Search

Objective: To assess whether there are differences in skeletal maturation among subjects with horizontal, vertical, and neutral facial growth patterns. Material and methods: The study was performed on 48 latero-lateral craniographs of patients with horizontal, 48 with vertical and 50 with neutral growth patterns aged 12 to 18 years. Eight variables from the Zagreb 82 MOD, Bracchetti and Accord analysis, were selected for measuring angular and linear parameters on latero-lateral craniographs. The assessment of skeletal maturation was done by using the CVMS method. Results: Sta-tistical analysis showed significant differences in skeletal maturity (p 0.05) in skeletal maturity among subjects with ver-tical growth patterns compared with horizontal and neutral. In terms of stages of skeletal maturity, patients with a horizontal and neutral growth pattern in the younger group were on average in the fourth stage, and those with a vertical growth pattern in the third stage. In the older group, patients with a horizontal and neutral growth pattern were on average in the fifth stage of skeletal maturity and those with a vertical growth pattern in the fourth stage. Conclusion: According to the growth pat-tern, patients differ in the stage of skeletal maturity., Svrha rada: Odrediti postoji li razlika u stupnju skeletne zrelosti između pacijenata s horizontalnim, vertikalnim i neutralnim obrascem vertikalnoga rasta lica. Materijal i metoda: U istraživanju je korišteno 48 laterolateralnih kraniograma pacijenata u dobi od 12 do 18 godina s horizontalnim obrascem vertikalnoga rasta lica, 48 s vertikalnim i 50 s neutralnim. Za procjenu obrasca korišteno je osam varijabli iz MOD analize Zagreb 82, a za određivanje stupnja skeletne maturacije metoda prema Baccettiju i Accordu. Rezultati: Statistička analiza pokazala je značajne razlike u stupnju skelet-ne zrelosti (p < 0,001) između pacijenata s horizontalnim i vertikalnim obrascem rasta te između onih s neutralnim i vertikalnim (p < 0,05). Između pacijenata s horizontalnim i neutralnim rastom nije bilo statistički značajne razlike. Unutar mlađe dobne skupine (12 – 15 godina) ustanovljena je statistički značajna razlika (p < 0,05) između pacijenata s horizontalnim i vertikalnim obrascem rasta. U starijoj skupini (16 – 18 godina) pronađena je statistički značajna razlika (p > 0,05) u stupnju skeletne zrelosti kod pacijenata s vertikalnim obrascem rasta u odnosu prema onima s horizontalnim i neutralnim. Pacijenti s horizontalnim i neutralnim obrascem rasta unutar mlađe dobne skupine bili su najčešće u četvrtom stupnju skeletne zrelosti, a oni s vertikalnim u trećem. Unutar starije dobne skupine, pacijenti s horizontalnim i neutralnim obrascem rasta najčešće su bili u petom stupnju, a oni s vertikalnim u četvrtom stupnju skeletne zrelosti. Zaključak: S obzirom na obrazac rasta, pacijenti se razlikuju u stupnju skeletne zrelosti.

This case report presents the treatment of a 21-year-old male patient with class III skeletal malocclusion, an open bite, and vertical growth pattern. He was managed with surgically assisted rapid palatal expansion (SARPE) along with an orthopedic facemask. The duration of treatment was 16 months. Significant improvement and favourable outcome were observed concerning both facial appearance and paraclinical parameters after completion of treatment.

Dental therapy of traumatically ankylosed maxillary anterior teeth with an additional slight root resorption represents a great challenge for the restorative team and requires intensive planning and communication between patient, dentist, orthodontist, periodontist, and dental technician. The inhibition of vertical growth often makes dental intervention indispensable. Porcelain laminate veneers have been successfully used for more than two decades, mainly on anterior teeth, and was the minimally invasive treatment option for the present case report. Preprosthetic planning with a digital approach of the width-length ratio and the red-white esthetics were important prerequisites for a satisfactory treatment result. The treatment goal was clarified using a wax-up and a corresponding template for intraoral verification with a mock-up. The template also served as a preparation guide. Despite all risk factors, including the endodontic treatment, the 3-mm intruded position, and the slight root resorption, the patient and the restorative team decided to restore the situation with two feldspathic-ceramic veneers to provide an esthetic, time-saving, nonsurgical process for the patient.

Background A key factor in planning orthodontic treatment is the position of the lower incisor, which must keep a correct relationship with its underlying bony support, the mandibular symphysis. Objectives To determine whether there is a statistically significant relationship among the position of the lower incisor, Holdaway ratio, symphyseal morphology, and facial pattern. Methods A total of 100 patients were randomly selected from the records of the Master in Orthodontics and Dentofacial Orthopedics (University of Seville, Spain). Measurements were made manually on pretreatment cephalograms by two operators using Aki analysis to assess the height/width ratio (H/A), mandibular plane with point B–Menton, and the retro-occlusion of the Jarabak/MSE analysis to determine the facial biotype. A descriptive analysis of the data was made evaluating the possible correlations between the Holdaway ratio and H/A, and the Holdaway ratio and mandibular angle. Results The correlation among facial pattern, H/A, and the Holdaway ratio proved significant ( P Conclusions Symphyseal morphology is correlated to facial growth pattern and lower incisal inclination. There are biological limits to inclination movements of the lower incisor in narrow symphysis, which are usually found in vertical growth patterns.

This study aimed to compare sinus volume and dimensions in patients with high-, low-, and normal-angle vertical growth patterns using cone-beam computed tomography (CBCT).According to skeletal vertical face growth patterns, 60 adults (31 female, 29 male, average age: 29.90 ± 10.91 years) were divided into three groups equally: high-angle, low-angle, and normal-angle groups. Cephalometric tracings were obtained from CBCT images and SN-GoGn (angle between Sella-Nasion line and Gonion-Gnathion line) cephalometric angular measurements used for the classification of skeletal vertical pattern evaluations. Morphological and dimensional changes in the maxillary sinuses were evaluated on CBCT images. Data were analyzed using the one-way ANOVA, Kruskall-Wallis, and Mann-Whitney U statistical tests.There were no statistically significant differences among the groups in terms of age (p .05). The low-angle vertical growth pattern group showed significantly better results than the high-angle group in the right maxillary sinus length parameter (p .05).According to the results, the high-angle subjects showed statistically lower values in terms of maxillary sinus length and width than the low-angle subjects. There were no effects of vertical face development on right and left maxillary sinus volumes. The results of this study may be useful in maxillary sinus evaluation when planning for orthognathic surgery and orthodontic mini screw application in various vertical face patterns.

