orthodontics, Department of Dentistry and Oral health, Aarhus University, Faculty of HEALTH, Aarhus, Denmark
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Jiang C, Liu Y, Cheng Q, He W, Fang S, Lan T, Wang J. Chin remodeling in a patient with bimaxillary protrusion and open bite by using mini-implants for temporary anchorage. Am J Orthod Dentofacial Orthop 2018; 153:436-444. [PMID: 29501119 DOI: 10.1016/j.ajodo.2016.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/01/2016] [Accepted: 11/01/2016] [Indexed: 02/05/2023]
Abstract
Patients with bimaxillary protrusion may have an unattractive profile with a retruded chin contour. Correction of the severely protrusive anterior alveolar bone and teeth combined with a moderate open bite without orthognathic surgery can be challenging. This case report describes the orthodontic treatment of a woman with severe bimaxillary protrusion and a moderate open bite. Excellent chin morphology and facial appearance were obtained with the extraction of 4 first premolars and 4 third molars, and total distalization of both arches with 4 mini-implants, one in each quadrant between the second premolar and the first molar. The total treatment time was 30 months.
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Affiliation(s)
- Chunmiao Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Orthodontics, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yinghong Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qian Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wei He
- Department of Orthodontics, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Shanbao Fang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Tingting Lan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jun Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Suppersberger Hamre S, Ersland GA, Daux V, Parson W, Wilkinson C. Three individuals, three stories, three burials from medieval Trondheim, Norway. PLoS One 2017; 12:e0180277. [PMID: 28671986 PMCID: PMC5495345 DOI: 10.1371/journal.pone.0180277] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/13/2017] [Indexed: 11/19/2022] Open
Abstract
This article presents the life stories of three individuals who lived in Trondheim, Norway, during the 13th century. Based on skeletal examinations, facial reconstructions, genetic analyses, and stable oxygen isotope analyses, the birthplace, mobility, ancestry, pathology, and physical appearance of these people are presented. The stories are discussed within the relevant historical context. These three people would have been ordinary citizens, without any privileges out of the ordinary, which makes them quite rare in the academic literature. Through the study of individuals one gets a unique look into the Norwegian medieval society.
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Affiliation(s)
- Stian Suppersberger Hamre
- Department of Archaeology, History, Cultural Studies and Religion, University og Bergen, Bergen, Norway
- * E-mail:
| | - Geir Atle Ersland
- Department of Archaeology, History, Cultural Studies and Religion, University og Bergen, Bergen, Norway
| | - Valérie Daux
- Laboratoire des Sciences du Climat et de l’Environnement, UMR CNRS/CEA/UVSQ/IPSL, Gif-sur-Yvette, France
| | - Walther Parson
- Institute of Legal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Caroline Wilkinson
- Face Lab, Liverpool Science Park IC1, Mount Pleasant, Liverpool, England
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Huete MI, Ibáñez O, Wilkinson C, Kahana T. Past, present, and future of craniofacial superimposition: Literature and international surveys. Leg Med (Tokyo) 2015; 17:267-78. [DOI: 10.1016/j.legalmed.2015.02.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 02/02/2015] [Accepted: 02/03/2015] [Indexed: 11/16/2022]
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Tanaka O, Fabianski ST, Karakida LM, Knop LAH, Retamoso LB. Modificações no pogônio e no nariz de acordo com o modo respiratório. Dental Press J Orthod 2011. [DOI: 10.1590/s2176-94512011000600013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUÇÃO: o perfil mole do indivíduo é resultado de mudanças complexas que ocorrem nos tecidos duros e moles das estruturas faciais. O pogônio e o nariz são estruturas dominantes na face e influenciam no grau de convexidade do perfil. Assim, é fundamental a análise das estruturas do pogônio e a inclusão das estruturas nasais no plano de tratamento ortodôntico. OBJETIVO: avaliar longitudinalmente as modificações dimensionais no plano anteroposterior do pogônio e do nariz de indivíduos com má oclusão de Classe II, divisão 1 de Angle, em dois momentos distintos do desenvolvimento craniofacial. MÉTODOS: foram realizados traçados cefalométricos sobre telerradiografias em norma lateral de 40 indivíduos, sendo 23 respiradores predominantemente nasais (RN) e 17 predominantemente bucais (RB). RESULTADOS: foram obtidas as medidas lineares e angulares LS'-Pog', LS'-B', B'-Pog', Pog'-PogTeg', Linha NB, Pog-NB, N'-Prn, Prn-NPog, N-Prn-Sn e Prn-Sn-LS. O teste ANOVA a dois critérios com medidas repetidas foi aplicado para indicar diferenças entre os valores médios dessas variáveis segundo os momentos e/ou modo respiratório. Observou-se que as variáveis LS'-B', Pog'-PogTeg', Linha NB e Pog-NB, N'-Prn, Prn-NPog, N-Prn-Sn e Prn-Sn-LS apresentaram diferença significativa (p<0,05) quando comparados os momentos final e inicial, embora não houvesse diferença significativa entre os modos respiratórios. Em nenhuma das variáveis se observou interação entre o modo respiratório e os momentos. CONCLUSÃO: há alteração estatisticamente significativa do pogônio e do nariz no plano anteroposterior no decorrer do crescimento, porém sem qualquer interferência do modo respiratório.
