Objective: This case report describes orthodontic treatment of contracted mandibular arch using a trombone appliance. Methods: A 14-year-old girl with Class II division 2 malocclusion, retroclined maxillary incisors, and buccally displaced maxillary canines required dental expansion in 3 spatial directions to correct the contracted maxillary and mandibular arches. In the initial phase of treatment, the maxillary arch was expanded and distalized using a quad-helix appliance and cervical headgear. Following the expansion and leveling of the maxillary arch, a trombone appliance was used to expand the mandibular arch. On correction of the mandibular arch and provision of sufficient space to level the mandibular teeth, fixed orthodontic treatment phase was initiated. Results: A trombone appliance proved effective in correcting the contracted mandibular arch. Because of labiolingual and transversal expansion, the mandibular dental arch perimeter was increased by 7.4 mm; the misalignment of the mandibular teeth was corrected successfully. Conclusions: A trombone appliance may serve as an appropriate clinical alternative for treating moderate mandibular arch crowding caused by the contraction of the dental arch.
Purpose: This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. Materials and Methods: A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. Results: The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. Conclusion: The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females.
Developmental changes of dental arch width and length from 6.6 to 13.6 yews of age have been studied in twenty boys and thirteen girls in Korean school children. A series of 8 dental casts obtained from each child was measured in the intercanine width, intermolar width and arch length. Afterwards, mean value and each standard deviation of each age group and each gender were obtained, and corresponding graphs were drawn. The finding of this study can be summarized as follows : 1. Maxillary intercanine widths increased until age of 13.5 in males and age of 12.5 in females. On the other hand, mandibular intercanine widths increased until age of 11.5 in males and age of 9.6 in females and after there were no changes. 2. Maxillary intermolar widths increased until age of 13.5, but annual increments reduce from age of 12.5 in both sex. Mandibular intermolar widths increased until age of 13.5 in males and age of 12.5 in females. Annual increments of maxillary intermolar width greater than those of mandibular intercanine width in both sex. 3. Maxillary dental arch lengths increased until age of 10.6 in both sex, and after decreased until age of 13.6. Mandibular dental arch lengths increased until age of 10.5 in males and age of 9.6 in females, and after decreased until a9e of 13.6. 4. Developmental changes of dental arch width and length showed individual variation.
Moebius syndrome (MBS) is a congenital neurologic disorder that causes cranio-facial abnormalities. It involves paralysis of the VI and VII cranial nerves and causes bilateral or unilateral facial paralysis, eye movement disorder, and deformation of the upper and lower limbs. The orofacial dysfunctions include microstomia, micrognathia, hypotonic mimetic and lip muscles, dental enamel hypoplasia, tongue deformity, open bite or deep overbite, maxillary hypoplasia, high arched palate, mandibular hyperplasia or features indicating mandibular hypoplasia. This case report presents a 7-year-old male patient who was diagnosed with MBS at the age 2 years. The patient displayed typical clinical symptoms and was diagnosed with Class II malocclusion with a large overjet/overbite, tongue deformity and motion limitation, and lip closure incompetency. Treatment was initiated using a removable appliance for left scissor bite correction. After permanent tooth eruption, fixed appliance treatment was performed for correction of the arch width discrepancy and deep overbite. A self-ligation system and wide-width arch form wire were used during the treatment to expand the arch width. After 30 months of phase II treatment, the alignment of the dental arch and stable molar occlusion was achieved. Function and occlusion remained stable with a Class I canine and molar relationship, and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, it is important to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long-term retention and follow-up.
Journal of the korean academy of Pediatric Dentistry
/
v.25
no.2
/
pp.383-399
/
1998
Tooth development is usually described in four stages such as bud stage, cap stage, bell stage and crown stage. Exact time of appearance of tooth primordia is different among reports, and up to now there is no timetable regarding initial tooth development. To understand the congenital malformations and other disorders of the orofacial region, there is a need to establish a standard timetable on early tooth development. Till now, studies on the tooth development were mainly on later fetuses, and only few reports on early stage. Also, there were no reports on the time when bud stage turns to cap stage, and cap stage to bell stage. In this study, external morphology of face and the early development of the tooth, and transition of bud stage to cap stage, cap stage to bell stage were studied using 27 staged human embryos and 9 serially sectioned human fetuses. The results are as follows: 1. Mandibular region was formed by union of both mandibular arch at stage 15, and maxillary region by union of maxillary arch, medial nasal prominence, and intermaxillary segment at stage 19. 2. Ectodermal thickening which represents the primordia of tooth appeared in mandibular region at stage 13, and maxillary region at stage 15. 3. Bud stage began from mandibular primary central incisor at stage 17, and maxillary primary central incisor at stage 18. And the sequence of appearance was in the mandibular primary lateral incisor at stage 19, maxillary primary lateral incisor at stage 20, mandibular primary canine at stage 22, maxillary primary canine and primary first molar at stage 23, madibular primary first molar and maxillary primary second molar at 9th week, and mandibular primary second molar at 10th week of development. 4. Cap stage began from the primary anterior teeth at 9th week, and primary second molar still had the characteristics of cap stage at 12th week of development. 5. Transition to bell stage started from the primary anterior teeth at 12th week, and primary second molar started at 16th week of development. 6. Trnasition to crown stage started from primary anterior teeth at 16th week, and primary second molar at 26th week of development.