Gummy smile is one of the major complaints of patients, due to its influence on the self-esteem. It is known that it has a multifactorial cause and can be present in the excessive vertical growth of the maxilla, excessive labial contraction, short upper lip and extrusion of the anterior teeth. The use of the botulinum toxin can be associated with additional treatments or be applied individually, according to the need of each patient. The goal of this research study was to present a clinical case using botulinum toxin type A as an alternative therapy to correct the gummy smile. A 22-year-old patient, presenting vertical maxillary growth, reporting aesthetic discomfort while smiling, chose for an alternative treatment therapy with the application of botulinum toxin to correct the accentuated gingival display. The results show that the toxin is a satisfactory treatment option and its indication is considered a fast, effective, easy and safe treatment method, being a more conservative approach compared to surgical procedures. RESUMO O sorriso gengival, é uma das grandes queixas dos pacientes, devido a sua influência na auto estima do mesmo. Sua causa é multifatorial, podendo estar presente no excesso de crescimento vertical da maxila, contração labial excessiva, lábio superior curto e extrusão dos dentes anteriores. A aplicação da toxina botulínica pode ser associada a outros tratamentos ou isoladamente, de acordo com a necessidade de cada paciente. O objetivo desse trabalho foi apresentar um caso clinico utilizando a toxina botulínica tipo A como uma alternativa terapêutica para a correção do sorriso gengival. Paciente, 22 anos, apresentando crescimento vertical da maxila, relatando desconforto estético ao sorrir, optou pela alternativa terapêutica, com a aplicação da toxina botulínica para correção da exposição gengival acentuada. Os resultados encontrados mostram que a toxina é um tratamento satisfatório e sua indicação é considerada um tratamento rápido, eficaz, fácil e seguro. Um método mais conservador quando comparado aos procedimentos cirúrgicos.

Aim:To assess the skeletal and dental maturation of different facial types in growing children of south Indian population. Material and Methods: This study comprised of 60 samples with age group of 9-13 years and divided into 3 groups i.e Average growth pattern (control), Vertical growth pattern and Horizontal growth pattern . Lateral cephalograph , Hand wrist radiograph and Panoramic radiograph of each sample was assessed for skeletal and dental age using CVMI, SMI stages and tooth calcification stages . Chronological age was recorded by their last date of birth .All data in the groups was analyzed by student t test. Results: Students t -test was applied and Statistically significant difference was noted with dental and skeletal ages betweenhorizontal and vertical growth pattern, Conclusion : Subjects with vertical growth pattern presented a tendency to have earlier dental and skeletal maturation compared to horizontal growth pattern .

B.B., a 21-year-old girl, presented with the chief complaint of forwardly placed upper front teeth and gummy smile. Diagnosis revealed prognathic maxilla and average mandible, Class II skeletal base with vertical growth pattern, end-on molars and Class II canine relationship bilaterally, convex profile, potentially incompetent lips, gummy smile, and protrusive lower lip. The patient′s treatment plan was extraction of all first bicuspids and retraction using temporary anchorage devices. Anchorage was reinforced using microimplants in the maxillary arch and second molar banding in the mandibular arch. The implants were placed high up in the vestibule to have more of an intrusive component and to reduce gummy smile at the end of the treatment.

Introduction: The relationship between upper airways and changes in facial morphology has been extensively debated in the literature and remains controversial. Although many studies have been done regarding comparison of the nasopharyngeal space among patients with vertical and sagittal dysplasia, none so far has been carried out regarding relation between nasopharyngeal space and facial form. In view of the need to uncover new evidence to contribute to and assist in addressing this complex issue, this composite study was aimed to evaluate the variations in pharyngeal airway spaces in Class I and Class II malocclusions and their effect on facial form. Materials and Methods: The study was conducted on 180 subjects aged between 18 and 26 years. Subjects were divided into two groups; Class I and Class II malocclusions. Pharyngeal airway and facial forms were analyzed by cephalometrics and anthropometrics, respectively. Results: Results showed that McNamara's lower pharyngeal width is significantly less in Class II males than Class I males with statistically significant ( P = 0.009). Anthropometrically, nasal width (al r -al l ) is significantly less in Class II females than in Class I females ( P = 0.021). The lower aerial width and adenoid pharyngeal wall area had statistically significant difference between normo-, hypo-, and hyper-divergent growth patterns. Conclusion: It was concluded that sagittal mandibular development had significant effects on the dimensions of lower pharyngeal airway passage. Vertical dysplasia significantly affects the upper pharyngeal airway passage with a lesser value in vertical growth pattern than horizontal growth pattern. Facial form in vertical dysplasia showed a statistically significant difference between normal, horizontal, and vertical growth patterns. A significant correlation was found between variation in pharyngeal airway spaces to facial form in sagittal and vertical dysplasia.

Skeletal Class II malocclusion with mandibular deficiency and maxillary excess is a severe skeletal problem encountered in growing individuals. Correction of mandibular deficiency and maxillary excess in a skeletal Class II patient with a vertical growth pattern poses a great challenge. The control of vertical dimension becomes very important as downward and backward rotation of mandible will exaggerate the facial convexity. The present case signifies the importance of functional jaw orthopedic treatment in a vertically growing female patient with mandibular deficiency and maxillary vertical excess. Activator headgear combination was used for skeletal correction which was followed by fixed mechanotherapy. Superimposition of pretreatment and posttreatment cephalometric tracings shows desired treatment outcomes.

Bu çalışmanın amacı; büyüme gelişim dönemi içerisindeki iskeletsel Sınıf III malokluzyona sahip hastaların, dik yön gelişimlerine göre üç gruba ayırarak (dik yönü azalmış, dik yönü normal ve dik yönü artmış), yüz maskesi tedavisi sonucunda bu üç grup içerisinde iskeletsel, dental ve yumuşak dokuda meydana gelen değişimlerin sefalometrik olarak karşılaştırılmalı olarak incelenmesidir.Araştırmaya dahil edilen 58 iskeletsel Sınıf III malokluzyona sahip hasta; SNGoMe açısı ve Jarabak oranı dikkate alınarak; 22'si dik yönü azalmış (yaş ortalaması 10,53±0,32), 16'sı dik yönü artmış (yaş ortalaması 10,39±0,4) ve 20'si dik yönü normal (yaş ortalaması ve 10,02±0,33) olmak üzere üç gruba ayrıldı. Hastaların tümüne sabit okluzyonu kapalı akrilik plaktan destek alınarak, kanin dişlerin mesialinden 20-30° aşağıya doğru 450-500 gr kuvvet uygulanmıştır. Tedavi pozitif overjet elde edilene kadar ortalama 8 ay sürmüştür. Petit tipi yüz maskesi tedavisi aşamasını tamamlamış hastaların tedavi başı ve sonuna ait toplam 116 adet lateral sefalometrik radyograf değerlendirilmiştir. Elde edilen veriler; grup içi değişimlerin değerlendirilmesinde eşleştirilmiş t testi, gruplar arası farkların değerlendirilmesinde ise ANOVA testi ile uygulanmıştır. İkili grup karşılaştırmaları için Tukey analizi uygulanmıştır.Bütün hastalarda anterior çapraz kapanış ve yumuşak doku profili düzelmiştir. Tedavi sonunda her üç grupta da, SNA°, ANB°, A-y, 1-NA(mm), SN/GoMe°, Co-A, değerlerinde anlamlı miktarda artış gözlenirken, B-y, Pog-y ve 1-NB(°) anlamlı derecede azalma görülmüştür. Bu parametrelerdeki değişimler gruplar arasında istatistiksel olarak benzer bulunmuştur. ANS-y ve PNS-y değerlerinde dik yönü azalmış grupta diğer iki gruba göre istatistiksel olarak anlamlı bir artış tespit edilmiştir. Jarabak oranı ve (FH┴N)-Pg (mm) uzunluğunda, dik yönü normal grupta diğer gruplara göre istatistiksel olarak anlamlı bir azalma görülmüştür. FMA açısında ise dik yönü artmış grupta diğer iki gruba göre anlamlı bir şekilde az artış bulunmuştur. Bu parametrelerdeki değişim gruplar arasında istatistiksel olarak önemli ölçüde farklı bulunmuştur (p