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Retamoso LB, Knop LAH, Guariza Filho O, Tanaka OM. Facial and dental alterations according to the breathing pattern. J Appl Oral Sci 2011; 19:175-81. [PMID: 21552720 PMCID: PMC4243757 DOI: 10.1590/s1678-77572011000200015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Accepted: 05/18/2010] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED There is controversy in the literature about possible interaction of the respiratory mode with the facial and dental structures. OBJECTIVES The aim of this study was to perform a longitudinal assessment of the changes in facial and dental structures in Angle's Class II, division 1 malocclusion individuals, divided according to the respiratory pattern (predominantly nasal or mouth), at two distinct moments of craniofacial development. MATERIAL AND METHODS Pogonium and nose measurements were made on the lateral cephalometric tracings (LS'-Pog', LS'-B', B'-Pog', Pog'-PogTeg', Line NB, Pog-NB, N'-Prn, Prn-NPog, N-Prn-Sn, Prn-Sn-LS). Dental measurements were made on the plaster models (distances between the tips of the canine cusps and the tips of mesial cusps of the first molars) of 40 individuals aged 10 to 14 years (moment 1) and 13 to 16 years (moment 2), 23 being nose breathers (NB) and 17 being predominantly mouth breathers (MB). RESULTS The Student's-t test and two-way ANOVA with repeated measures were applied to indicate differences between the mean values of these variables according to the moments and/or respiratory mode. CONCLUSIONS There were alterations in the facial measurements, without interference of the breathing pattern. However, the breathing pattern influenced dental alterations.
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Abstract
Facial reconstruction is employed in the context of forensic investigation and for creating three-dimensional portraits of people from the past, from ancient Egyptian mummies and bog bodies to digital animations of J. S. Bach. This paper considers a facial reconstruction method (commonly known as the Manchester method) associated with the depiction and identification of the deceased from skeletal remains. Issues of artistic licence and scientific rigour, in relation to soft tissue reconstruction, anatomical variation and skeletal assessment, are discussed. The need for artistic interpretation is greatest where only skeletal material is available, particularly for the morphology of the ears and mouth, and with the skin for an ageing adult. The greatest accuracy is possible when information is available from preserved soft tissue, from a portrait, or from a pathological condition or healed injury.
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Abed Y, Har-Zion G, Redlich M. Lip posture following debonding of labial appliances based on conventional profile photographs. Angle Orthod 2009; 79:235-9. [PMID: 19216600 DOI: 10.2319/030608-133.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2008] [Accepted: 04/01/2008] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess changes in lip posture following debonding of labial appliances on the basis of a new soft tissue analysis performed by computerized tools with the use of conventional nonstandardized profile photographic pictures. MATERIALS AND METHODS Profile photographs of 33 patients were taken just before and just after debonding of labial brackets. Pictures were examined twice through custom-made analysis in which Viewbox software was used. The validity of this new analysis was assessed in a preliminary study. A reference line was constructed between the center of the tragus and the outer canthus. The point where this elongated line intersected with the profile was coined nasion-modified and served as the vertex point for angles used to evaluate the prominence of the lips. The final position of the lines was determined when they were tangent to the appropriate landmarks. Analysis of variance (ANOVA) and t-tests for paired differences were used. RESULTS The reproducibility of this photoanalysis was confirmed in the preliminary study, in that no significant differences were found between measurements (P < .05). No statistically significant differences were noted in lip posture between pre-debonding and post-debonding pictures (P < .05). CONCLUSIONS In keeping with the design of this study, soft tissue profile photoanalysis showed that the presence of bonded labial appliances had no effect on lip posture.
