Henry W. Fields

Occlusal Forces in Normal- and Long-face Adults

Using both quartz- and foil-based piezo-electric force transducers, occlusal forces during swallow, simulated chewing, and maximum effort were evaluated in 19 long-face and 21 normal individuals. Forces were measured at 2.5 mm and 6.0 mm molar separation. Longface individuals have significantly less occlusal force during maximum effort, simulated chewing, and swallowing than do individuals with normal vertical facial dimensions. No differences in forces between 2.5- and 6.0-mm jaw separation were observed for either group.

Facial pattern differences in long-faced children and adults☆

Vertical facial morphology has traditionally been studied by examining subjects chosen because of open bite/overbite or mandibular plane angle. The underlying skeletal and dental morphology associated with clinical facial appearance of normal and vertically dysplastic children and adults has not been well documented. The purposes of this study were to (1) describe vertical facial morphology in long-, normal-, and short-faced children and long-faced and normal adults, and (2) identify morphologic factors associated with the clinical evaluation of long-faced and normal subjects. Forty-two children, 6 to 12 years old, and forty-two young adults with varied vertical facial types were examined clinically and separated into three vertical classifications: long, normal, or short face. Lateral cephalometric radiographs were obtained in natural head position and seven angular, eighteen linear, and six ratio measurements were made. Descriptive statistics were used to characterize all groups, and intergroup differences were compared using analysis of variance for the three child groups and the t test for the two adult groups. For both long-faced children and adults, anterior total face height, mandibular plane angle, gonial angle, and mandibulopalatal plane angle were significantly greater than normal. Ramus height was not significantly different from normal in the children, but there was a tendency for long-faced adults to have short rami. Excessive dentoalveolar development was evident in long-faced children but not in adults. Factors associated with the clinical identification of vertical dysplastic subjects were identified by a principal component analysis. For each component, a variable highly correlated with that component was selected.(ABSTRACT TRUNCATED AT 250 WORDS)

Occlusal Forces in Normal- and Long-face Children

In children aged from six to 11 yr, forces of dental occlusion during swallowing, simulated chewing, and hard biting are similar for normal- and long-face individuals. Forces in the normal- and long-face children are similar to those in long-face adults, but are about half those in normal adults. It appears that individuals with the long-face pattern fail to gain strength normally in the mandibular elevator muscles.

Variables Affecting Measurements of Vertical Occlusal Force

Previous studies of occlusal force have provided conflicting results. The purpose of these studies was to determine whether the extent of vertical opening, contralateral occlusal support, or head posture influenced vertical occlusal forces during swallowing, simulated chewing, and maximum biting effort. Three samples of subjects with normal vertical facial proportions - one each of children, adolescents, and young adults - were evaluated to determine the effects of changes in small (2.5 vs. 6.0 mm) vertical separation of the first molars. A sample of young adults was used to evaluate changes in large (10-40 mm) vertical openings, and a sample of adolescents was used to investigate the effect of contralateral support and head posture. All between-group comparisons were evaluated using non-parametric statistics. For the small vertical openings, there was significantly more vertical occlusal force at 6.0 than 2.5 mm in children during swallowing and chewing but not during maximum biting effort. In adults, there was significantly more force during swallowing at 6.0 than at 2.5 mm separation, but no differences in chewing or maximum biting. Increasingly large vertical openings resulted in a progressive increase in maximum bite force to a maximum at about 20 mm, followed by a decrease and then a second increase to near-maximum force at about 40 mm for young adults. There were no significant differences in vertical force with or without contralateral support or between flexed, normal, and extended head postures at either of the small openings.

The effect of orthognathic surgery on occlusal force

To investigate the effect of orthognathic surgery on occlusal force, such force was measured during maximum effort, chewing, and swallowing in 70 patients who had superior repositioning of the maxilla and/or mandibular advancement or setback. Larger changes in occlusal force than could be accounted for by the altered geometry were observed in all groups. Of 15 patients who had only superior repositioning of the maxilla, ten had greater than 20% increase in occlusal force, three had little change, and two showed a greater than 20% decrease. When the mandible was advanced, 11 of 34 patients had greater than 20% increase in maximum biting force, 11 had little or no change, and 12 had greater than 20% decrease. When the mandible was set back, six of the 21 patients had greater than 20% increase, nine had little or no change, and six had greater than 20% decrease. It appears that considerable change in bit force, which is not primarily related to jaw geometry, occurs after orthognathic surgery.

Orthodontic-restorative treatment for relative mandibular anterior excess tooth-size problems

The diagnostic and conventional treatment techniques used to resolve relative mandibular anterior excess tooth-size problems are reviewed. An alternative solution to these problems, which involves an orthodontic-restorative technique, is described. Specific problems which may be encountered with this technique are also discussed. Three cases are presented, with posttreatment documentation for at least one year. It appears that this technique offers a successful semipermanent treatment for selected cases.

Intracoronal radiolucencies within unerupted teeth: Case report and review of literature

A panoramic radiograph obtained during orthodontic treatment revealed an intracoronal radiolucency within an unerupted permanent second molar. This unusual entity was successfully treated by surgical and endodontic intervention, followed by restorative and orthodontic treatment. These treatments enabled the tooth to maintain pulpal vitality, erupt, complete root formation, and function. This report will review the proposed etiologies for this condition, discuss the need for surgical intervention, and present the details of the case.

Reliability of soft tissue profile analysis in children.

Soft tissue outlines from profile radiographs, with or without supplementary photographs, do not provide enough information to reliably assess the underlying skeletal pattern in children 8 and 12 years old. Assessment was less reliable at 8 than at 12 years of age. Prognathic patterns were not as readily identified as retrognathic patterns. Specialty training did not affect the correctness of these limited assessments.