Introduction Significant relationships between the pharyngeal structures and both dento-facial and craniofacial structures have been reported. Hyper-divergent patients may lead to narrower antero-posterior dimensions of the airway. Some authors associated vertical growth pattern with obstruction of the upper and lower pharyngeal airways others associated mouth breathing and Class II malocclusion. So the aim of this study was to assess the upper and lower pharyngeal airway width in different antero-posterior and vertical growth patterns and to evaluate sexual dimorphism in a group of Egyptian patients. Patients and method A sample of 300 Egyptian patients had divided into (5) groups (each group 60 patients) group 1 Class I, group 2 and 3 Class II division 1 (maxillary prognathism and mandibular deficiency), group 4 and 5 Class III (maxillary deficiency and mandibular prognathism). Each group was divided into three sub groups (hypo-hyper and normal divergent) vertical growth pattern. Each subgroup consists of 10 male and 10 female. The upper and lower pharyngeal airway widths were measured and compared for all groups. Results Significant differences had exist regarding lower pharyngeal airway between Class I and class II division 1, Class I and Class III mandibular prognathism, Class II and Class III maxillary deficiency, Class II and Class III mandibular prognathism. Significant differences between hypo, hyper and normal vertical growth pattern. Conclusions In all groups hyper-divergent growth had narrower airway than normal and hypo-divergent growth. Class III had wider airway than Class I malocclusion. Class I had wider airway than Class II division 1 malocclusion. Lower pharyngeal airway in class II division 1 had the narrowest width in all groups. Lower pharyngeal airway in class III mandibular prognathism had the widest width in all groups. Males have wider pharyngeal airway than females.

Class III malformations are the corollary of insufficient forward growth of the maxilla, excessive forward mandibular growth or a combination of both. It is often combined with excessive vertical growth and less frequently with insufficient vertical development. In many instances, sagittal split osteotomy is the method of choice for mild to moderate mandibular prognathism. However, it has been suggested that the sagittal split method is contraindicated in cases of mandibular prognathism with severe anterior open bite, and requiring more than 8–10 mm of mandibular posterior repositioning. This operative technique appeared very unstable and the results were unpredictable. Bilateral sagittal split ramus osteotomy result depended on the ability of the surgeon to position correctly the two proximal fragments during intervention under general anaesthesia. Moreover, with a large mandibular setback, the risk of inducing obstructive sleep apnoea was high. This case report highlights the successful management of a 19-year-old female with skeletal class III malocclusion with open bite by combined orthodontic surgical treatment, where correction was done during bi-jaw surgery not only to correct the skeletal malformations but also to correct the midline deviation without extraction of teeth.

An orthodontic case report is presented. The patient was a 12 year old autistic male with class II, augmented overjet, vertical growth and anterior open bite. He also exhibited tongue-thrust habit. A surgical treatment was ideal for this case but because of his neurological problem, it was decided to use an alternative orthodontic treatment. The orthodontic treatment included: Hyrax, high-pull-headgear, double transpalatal bar with acrylic button and elastics. After a three year treatment, class I approximation was obtained, open bite was corrected and vertical growth was controlled. The patient’s tonguethrust habit was controlled using a wrap-around retainer with tongue corrector. This retainer was placed on the maxillary arch and on the lower, a lingual bonded retainer was used. The camouflage orthodontic treatment was successful because good behavioral techniques for autism patients were used. Key words: High-pull headgear, double transpalatal bar, tongue-thrust habit, lingual trap, oral breather, vertical growth, autism.

Background: Cleft lip and palate is one the most common congenital malformations that affect human faces in all ethnic, economic level, and educational groups. It may cause speech and psychological problems. This study presents the skeletal and dental characteristics of cleft lip and palate patients treated with maxillary orthopedics, orthodontics and surgery during their infant and adolescence years. Method: A retrospective cephalometric analysis study was performed in 2013 using the Dolphin Imaging System of 26 lateral head fi lms and 26 posteroanterior X-rays of cleft lip and palate adult patients who received orthopedic, orthodontic and/or surgical treatment during their infancy and adolescence between 1969 and 1985. All X-rays were taken during 1995-2002. Result: Most of the subjects presented a mesofacial growth pattern, a skeletal Class III maxilomandibular relation, a large mandibular body length, an increase in the vertical growth of the maxilla, and an increase in the facial, maxillary, nasal, intermolar and intercanine width, with a normal Overjet and Overbite and retroclined upper incisors. Key words: Cleft lip and palate, cleft lip, cephalometric analysis, orthopedic treatment, orthodontic and surgical treatment in adulthood, Dolphin Imaging System.