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Affiliation(s)
- Yossi Abed
- Department of Orthodontics, Hebrew University, Jerusalem, Israel
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Erdinc AE, Nanda RS, Dandajena TC. Profile changes of patients treated with and without premolar extractions. Am J Orthod Dentofacial Orthop 2007; 132:324-31. [PMID: 17826600 DOI: 10.1016/j.ajodo.2005.08.045] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2005] [Revised: 07/29/2005] [Accepted: 08/17/2005] [Indexed: 10/22/2022]
Abstract
INTRODUCTION In this study, we evaluated and compared treatment effects and long-term soft-tissue profile changes in patients treated with extraction of 4 first premolars and with a nonextraction protocol. METHODS Cephalometric records of 98 patients were evaluated. For half (n = 49) of the patients, treatment included the extraction of 4 first premolars; the other 49 patients had no premolar extractions. The groups were evaluated before treatment (T1), at the end of treatment (T2), and at least 4 years postretention (T3). RESULTS At T1, the extraction group had more protrusive lower lips than the nonextraction group, as measured by the Z-angle. At T2, the Z-angles had improved in both groups and were not significantly different. During treatment, upper lip vermilion and superior thicknesses increased, whereas lower lip vermilion thickness decreased in both groups. Except for lower lip inferior thickness, which increased significantly in the nonextraction group, no other soft-tissue differences were significant. Significant growth of the nose occurred during from T1 to T2 in both groups, and there was a tendency for the incisors in both groups to return to pretreatment values. The nose also continued to grow during that period. CONCLUSIONS Overall, the soft-tissue facial profile measurements for both extraction and nonextraction samples were similar at T3, and there were no clinically significant correlations between hard- and soft-tissue variables at T1, T2, and T3.
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Affiliation(s)
- Aslihan Ertan Erdinc
- Department of Orthodontics, Faculty of Dentistry, University of Ege, Ege, Turkey
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Shearn BN, Woods MG. An occlusal and cephalometric analysis of lower first and second premolar extraction effects. Am J Orthod Dentofacial Orthop 2000; 117:351-61. [PMID: 10715095 DOI: 10.1016/s0889-5406(00)70240-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study was designed to examine lateral cephalometric and arch dimensional changes that occur in the mandibular arch during orthodontic treatment involving the extractions of various premolars. Pretreatment and posttreatment records of 73 patients were chosen at random from completed cases in the practice of one experienced orthodontist. Eighteen involved the extraction of lower first premolars, and 55 involved the extraction of lower second premolars. Of these 55, 29 involved the extraction of upper first premolars and 26 involved the extraction of upper second premolars. In the lower first premolar group, however, all 18 involved the extraction of upper first premolars. Males and females were evenly represented in the 3 subgroups. Pretreatment factors that suggested a basis for the extraction choice in this group of patients were found to include incisal overjet, molar relationship, and underlying vertical facial pattern. A wide variety of arch dimensional changes was found with different lower premolar extraction patterns. There was evidence, however, of more intermolar arch width reduction after the extraction of lower second premolars than lower first premolars. Orthodontic treatment with the extraction of premolars did not consistently cause a retrusive effect on the incisors. In fact, instances of proclination of the incisors occurred within all of the extraction groups. A large amount of individual variation in incisor and molar changes accompanied treatment involving all lower premolar extraction patterns.
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Affiliation(s)
- B N Shearn
- Orthodontic Unit, School of Dental Science, The University of Melbourne, Australia
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Battagel JM, Battagel NJ. Facial aesthetics following edgewise and Fränkel appliance therapy: the application of Chernoff faces. BRITISH JOURNAL OF ORTHODONTICS 1994; 21:139-49. [PMID: 8043562 DOI: 10.1179/bjo.21.2.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study investigates an application of the graphical technique of multivariate data description, 'Chernoff faces', to orthodontics. This method of pictorial presentation allows the simultaneous examination of several measurements in a single figure. Each variable is represented by a scaled feature of the human face: the size and position of the ears, eyes, eyebrows, nose, and mouth, as well as the face itself, are used to display data in a diagrammatic form. Using this method, the individual post-treatment results of 62 severe Class II division 1 cases treated by either Fränkel or Edgewise appliance therapy were compared. Nine cephalometric variables were chosen, describing the profile and the antero-posterior positions of the lower jaw and teeth, and stylized cartoon faces drawn for each child. These were compared with a control face prepared from untreated children of the same sex and age. Overall, children treated with Fränkel appliances showed a more normal relationship of the lips to Ricketts' aesthetic line and a greater prominence of the lower face. This difference between the two groups was most marked in the soft tissues. In a few cases, however, the appearance of the Edgewise treated children was indistinguishable from that of the controls. It is concluded that Chernoff faces, by portraying several pertinent aspects of data simultaneously, may be a useful adjunct to the presentation of orthodontic findings.