Journal of Dental Rehabilitation and Applied Science
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v.16
no.1
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pp.37-49
/
2000
It was clinically important to substitute the physiologic centric relation to the therapeutic position of the patients who needed the oral rehabilitation or occlusal treatment. There were several methods for recording the centric relation. One of the known methods was to use the gothic arch tracer. However the existing intraoral device was difficult to adjust the three dimensional angulation of the recording plate and recording stylus depending on the hinge movement arch of the individual. The purpose of this study was to develop new intraoral tracer which had adjustable stylus within hinge movement arch for the record of centric relation and to evaluate the clinical application of this device. The results were as follow; 1. A stylus of new developed intraoral tracer was so adjustable that the recording of mandibular positions could be reproducible within the hinge movement arc. 2. A record plate of new developed intraoral tracer was so adjustable to parallel with the occlusal plane that lateral recording of mandibular position was able to obtain stably. This study showed that new developed intraoral tracer allowed the determination of the treatment position which can be used in the full mouth rehabilitation and occlusal treatments.
This study was carried out as a part of the semi-longitudinal study on growth and development of Korean children, with purpose of observing the growth change in arch form., 736 pairs, of study models were taken for 3 years. Mesio-distal diameter of each tooth, intercanine width, intermolar width, canine arch depth, molar arch depth and arch perimeters were measured. Afterwards, mean value and each standard deviation of each age group and each gender were obtained, and corresponding graphs were drawn. The following conclusions were obtained : 1. Mesio-distal diameters of maxillary central incisor, maxillary 2nd molar, mandibular canine, and mandibular 2nd molar showed statistical difierences between boys and girls. 2. Intercanine width shows a gradual increase until age of 11. 3. Intermolar width in maxilla shows continuous increase, and the tendency of increase is more apparent between age of 9 and 14. In mandible, various pattern was shown until age of 9, and after, a slight increase. 4. Canine arch depth shows the increasing tendency until age of 13 in maxilla and 11 in mandible. 5. Molar arch depth shows the pattern of increase until age of 10 in male and 9 in female, which is more apparent in maxilla. After age of 9 or 10,dereasing pattrn was significantly shown until age of 15 in maxilla and age of 12 in mandible. 6. Arch perimeters in maxilla and mandible showed gradual increase until age of 10, and the tendency of increase was more apparent in maxilla; however, between the age of 10 and 14, arch perimeters of maxilla and mandible showed gradual decrease which was more apparent in mandible.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.38
no.4
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pp.249-254
/
2012
Bilateral coronoid process hyperplasia is a rare condition characterized by an enlarged mandibular coronoid process. The painless progressive reduction of a mouth opening is caused by coronoid process impingement on the posterior aspect of the zygomatic bone. Hyperplasia of the bilateral coronoid process leads to the restriction of a mandibular opening consequent to the impingement of the enlarged coronoid process on the temporal surface of the zygomatic bone or with the medial surface of the zygomatic arch. The process has been diagnosed as developmental hyperplasia. Otherwise, the development of the coronoid process may be associated with growth hormone. This paper describes a case of trismus caused by coronoid hyperplasia in an idiopathic short-stature patient who received growth hormone therapy by somatropin injections.
Purpose : The purpose of this study was to propose standard values for alveolar and basal bone in normal adult mandibles, and radiologically analyze the remodeling process of the edentulous mandible by examining molar areas and comparing them to the established normal values. Materials and Methods : Panoramic and CT scans of mandible were performed on 20 normal adults and 20 edentulous or partially edentulous adults. In both groups, arch half diameter and distance of alveolar bone were measured. Also the distance from the mandibular canal to the caudal edges, the buccal and lingual external borders of basal bone, were measured. A statistical comparison between the mean values of normal and edentulous mandibles was carried out in the selected areas. Results : There was evidence of decreasing arch half diameter and distance in the edentulous mandible, but statistically no significant change was seen between the normal and edentulous alveolar bone. There was evidence of decreasing buccal basal bone and increasing in the lingual basal bone in the edentulous mandible. A statistically significant difference between normal and edentulous mandibles was noted in the buccal basal bone. Conclusion: There was an inward and forward atrophic change of the edentulous mandibular molar area compared to the control. CT scanning required the use of sophisticated and expensive procedures to analyze the remodeling process of edentulous mandibles. Consequently, the development and application of a more simplified and objective radiographic procedure for broad and long-term study of remodeling procedures of edentulous mandible was recommended.
It is commonly assumed that nasorespiratory function can exert a dramatic effect upon the development of the dentofacial complex. Specially, it has been stated that chronic nasal obstruction leads to mouth breathing, which causes altered tongue and mandibular positions. If this occurs during a period of active growth, the outcome is development of the "adenoid facies". Such patients characteristically manifest a vertically long lower third facial height, narrow alar bases, lip incompetence, a long and narrow maxillary arch and a greater than normal mandibular plane angle. But several authors have reported that so-called adenoid facies is not always associated with adenoids and mouth breathing, and that a particular type of dentition is not always found in mouth breathers with or without adenoids. Some authors have believed adenoids lead to mouth breathing in cases with particular facial characteristics and types of dentition. We assumed that the ability to adapt to individual's neuromuscular complex is various. So, we compared the difference of influence of mouth breathing between childrens who have different facial types. This study included 60 patients and they were divided into three groups by Rickett's facial type. Their dentition and tongue position were compared. The results are as follows. 1. There is a significant difference in arch width of upper molars between different facial types. Especially dolichofacial type patients have narrowest arch width. 2. There is a significant difference in tongue position between different facial types. Especially dolichofacial type patients have lowest positioned tongue.
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