Introduction: Poor anteroposterior mandibular relations comprise the largest number of cases. In this group class II malocclusion is the most frequent. Orthodontists began using extraoral forces with modifi ed Hawley retainers many years ago. Margolis realized that removable appliances combined with extraoral forces could not only serve as good containers, but be used as effective correction mechanisms. He called his appliance ACCO (AC acrylic, CO cervico occipital anchorage). Objective: The objectives of the case hereby presented were maxillary growth control and try to protrude the mandible. Case presentation: A 10 year-3 month-old female patient attended the Orthodontics Clinic at the Division of Postgraduate Studies and Research at the National Autonomous University of Mexico. She presented a skeletal class II due to mandibular retrusion and maxillary protrusion, a vertical growth pattern, excessive growth of the nasomaxillary complex and protrusive incisors. Treatment: Orthopedic: ACCO with high traction and impact to retrude the maxilla and decrease vertical growth; with expansion screw (one turn a week). Headgear: nocturnal use and three to four hours in the afternoon. Active plate 24 hours and the patient was told to remove it for eating. Orthodontic treatment: .022 Roth fi xed appliances retention: bimaxillary appliance for nocturnal use. Results: After fi ve months of ACCO use, cephalometric tracings were performed again and the following values were obtained: maxillomandibular relationship: ANB 5o (initial 11o ), Wits 2 mm (initial 3 mm), Bimler overjet 9 mm (initial 10 mm) convexity 6 mm (initial 11 mm). Maxillary position: SNA 82o (initial 87o ) mandibular position: SNB: 78o (initial 76o ). Facial pattern: facial cone of 67o (61o initial dolichofacial). Vertical dimension: SN-mandibular 36.5o (initial 42o), FMA (Tweed) 35o (initial 43o), Goniac (Jarabak) 130o (initial 128o ). Incisor Inclination: UpI/SN 114o (initial 117o), LowI/Mand remained the same (95o). Conclusions: Orthopedics in conjunction with orthodontics harmonizes the maxilla and mandible and at the same time provides natural facial aesthetics, while maintaining proper functions: chewing, swallowing, phonation and breathing. It is vitally important to perform a timely diagnosis in order to intervene orthopedically, correct this kind of malocclusions and limit or prevent its severity. Key words: ACCO, headgear, vertical control.

Introduction The purposes of this study were to evaluate the facial soft-tissue thicknesses and craniofacial morphologies of patients affected by bilateral cleft lip and palate (BCLP) and to compare the findings with a well-matched control group without any clefts using cone-beam computed tomography. Methods The study sample consisted of 40 retrospectively and randomly selected patients divided into 2 groups: a BCLP group (20 patients; mean age, 13.78 ± 3.20 years) and an age- and sex-matched control group without clefts (20 patients; mean age, 13.94 ± 2.52 years). Craniofacial and facial soft-tissue thickness measurements were made with cone-beam computed tomography. The Student t test and multiple linear regression analyses were performed for the statistical evaluations. Results The BCLP group had an increased SN-MP angle ( P = 0.003), a decreased Co-A ( P = 0.000), and retruded maxillary ( P = 0.000) and mandibular ( P = 0.026) incisors. In addition, patients affected by BCLP had statistically significantly decreased thickness measurements for the variables subnasale ( P = 0.005) and labrale superior ( P = 0.026) compared with the controls. The most predictive variables were found at U1-SN (r = 0.417, P = 0.004), IMPA (r = 0.368, P = 0.010), and ANB (r = −0.297, P = 0.031) for subnasale and U1-SN (r = 0.284, P = 0.038) for labrale superior. Conclusions The BCLP group showed greater vertical growth, greater retrusion of the maxilla and the maxillary and mandibular incisors, and decreased subnasale and labrale superior thicknesses compared with the well-matched controls without clefts. These differences should be taken into account when planning orthodontic and orthognathic surgery treatment for those patients.

Background This study was designed to evaluate the “effective” temporomandibular joint changes (the sum of condylar modeling, glenoid fossa modeling, and condylar position changes within the fossa) and their influence on mandibular rotation in Class II Division 1 malocclusion cases treated with Twin Block appliance using a maximum and stepwise advancement approach. Methods Sixty Class II Division 1 cases with normal growth patterns in the age group of 12 to 14 years were treated with the Twin Block appliance and randomly assigned to one of two groups: 1) maximum advancement (n = 30); and 2) stepwise advancement (n = 30). The Bolton Standards served as a control group. Lateral head films were obtained before treatment and after successful treatment (mean 1 year). Results Compared with the control groups, both treatment groups showed significant vertical growth changes. Sagittal growth direction was posterior with maximum advancement and anterior with stepwise advancement. Resultant mandibular rotation was in the anterior direction and was greater with stepwise advancement. Conclusions Myofunctional therapy after maximum and stepwise advancement with the Twin Block appliance showed a favorable effect in the temporomandibular joint region. Stepwise advancement showed greater vertical growth and more favorable anteriorly directed horizontal growth in the temporomandibular joint region on a short-term basis.

Introduction The aim of this longitudinal study was to investigate mandibular rotation and angular remodeling in mouth-breathing children compared with nasal-breathing children. Methods The sample included 55 severely obstructed mouth-breathing children (mean age, 6.1 years) and 55 nasal-breathing children (mean age, 7.3 years). The cephalograms at baseline and after 1 year were traced and measured, and superimpositions were made to determine true mandibular rotation, apparent rotation, and angular remodeling. The significance level was set at 5%. Results The mouth-breathing children had a longer face cephalometric pattern compared with nasal-breathing children. No cranial deflection differences were observed. No changes in the vertical growth pattern were observed during the 1-year period in either group. There were no statistically significant differences between the groups regarding apparent rotation (mouth breathing, −0.54°, vs nasal breathing, −0.41°). In comparison with the nasal breathers, the mouth breathers showed statistically significant lower yearly rates of counterclockwise true rotation (mouth breathing, −0.60°, vs nasal breathing, −1.31°) and angular remodeling (mouth breathing, 0.06°, vs nasal breathing, 0.87°). Conclusions Mouth-breathing children had a hyperdivergent cephalometric pattern, but against all expectations, counterclockwise true mandibular and apparent rotations were the average observations. Mouth-breathing children showed less true rotation and angular remodeling than did nasal breathers; however, apparent rotations were similar.

Objective: To evaluate condylar and ramal vertical asymmetry in adult orthodontic patients with different vertical growth patterns and a clinically normal sagittal skeletal pattern using cone-beam computed tomography (CBCT). Materials and Methods: The study sample consisted of 101 adult orthodontic patients (48 men and 53 women) divided into three groups according to their vertical growth patterns: high- (33 patients; mean age, 25.06 ± 6.05 years), low- (34 patients; mean age, 24.88 ± 5.22 years), and normal-angle (34 patients; mean age, 24.14 ± 4.26 years) groups. Condylar, ramal, condylar plus ramal height, and index measurements were performed using CBCT images and analyzed using one-way analysis of variance and post hoc Tukey tests. Results: There was no statistically significant difference in height measurements between right and left sides in each group, except a slight difference of approximately 0.5 mm for condylar height (CH) in the low-angle group (P < .05). No statistically significant gender differences were found for the values (P > .05). In the high-angle group, the ramal height (RH) and condylar plus ramal height (CH + RH) on both sides were found to be less than those of the low- (P < .001) and normal-angle groups (P < .017 and P > .017, respectively), and the asymmetry index values were slightly higher than those of the low- and normal-angle groups (P > .05). Conclusions: The high-angle group showed statistically significantly smaller values of RH and CH + RH on both sides and statistically insignificantly higher asymmetry index values than the low- and normal-angle groups.