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Affiliation(s)
- J M Battagel
- Department of Child Dental Health, London Hospital Medical College Dental School, UK
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Tindlund RS, Rygh P. Soft-tissue profile changes during widening and protraction of the maxilla in patients with cleft lip and palate compared with normal growth and development. Cleft Palate Craniofac J 1993; 30:454-68. [PMID: 8218309 DOI: 10.1597/1545-1569_1993_030_0454_stpcdw_2.3.co_2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
During the last 15 years, cleft lip and palate (CLP) patients with maxillary deficiency in the care of the Bergen CLP team have undergone an interceptive orthopedic treatment phase during the deciduous and mixed dentition period. The present study includes 68 patients who received maxillary transverse expansion by use of a modified quad-helix appliance and 98 cases given maxillary protraction by a facial mask. All cases were treated until an acceptable normal occlusion was attained. Lateral cephalograms were taken immediately before and after the active treatment periods. Sagittal changes of the soft-tissue profile during transverse expansion and protraction were analyzed separately for unilateral complete cleft lip and palate (UCLP) patients and bilateral complete cleft lip and palate (BCLP) patients. The soft-tissue profiles of the groups were compared to growth changes of noncleft age-matched children (NORM group). During the short period of maxillary transverse expansion (mean period, 3.5 months) no significant change of the soft-tissue profile was found, except in the protrusion of the lower lip in the BCLP group. During the period of maxillary protraction (mean periods, 12 months in the UCLP group and 15 months in the BCLP group) the soft-tissue profile improved significantly by reducing the characteristic tendency towards a concave profile in CLP patients with maxillary deficiency. Significant increases of the sagittal maxillomandibular lip relation (angle SS-N-SM: mean increase, 2.5 degrees) and the Holdaway-angle (H-angle: mean increase, 3.0 degrees) were found to be similar in the UCLP and BCLP groups. However, the use of different reference lines for evaluation of treatment effects upon the soft-tissue profile resulted in conflicting findings suggesting that anteriorly situated reference lines are more suitable for the evaluation of CLP patients. Thus, the esthetic line (E.line) indicated a favorable position of the lips after treatment; the subspinale-pogonion line (ss.pg) revealed an improved soft-tissue profile; the soft-tissue-facial line (N.PG) showed a retruded nose and upper lip; whereas basal references such as the nasionsella line (NSL) and the occlusal-line perpendicular (OLP) mainly showed major differences between the CLP groups and the NORM groups.
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Affiliation(s)
- R S Tindlund
- Department of Orthodontics and Facial Orthopedics, University of Bergen, Norway
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Young TM, Smith RJ. Effects of orthodontics on the facial profile: a comparison of changes during nonextraction and four premolar extraction treatment. Am J Orthod Dentofacial Orthop 1993; 103:452-8. [PMID: 8480714 DOI: 10.1016/s0889-5406(05)81796-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Cephalometric radiographs were used to examine soft tissue profiles of 198 orthodontic patients treated with full fixed appliances without extraction of any permanent teeth. Records were selected at random from five sources: cases treated by a Tweed Foundation instructor using the Tweed technique, patients treated with the Begg appliance, patients treated in one of two different practices with pretorqued, preangulated edgewise appliances, and patients treated in two stages with a functional appliance followed by full fixed edgewise appliances. The criteria for selection of cases and the methods of data collection were designed to allow comparisons with data collected by Drobocky and Smith on patients treated with extraction of four first premolars. Although the mean value of soft tissue changes were smaller in the nonextraction patients, the variability of these changes were generally as great as in the four premolar extraction cases. In addition, the percentage of undesirable facial changes was similar in the extraction and nonextraction samples. The results provide additional evidence that it is simplistic and incorrect to blame undesirable facial esthetics after orthodontic treatment on the extraction of premolars.
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Affiliation(s)
- T M Young
- Department of Orthodontics, Washington University School of Dental Medicine
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Abstract
The aim of this study was to determine whether sagittal and vertical aberrations in intermaxillary incisal tooth and jaw relationships were reflected in facial morphology. One hundred seventy-two children (79 girls and 93 boys), 12 to 14 years of age, were selected from the Orthodontic Department, University of Giessen. Pretreatment profile and frontal facial photographs as well as profile roentgenograms in centric occlusion for each child were made. The method consisted of (1) a personal appraisal of the existing incisal tooth and jaw relationship by visual inspection of facial photographs, (2) a validity assessment of these personal appraisals, and (3) a comparison of linear and angular measurements made from facial photographs and from lateral headfilms. The result of this investigation revealed that a large overjet and a Class II, Division 2 incisal tooth relationship were most often reflected in the face. A Class III incisal tooth relationship and an open bite, however, were difficult to detect. Sagittal maxillary and mandibular positions could only occasionally be determined on the basis of facial appearance, while a Class II jaw base relationship (large ANB angle) could easily be seen. The vertical jaw relationship (mandibular plane angle and anterior facial height index) could be determined with relatively high precision. When the measurements from the facial photographs were compared with those from the lateral headfilms, moderate to high correlations were found between skeletal and soft tissue readings: ANB angle (r = +0.63), mandibular plane angle (r = +0.93), and anterior facial height index (r = +0.86). It was concluded that sagittal and vertical dental and skeletal intermaxillary malrelationships were only partly reflected in the face.
