These results confirm the findings of previous studies of the effect of rapid maxillary expansion on the maxilla. Additionally, we found that only the cross-sectional area of the upper airway at the posterior nasal spine to basion level significantly gains a moderate increase after rapid maxillary expansion.
Few studies of dentofacial and orthodontic structural relationships relative to temporomandibular joint (TMJ) dysfunction have been reported. We undertook this investigation to determine any correlation of orthodontic and dentofacial characteristics with TMJ bilateral disc displacement. The population of patients was selected from a TMJ clinic where a control group of asymptomatic volunteers had been previously established and standardized. Differences in skeletal structural features were determined among three study groups: (1) asymptomatic volunteers with no TMJ disk displacement, (2) symptomatic patients with no TMJ disc displacement, and (3) symptomatic patients with bilateral TMJ disk displacement. Thirty-two asymptomatic volunteers without disk displacement (25 female, 7 male) were compared with the same number each of symptomatic patients without TMJ disk displacement and symptomatic patients with bilateral TMJ disk displacement. All subjects had undergone a standardized clinical examination, bilateral TMJ magnetic resonance imaging, and lateral cephalometric radiographic analysis. The groups were matched according to sex, TMJ status, age, and Angle classification of malocclusion. Seventeen lateral cephalometric radiographic cranial base, maxillomandibular, and vertical dimension variables were evaluated and compared among the study groups. The mean angle of SNB, or the intersection of the sella-nasion plane and the nasion-point B line (indicating mandibular retrognathism relative to cranial base), of the symptomatic patients-with-displacement group was significantly smaller than that in the asymptomatic volunteers and symptomatic patients without bilateral disk displacement (p < 0.05). Female subjects showed smaller linear measurements of mandibular length, lower facial height, and total anterior facial height than male subjects in all three groups (p < 0.05). The mean angle of ANB, or the intersection of the nasion-point A and nasion-point B planes (indicating retrognathism of mandible relative to maxilla), was significantly greater in female than in male subjects, in all groups (p < 0.05). Symptomatic patients with bilateral disk displacement had a retropositioned mandible, indicated by a smaller mean SNB angle compared with that in asymptomatic volunteers and symptomatic patients with no disk displacement on either side. Lateral cephalometric radiographic assessment may improve predictability of TMJ disk displacement in orthodontic patients but is not diagnostic; nor does the assessment explain any cause-and-effect relationship.
Purpose:In full mouth reconstructive dentistry, the occlusal vertical dimension(OVD) is often increased to provide adequate restorative space or for esthetic reasons. The purpose of this study was to analyze the effect of occlusal vertical dimension on dimensional measurements of the smile.
Materials and Methods:30 dental students, 12 male and 18 female between the ages of 21 -30 participated in this study. Polyvinyl Siloxane bite splints of 2mm, 4mm, 6mm, 8mm thicknesses were fabricated on stone casts mounted on semi-adjustable articulators. A wall-mounted head positioning device, modified from a cephalometric unit was used to stabilize head positions. Three photographs each at OVD of +0mm, +2mm, +4mm, +6mm, +8mm were taken using a DSLR camera mounted on a tripod. Measurements were made in Adobe Photoshop CS5, using the width of the maxillary central incisors to convert pixel measurements to millimeter measurements.
Results:One way repeated measures ANOVA found statistically significant differences in interlabial gap height, incisal edge -lower lip length, and display zone area with increasing OVD. No statistically significant differences were found for intercommisural width and incisal edge -upper lip length.
Conclusions:This study demonstrates that excessive increase of OVD may lead to excessive interlabial gap height, incisal edge -lower lip length, and display zone area. A lengthening of the upper lip at smile should not be expected with increasing OVD. In addition, a change in the width of the smile should not be expected with increasing OVD. i ACKNOWLEDGEMENTS
A 13-year-old sought treatment for a severely compromised maxillary left central incisor and an impacted fully developed left canine. Extraction of both teeth became necessary. As the key component of the revised comprehensive treatment plan, the right maxillary central incisor was moved into the position of the left central incisor. All other maxillary teeth were moved mesially to close any gaps. Active orthodontic treatment was completed after 34 months. Frenectomy, minor periodontal surgeries, and bonded lingual retainers were used to improve aesthetics and stabilize the tooth positions. The patient was pleased with the treatment outcome. Cone-beam computed tomography provided evidence that the tooth movement was accompanied by a deviation of the most anterior portion of the median palatine suture. This observation may make relapse more likely if long-term retention cannot be ensured. Root resorption was not observed as a consequence of the major tooth movement.
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