Objective: To determine whether dentoalveolar changes or vertical condylar growth is more closely related to the true forward rotation of the mandible during the transition between the late primary and early mixed dentition stages of development. Materials and Methods: The sample included 50 subjects (25 males and 25 females) with Class I (N = 25) and Class II (N = 25) molar relationships. They were selected based on the availability of lateral cephalograms at two developmental stages: T1: last film with complete primary dentition (5.8 ± 0.4 years) and T2: first film with permanent incisors and permanent molars fully erupted (8.0 ± 0.2 years). Seventeen landmarks were identified and 22 measurements were calculated. The mandibles at T1 and T2 were superimposed using natural reference structures in order to measure true mandibular rotation. Results: The mandible underwent −2.4° ± 2.6° of true rotation, 1.9° ± 2.4° of remodeling, and −0.6° ± 1.8° of apparent rotation. There were no significant sex or Class differences in true rotation, remodeling, and apparent rotation. There was a moderate correlation (r = 0.76) between true rotation and remodeling and a moderately low correlation (r = 0.40) between true rotation and apparent rotation. There was a weak correlation between true rotation and SNA (r = 0.28). True rotation was most closely associated with the increases in U1/S-N (r = −0.34), increases in U1/PP (r = −0.36), and decreases in Id-Me (r = 0.36). Conclusions: Independent of sex and Class, the true mandibular rotation that occurred between the late primary and early mixed dentition was mostly masked by angular remodeling, resulting in limited amounts of apparent rotation. True rotation was significantly related to anterior dentoalveolar changes but not to the vertical growth changes that occurred.

Aim: Comparison of the long-term follow-up until the completion of growth of two homogeneous samples of children affected by hemifacial microsomia (HFM), one treated by mandibular distraction osteogenesis (DO) in the deciduous or early mixed dentition, the other not subjected to any treatment until adulthood. Material: Fourteen patients affected by vertically severe type I or II HFM were operated at an average age of 5.9 years with an average follow-up of 11.2 years. They were compared to a sample of eight patients who were never treated until the completion of growth. Methods: Mandibular vertical changes were measured on panoramic radiographs taken at different time points. Ratios between affected and non affected ramal heights were calculated and compared. Results: In the DO sample, after correction, mandibular vertical changes showed a gradual return of the asymmetry with growth in all patients. The ratio in the non treated sample was unchanged between the initial and the long term panoramic x-rays. Conclusion: The facial proportions of HFM patients are maintained, when not treated, throughout growth. The same proportions return to their original asymmetry after DO. Even though short term aesthetic and psychological advantages of distraction osteogenesis are well accepted, early surgery should only be applied after careful patient selection and honest clarification of the long term recurrence by genetically guided craniofacial growth pattern. © 2011 European Association for Cranio-Maxillo-Facial Surgery.

Analysis of the effects and side effects of treatment of patients with moderate skeletal Class III and vertical growth pattern by means of extraction of the second molars in the lower jaw.A total of 20 patients with a mean age of 12.9 years were examined retrospectively. Inclusion criteria consisted of a Wits value of 0 to -5, a posterior growth pattern of the mandible (Hasund analysis), an overjet of -2 to 1 mm, and an overbite of 0 to -3 mm. Treatment was performed using a straight-wire appliance. As part of the treatment, the lower second molars were extracted and Class III elastics attached. Cephalograms and orthopantomograms taken before and after treatment were used for evaluation.Treatment resulted in a significant change in the mean overjet from 0.5 mm to 2.1 mm and the attainment of a positive mean overbite of -1.0 mm to 0.9 mm. The occlusal plane rotated anteriorly from 18.8° to 13.7°. The skeletal parameters showed a change in the Wits value from -3.3 mm to -1.4 mm and an anterior mandibular rotation (ML-NSL 35.5° vs. 32.0°). The soft tissues revealed an increase in the distance between the lower lip and the "esthetic line" to the posterior (-2.0 mm vs. -3.9 mm).Dental compensation of moderate skeletal Class III with a tendency to an anterior open bite with vertical growth pattern by extracting the lower second molars, combined with Class III elastics, resulted in an anterior rotation of the occlusal plane and mandible. Eighteen of 20 patients achieved a physiological overjet and positive overbite. A prerequisite for this therapy is the presence of lower wisdom teeth; a potential side effect is elongation of the upper second molars.

The objective of this article is to demonstrate the effectiveness of good cooperation between orthodontists and Ear, Nose, and Throat specialists because of the importance of freeing the upper airways from obstruction in order to achieve a good orthodontic result as well as the other side of the coin, the beneficial effect orthodontic treatment can have in stimulating a functional liberation of those airways when no mechanical blockage is present. The article will emphasize how important it is for orthodontists to understand and to be alert to the signs and symptoms that would indicate the need for an ENT evaluation.

To quantify longitudinal cranial base growth from prepubertal through postpubertal stages of development, as defined by biological indicators of individual skeletal maturity (cervical vertebral maturation - CVM) method and to determine if there is sexual dimorphism resulting from cranial base growth.A longitudinal cephalometric study.The Dental School of Paulista University, Brazil.36 subjects (21 females, 15 males) who were part of a longitudinal growth study and exhibited normal facial and normal vertical growth patterns.Growth maturation of cervical vertebrae stages was assessed by two examiners independently. Cranial base measurements were carried out by one individual and repeated after one month. The growth increments over time were assessed with the one-way repeated-measures analysis of variance and post hoc Tukey multiple comparisions.There were no significant gender differences. There was a significant increase in all cephalometric measures between the different time points. Ba-Na showed the greatest amount of growth (mean change=2.8 mm). From T2-T3, the greatest amount of growth was found for Se-Na (mean change=3.4 mm) and the lowest for CC-Na (mean change=1.4 mm). Comparing overall changes (T1-T3) all the measurements showed statistically significantly increases (P0.05). For all comparisons of between-stage changes the cranial base grew more than 2.0 mm during the pubertal growth.Linear variables of cranial base showed significant growth during pubertal stages (pre-peak, peak and post-peak). No significant differences.

Background. Idiopathic apical root resorption usually presents as a chance radiographic finding. It may be widespread, affecting the majority of teeth, with implications for the longevity of the dentition. Case report. Three cases of significant idiopathic apical resorption resulting, respectively, in prevention, abandonment, and alternative methods of orthodontic treatment are described. Conclusion. Significant idiopathic resorption may present as a chance radiographic finding, as pain, or excessive mobility. The prognosis for affected teeth is often poor with very limited scope for orthodontic movement due to the likelihood of uncontrolled resorption. Definitive prosthetic rehabilitation is often best deferred until adulthood due to the potential for further resorption during adolescence in addition to vertical growth considerations.