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Affiliation(s)
- C Bittner
- Department of Orthodontics, University of Giessen, West Germany
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19
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Denis KL, Speidel TM. Comparison of three methods of profile change prediction in the adult orthodontic patient. Am J Orthod Dentofacial Orthop 1987; 92:396-402. [PMID: 3479007 DOI: 10.1016/0889-5406(87)90260-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Potential changes in the contour of the facial profile that accompany tooth movement can be important considerations in developing an orthodontic treatment plan. The objective of this study was to compare the accuracy of three different methods of predicting horizontal soft-tissue changes. Eighty-three nongrowing, orthodontically treated patients comprised the sample. Pretreatment and posttreatment lateral cephalometric hard- and soft-tissue landmark points were digitized. A coordinate system was defined, landmark coordinates were corrected for magnification, and then hard- and soft-tissue, angular, and linear measures were calculated by computer programs developed on a DEC PDP 11/44. The accuracy of prediction of soft-tissue landmark changes was compared for three prediction methods: (1) use of ratios of means of soft-tissue changes to corresponding hard-tissue changes, (2) use of a bivariate regression equation on corresponding hard-tissue landmark changes, and (3) use of stepwise multiple regression with hard-tissue changes and initial hard- and soft-tissue facial characteristics as predictor variables. For predicting changes of four soft-tissue points, multiple regression equations were slightly more accurate than ratio of means predictions. The standard errors of the estimate ranged from 0.7 to 1.1 mm for the multiple regression predictions; these were from 0.2 to 1.4 mm lower than those obtained for ratio of means predictions. The accuracy of the bivariate regression prediction technique fell between that of the other two methods. Examination of the residuals showed that the multiple regression equations consistently underpredicted the most extreme soft-tissue facial changes.
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Affiliation(s)
- K L Denis
- Department of Orthodontics, University of Minnesota, Minneapolis
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20
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Falck F, Köbel EM. [Changes in the soft tissue profile in treatment with function regulators]. FORTSCHRITTE DER KIEFERORTHOPADIE 1985; 46:407-15. [PMID: 3864726 DOI: 10.1007/bf02167687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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21
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Speth L, Sergl HG, Fuhr K. [Incisor position and soft tissue profile--an experimental study]. FORTSCHRITTE DER KIEFERORTHOPADIE 1984; 45:360-72. [PMID: 6594307 DOI: 10.1007/bf02371741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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22
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Edwards JG. Orthopedic effects with "conventional" fixed orthodontic appliances: a preliminary report. AMERICAN JOURNAL OF ORTHODONTICS 1983; 84:275-91. [PMID: 6578680 DOI: 10.1016/s0002-9416(83)90345-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This retrospective study involved sixty previously treated patients between the ages of 9 and 14 years, all of whom initially had Class II dental malocclusions. The primary purpose of the investigation was to determine whether orthodontic treatment with a specific round-wire edgewise technique (no extraoral forces) was simply producing dentoalveolar manipulations or was actually affecting measurable skeletal or orthopedic alterations in the craniofacial system. The mean linear changes before and after orthodontic treatment in the maxilla (Ar-ANS), mandible (Ar-PGN), and lower facial height (ANS-MN) were statistically compared with an untreated control group (the Burlington Growth Study). The study sample was analyzed selectively according to sex and also according to the angulation of the mandibular base to the anterior cranial base (the SNMP angle). Apparently, from the observations in this study, the particular edgewise technique employed for the orthodontic treatment of the sixty sample patients did statistically affect more than merely dentoalveolar alterations. The normal forward growth of the maxilla appeared to be hindered, the lower facial height was significantly increased (usually without an appreciable increase in the SNMP angle), and the mean increased growth of the mandible was also statistically significant. Admittedly not its primary purpose, this preliminary report appeared to at least indirectly compare, if not the actual treatment modalities, at least the treatment results between a specific fixed orthodontic appliance and certain removable "functional" appliances.
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