The full-face and profile photographic transparencies of 60 subjects (30 male, 30 female) divided equally among Angles Class I. Class II Division I, and Class III malocclusions, taken before and after orthodontic treatment, were randomly distributed in projector carousels and shown to four panels consisting of orthodontists, dental students, art students, and the parents of children undergoing orthodontic treatment. The faces were rated according to the method of Lundstrom et al. (1987). Full-face views generally were rated more attractive than profile views and Class II and Class III malocclusion subjects were rated lower than Class I malocclusion subjects. While the art student and parent panels were less critical in their appraisal of facial attractiveness, they were less sensitive to the changes brought about by orthodontic treatment than the orthodontist and dental student panels, although all could appreciate an improvement in the Class II Division I group.
The lateral skull radiographs of 124 boys aged approximately 10 years divided equally between the four angle classes were digitized in an effort to establish the relationship between cranial base size and shape and jaw relationship. Comparison of the means for occlusal groups showed a trend from class II to class III as cranial base dimensions and angle decreased. The condyle was also more distally positioned with respect to nasion, point A and the Pterygomaxillary vertical in the class II groups. Cranial base length correlated strongly with maxillary length but weakly with mandibular length. Nevertheless, the size of the maxilla did not influence its prognathism. The cranial base angle was strongly correlated (-0.7) with angle sella-nasion-point B. It is concluded that cranial base size and shape influence mandibular prognathism by determining the anteroposterior position of the condyle relative to the facial profile.
The pre-treatment lateral cephalograms of two groups of 20 subjects with severe Class III malocclusions were compared. One group had been considered suitable for orthodontic correction by the diagnosing clinician and the other offered orthognathic surgery. The most significant differences between the groups were in angle ANB, M/M ratio (P < 0·001), lower incisor inclination and Holdaway angle (P < 0·01). Threshold values for angle ANB and lower incisor angulation below which surgery was almost always carried out were—4 and 83 degrees, respectively.
Fifty-two patients (35 female, 17 male) completed questionnaires related to their experiences during the first 7 days of appliance wear (31 fixed, 21 removable) and then after 14 and 90 days. Most problems relating to discomfort and pain resolved within 4-7 days. The problems encountered with fixed appliances were generally more severe than with removable appliances. Swallowing and speech were more difficult with removable appliances and these problems persisted to some degree. Surprisingly, the embarrassment caused by wearing the appliance in public was similar whether it was fixed or removable.
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