Contains fulltext : 69907.pdf (Publisher’s version ) (Closed access) This long-term cephalometric study aimed to evaluate the craniofacial development of patients with a complete unilateral cleft lip and palate treated with a two-stage palatal closure, including delayed closure of the hard palate. Prediction models for cephalometric outcome at age 18 years were developed with the help of cephalometric values at 9 and 12 years. The objective need for surgery at age 18 was predicted from cephalometric values at age 9. Cephalograms of 43 consecutive patients with a complete unilateral cleft lip and palate were analysed at 9, 12 and 18 years. The patient group showed a retrusive craniofacial growth pattern for the maxilla and mandible, and a rather vertical growth pattern for the lower face. Using multiple linear regression, for most cephalometric variables, 40-80% of the cephalometric values at early adulthood could be explained by cephalometric values at the ages of 9 and 12 years, and gender, or by the values at age 9 only and gender. Several cephalometric variables at age 9 (s-n-ss, s-n-pg, sss-ns-sms, sss-ns-pgs) were found to be significant predictors for the need for surgery at 18. The need for surgery at age 18 was correctly predicted from age 9 for 85% of the investigated patient group.

Objective: To evaluate the long-term effects of rapid maxillary expansion (RME) via banded expanders in the sagittal and vertical facial planes. Materials and Methods: The sample consisted of 25 patients who had undergone RME (with either Haas-type or Hyrax hygienic expanders) followed by standard edgewise orthodontic therapy. This sample was compared with a group of 25 patients who had edgewise treatment only and with a control nontreatment group of 26 subjects, matched by age and gender with the patients of the other two groups. Lateral cephalograms were taken before treatment (T1), at the end of treatment (T2), and at 3 years posttreatment (T3), comprising a 5-year average time of observation. Results: RME treatment, in the long-term, did not influence the sagittal position of the apical jaw bases or the facial vertical dimension. Conclusion: Unfavorable cephalometric changes resulting immediately after RME are temporary, and therefore concerns about using RME in patients with vertical growth ...

Objective: To test the questions “Does cervical headgear treatment necessarily lead to a reduction of overbite?” and “Are there differences in treatment results due to different growth patterns or the initial overbite?” Materials and Methods: Initial and intermediary casts of 247 patients who had been treated exclusively with headgear were analyzed for changes in the occlusal relationship of the first molars and overbite. Orthodontic treatment consisted of the application of cervical headgear with nonangulated external arms applied at a force of 3.5–4.0 N. Only patients showing dental changes of occlusal relationship ≥4 mm during at least a 6-month treatment duration were selected. Growth patterns were identified by the y-axis values measured on lateral cephalograms obtained at study entry. Six groups were formed on the basis of these growth patterns. Results: Headgear treatment induced bite deepening in patients with vertical growth patterns and bite opening in patients with horizontal growth patterns. Further subdivision based on initial overbite revealed bite deepening in patients with small initial overbite and bite opening in patients with large initial overbite. These differences were statistically significant (P < .05). Only minor changes were observed in patients with an initial overbite of 3–4 mm. Conclusions: Overbite reductions were not dependent on the growth pattern. Orthodontists should expect bite opening in deep-bite situations and bite deepening in open-bite situations. However, initial overbite situations of 3–4 mm should not be expected to change in a significant way.

One hundred and twenty-one cleft children (67 with isolated cleft lip (CL), 32 with isolated submucous cleft palate (SMCP), and 22 with combined cleft lip and submucous cleft palate (CL + SMCP)) were compared retrospectively from lateral cephalograms taken at a mean age of 6.2 years (range 5.5-7.9). None of the children had had their palates repaired or been operated on to treat velopharyngeal insufficiency (VPI). The children with CL + SMCP and CL had similar morphology. They had greater maxillary length, greater maxillary and mandibular prominence, less vertical growth pattern, less deep nasopharyngeal airways, and thinner upper lips than those with isolated SMCP. After 6 years of age one patient with CL + SMCP, none with CL, and 16 with SMCP needed operations for VPI. This small series suggests that children with CL + SMCP and SMCP have different morphology. Although CL + SMCP is a combination of two types of clefts, it seems to be associated with similar morphology to CL.

We successfully treated a patient with achondroplasia with conventional orthodontic techniques. It was followed by long-term retention. The patient, a 12-year-old boy, had chief complaints of occlusal disturbance and mandibular protrusion. He had been diagnosed with achondroplasia and had growth hormone treatment in his early teenage years. His facial profile was concave with a bulging forehead and a retrognathic maxilla. It was characterized by a skeletal Class III jaw-base relationship with a retropositioned maxilla. At the age of 12 years 9 months, maxillary protraction was initiated with a reverse headgear; for 2 years 6 months, the maxillomandibular growth was controlled. After the growth spurt, at the age of 15 years 6 months, leveling and alignment of both dental arches were started with preadjusted edgewise appliances. After 83 months of multibracket treatment, an acceptable occlusion with a Class I molar relationship and an adequate interincisal relationship was achieved, despite the simultaneous marked vertical growth of the mandible. The resultant occlusion was stable during a 6-year retention period, although considerable forward-downward mandibular growth was observed. Conclusively, our results indicated the necessity of long-term observation in this patient with achondroplasia, especially because of the persistent mandibular growth.

Objective: The aim of this cross-sectional study was to compare craniofacial growth among operated and unoperated unilateral cleft lip and palate non-syndromic subjects. Materials and Methods: A sample of 180 subjects of Indian origin was selected. Of them, 90 were operated, and 90 were unoperated complete unilateral cleft lip and palate individuals. The subjects were divided into three age groups of 3-5, 8-10, and 20-25 years comprised of 30 patients in each group. The following measurements were evaluated: Angle and length of the cranial base; maxillary spatial positioning and length; mandibular spatial positioning; morphology and length; maxillomandibular relationship. Comparative analysis of the means between the groups was performed with Student's t-test at the significance levels of 5%. The ANOVA test has been performed to test the effect of time. Results: No significant differences were observed between the measurements that represented the angle and length of the cranial base of unoperated and the operated patients (P>0.05). There was statistically significant decrease ( P˂0.05) in the maxillary length (Co-A; 69.00 mm in 3-5 years, 68.33 mm in 8-10 years, and 67.17 mm in 20-25 years age group), and SNA angle (74.83Ί in 3-5 years, 74.17 Ί in 8-10 years and 73.17 Ί in 20-25 years age group) in operated group. No significant difference noticed on cephalometric values of the mandible, except Ar-Go-Me angle ( P˂0.05), which showed vertical growth pattern in unoperated patients (132.50 Ί in 3-5 years, 132.00 Ί I 8-10 years and 138.33 Ί in 20-25 years age group). Conclusion: Lip and palate repair has a significant influence on the maxilla and resulting in retarded growth of maxilla, which causes midface deficiency beyond acceptable sagittal limits. The Gonial angle showed vertical growth pattern in unoperated patients, but the cranial base angle and length of unoperated and the operated patients were similar.

Objective: This study evaluates the dentoskeletal effects of a mini-implant-supported maxillary expansion (MISME) appliance in comparison with two types of conventional expansion methods. Methods: Records of 42 patients with bilateral or unilateral posterior crossbite were included in this study. The patients were divided into three groups. In group 1, four miniscrews were placed to the palatal region and an acrylic expansion device was bonded on these screws. A bonded maxillary expansion appliance was used in group 2, while a banded expansion appliance was used in group 3. Measurements from cephalometric, postero-anterior radiographs, and dental casts taken before and after expansion were evaluated statistically. Results: ANB angle increased significantly in group 1 and 3. MISME group also showed an increase of SNA angle. Measurements regarding the vertical dimension did not change with MISME but significant posterior rotation was found in group 2 and 3. Overbite value showed a significant decrease in group 2 and 3, but remained stable in group 1. The nasal, maxillary, maxillary intermolar widths showed significant increases in all groups. The difference between MISME group and other groups in maxillary width was significant indicating more skeletal expansion in MISME group. The maxillary molars showed significant buccal tipping in group 2 and 3, while lingual tipping of molars was found in MISME group. Conclusions: MISME can be a better alternative to bonded expansion particularly in patients with vertical growth patterns and lack of anchorage teeth.

Introduction: Bimaxillary protrusion (BP) is a condition that results in the convexity of the face and lip incompetence. There are two forms of BP, a dentoalveolar type and a skeletal type each requiring a different treatment plan. Aims: The aims of this study were to cephalometrically determine the skeletal, dental and soft-tissue features of a sample of Sudanese adults with BP to establish the origin, growth pattern, and presence of gender dimorphism. Design: Descriptive, retrospective study. Setting: Orthodontic Clinics in University of Khartoum, Khartoum Dental Teaching Hospital and University of Science and Technology. Materials and Methods: Pretreatment lateral cephalometric radiographs of 60 patients (30 males and 30 females) with BP (mean age 25.4 ± 6 years) were collected and manually traced. Twenty-two variables were assessed and compared to Sudanese norms ( n = 73) which included (35 males and 38 females) of similar age (22.5 ± 3 years) using Student t -test and one sample t -test. Results: The sample revealed significantly smaller SNA, SNB angles and increased incisor protrusion and lip thickness than Sudanese norms ( P P Conclusion: It can be concluded that facial convexity in Sudanese patients with class 1 molars is a result of bimaxillary dentoalveolar protrusion and increased lip thickness. The patients also revealed a vertical growth pattern with males and females demonstrating similar cephalometric profiles. Treatment of such patient entails extraction of all first premolars with maximum anchorage.

Introduction: The purpose of this research was to compare the maturation stage of permanent teeth in subjects with vertical and horizontal growth patterns. Methods: Lateral cephalograms of 256 subjects were reviewed, and subjects were classified according to facial growth pattern. The 30 subjects with the greatest predominance of vertical growth and the 30 with the greatest predominance of horizontal growth were selected; these subjects comprised the vertical and horizontal groups, respectively. Panoramic radiographs of the subjects obtained at 8 years of age were used to evaluate the maturation of the permanent teeth, expressed by the dental age. Comparisons between groups were made with independent t tests. Results: A statistically significant difference was noted between the dental ages of the vertical and horizontal groups, with the vertical group having a more advanced dental age. Conclusion: Subjects with vertical growth patterns should be expected to mature dentally earlier than horizontal growers.

Does molar distalization as effected by cervical headgear increase the vertical dimension of occlusion in patients with vertical growth pattern? A sample of 86 patients with neutral and vertical growth pattern in the late mixed dentition stage underwent headgear treatment. Their initial and intermediary casts were retrospectively analyzed for occlusal relationships at the maxillary first molars and degrees of overjet and overbite. The only cases included were those in which headgear treatment was carried on for at least 6 months, achieving a minimum distalization of 4 mm. The intermediary casts were fabricated after headgear treatment had been completed and prior to the initiation of multiband treatment. Patients were divided into three groups (N, V1 and V2) according to the degrees of vertical growth pattern, which were determined based on y-axis angle values. Grouped by degrees of vertical growth, the data revealed occlusal relationship changes of 6–8 mm and overjet reductions of 0.6–1.2 mm. The overbite changes were unexpectedly small (0–0.04 mm). Grouped by degrees of overbite, the data revealed that headgear treatment increased the vertical dimension of occlusion in deep-bite patients (> 4 mm), while giving rise to decreases in patients with overbites of < 3 mm.

This study compared the buccolingual inclination of the posterior teeth in subjects with a horizontal growth pattern (proportionally short lower anterior face height) with that of subjects with a vertical growth pattern (proportionally long lower anterior face height). Seventy subjects with permanent dentition were divided into 2 groups. Group I comprised 35 subjects (16 male, 19 female) with Class II Division 2 malocclusion with a horizontal growth pattern, and group II comprised 35 subjects (15 male, 20 female) with a vertical growth pattern. Buccolingual inclinations of the first molar and second premolar were indirectly assessed on photocopies of buccolingual sections of these teeth by measuring their occlusal surface (represented by an imaginary line connecting the lingual and buccal cusps) inclination. The groups were compared with t tests (P

Objective: To evaluate the treatment effects of a hybrid hyrax-facemask (FM) combination in growing Class III patients. Material and Methods: A sample of 16 prepubertal patients (mean age, 9.5 ± 1.6 years) was investigated by means of pre- and posttreatment cephalograms. The treatment comprised rapid palatal expansion with a hybrid hyrax, a bone- and toothborne device. Simultaneously, maxillary protraction using an FM was performed. Mean treatment duration was 5.8 ± 1.6 months. The treatment group was compared with a matched control group of 16 untreated Class III subjects. Statistical comparisons were performed with the Mann-Whitney U-test. Results: Significant improvement in skeletal sagittal values could be observed in the treatment group over controls: SNA: 2.4°, SNB: −1.7°, Co-Gn: −2.3 mm, Wits appraisal: 4.5 mm. Regarding vertical changes, maintenance of vertical growth was obtained as shown by a small nonsignificant increase of FMA and a small significant decrease of the Co-Go-Me angle. Conclusions: The hybrid hyrax-FM combination was found to be effective for orthopedic treatment in growing Class III patients in the short term. Favorable skeletal changes were observed both in the maxilla and in the mandible. No dentoalveolar compensations were found.

OBJECTIVE: To compare the anterior dentoalveolar and skeletal maxillary cephalometric factors involved in excessive upper incisor crown exposure (UICE) in subjects with skeletal open bite Class II (SOBCIIG) and Class III (SOBCIIIG) against an untreated control group (CG). MATERIALS AND METHODS: Seventy pretreatment lateral cephalograms of orthodontic young adult patients (34 men, 36 women) were examined. The sample was divided into three groups according to both sagittal and vertical growth pattern and occlusion. The CG group (n = 25) included Class I, normodivergent cases with adequate overbite, and the SOBCIIG group (n = 25) and SOBCIIIG group (n = 20) included skeletal Class II or III malocclusions, respectively, with hyperdivergent pattern and negative overbite. Several cephalometric measurements were considered (skeletal and dental). Analysis of variance, multivariate analysis of covariance, and Tukey HSD post hoc tests were used. Principal component analysis (PCA) was used for reducing the number of cephalometric variables related to UICE. Finally, a multiple linear regression was calculated. RESULTS: Significant differences in UICE were found between the groups (P < .05). UICE was 3.9 mm in SOBCIIG, 2.5 mm in SOBCIIIG, and 0.4 mm in CG. PCA showed that a nondental component—including vertical maxillary height (VMH) and upper lip height (ULH)—was the only component significantly associated with UICE. The regression model had a moderate prediction capability. CONCLUSIONS: Although the UICE was statistically different in SOBCIIG, the values were within the esthetic standards. The UICE was mainly influenced by VMH and ULH.

This retrospective longitudinal study compared skeletal and dental changes in orthodontically treated patients with changes in a comparable untreated group to evaluate the relationship between skeletal changes and mandibular incisor crowding. Cephalograms and models of 44 untreated subjects from the Broadbent-Bolton Growth Study and 43 treated patients were evaluated at "posttreatment" (14.3 +/- 1.5 and 15.2 +/- 1.1 years, respectively) and at "postretention" (23.2 +/- 3.4 and 28.9 +/- 3.6 years, respectively). Cranial base and mandibular superimpositions were used to measure cephalometric changes. Tooth-size-arch-length discrepancy, contact irregularity, and space irregularity were measured. In both groups, growth in the vertical dimension was twice that in the horizontal dimension. The untreated subjects, who were younger, exhibited greater yearly vertical growth increments than did the treated subjects. The treated subjects exhibited greater overjet and overbite increases than did the untreated subjects. Yearly changes in tooth-size-arch-length discrepancy were greater in the untreated than in the treated subjects, but there were no differences in the changes in irregularity between the 2 groups. A multivariate regression model, relating posterior facial height (Ar-Go) increase and lower incisor eruption to change in space irregularity, explained 42% of the variation in the untreated group (r = 0.64; P

The aim of this study was to evaluate the effects of the pendulum appliance in dental Class II patients with varying vertical growth patterns and to evaluate the changes during the short-term stabilization period of 3 months. The sample (n=30) was divided into two groups based on their FMA degrees. The high-angle group consisted of 14 patients (10 girls and 4 boys) and had a mean age of 157.7+/-8.0 months. The low-angle group consisted of 16 patients (8 girls and 8 boys) and had a mean age of 155.5+/-18.6 months. Pretreatment, posttreatment and poststabilization cephalometric radiographs were obtained to measure the changes. Mann-Whitney U and Wilcoxon tests were used for statistical evaluation. The amount of upper molar distalization was 5.9 mm (p

A case report of the orthodontic treatment of a male adolescent with a Class I bimaxillary protrusive malocclusion, complicated by a vertical growth pattern and high mandibular plane angle. Treatment consisted of extraction of maxillary second premolars, mandibular first premolars, use of a transpalatal bar, occipital pull headgear, and light wire mechanics. An acceptable result was achieved, with a decrease in the facial axis, decrease in lip strain, and an attractive full smile. This case report was presented to the American Board of Orthodontics in partial fulfillment of the requirements for the certification process conducted by the Board.

Norms available for the posteroanterior (PA) cephalometric analysis yield different information. The material used to generate these standards is not clearly defined. The purpose of this study was to use data from the Bolton-Brush Growth Study to generate new norms for the PA analysis. The Bolton material is recognized as a controlled longitudinal record of growing children. The assumption that growth in the transverse dimension is the first to be completed is challenged by finding that increments in maxillary and mandibular width vary, like sagittal and vertical growth, according to gender and chronologic age.

Treatment of a skeletodental Class II vertical growth problem, combined with a severe arch length deficiency in both arches, presents a challenging orthodontic problem. This is the case report of a small-statured, 11-year, 10-month-old boy with a history of juvenile chronic arthritis and marked mandibular retrognathia who was treated with first premolar extractions in both arches. Unexpected favorable growth, with significant decrease of the mandibular plane angle over a long treatment period, provided a very satisfactory result. [This case report was presented to the American Board of Orthodontics in partial fulfillment of the requirements for the certification process.]

Introduction The purposes of this study were to examine and compare the craniofacial growth in girls with Class I or Class II occlusion from the ages of 9 to 18. Methods Twenty-five Class I (ANB, 1°-4°) and 21 Class II (ANB, >4°) untreated Caucasian girls were selected from the Burlington Growth Centre in Toronto, Ontario, Canada. Cephalograms of each subject at ages 9, 14, and 18 years were traced, and 29 parameters were measured. The growth changes in each parameter from ages 9 to 14, 14 to 18, and 9 to 18 were calculated, and comparisons of each parameter were made between the 2 groups. Results From ages 9 to 14, the Class I and Class II groups had similar skeletal growth patterns (increases of SNA and SNB angles, decreases of ANB, MP-SN, and gonial angles). Dentally, the Class II group showed less maxillary incisal proclination and more overbite than did the Class I group. From ages 14 to 18, the 2 groups also showed similar growth patterns, with little sagittal but continued vertical growth, and the MP-SN angle continued to decrease. From ages 9 to 18 (combined periods of 9-14 and 14-18), the 2 groups showed similar skeletal growth, with the exception of a slightly higher ANS-ME/N-Me in the Class I group. Dental changes were similar in the 2 groups, except that overbite increased slightly more in the Class II group. Conclusions Overall, the craniofacial growth patterns of Class I and Class II girls were similar. With growth, the face became more flattened with a decrease of the ANB angle, and the mandible demonstrated forward rotation with decreases of the MP-SN and gonial angles, and an increase of PFH:AFH.

Objective: To investigate the correlations between head posture and mandible growth in Deuteromalayid OURT (obstruction of the upper respiratory tract) patients with mouth breathing habit. Material & Methods: The study used cross sectional design for 64 subjects including 32 OURT patients with mouth breathing habit and 32 normal subjects, all 12 to 15 years old. Lateral cephalometry radiograph was taken for head posture measurements and mandibular growth (ramus height, mandibular length, and mandibular rotation) measurements. Results: The fraction of subjects with kifosis head posture in OURT with mouth breathing habit (34.4%) was larger than that in normal subjects (28.1%). There is no correlation between head posture and OURT with mouth breathing habit, but there is a correlation between OURT with mouth breathing habit and mandibular rotation. Conclusion: Patients with OURT and mouth breathing habit show more vertical growth of mandible than normal subjects.DOI: 10.14693/jdi.v15i1.78