Kazuto Terada

Three-dimensional analysis of condylar hyperplasia with computed tomography.

Three-dimensional surface reconstruction imaging from CT scans was used to study the deformity of the mandible in six patients with mandibular asymmetry. High-resolution axial CT scans of the mandible were obtained using Somatom-DR3 (Siemens). COSMOZONE-2SA (Nikon) with PC-9801VX21 (NEC) was used to reconstruct the three-dimensional images. The six patients were divided into two groups. One group was classified as unilateral hybrid forms and the other group was classified hemimandibular elongation on the diagnostic criteria of Obwegeser and Makek (1986). In the three-dimensional surface reconstruction, exact location and the degree of the deformity in the region from the ascending ramus to the condylar head and the lingual aspect from the ascending ramus to the mandibular body were accurately represented. In addition, the three-dimensional images could be easily rotated arbitrarily, precise evaluation could be done at every part of the mandible. On diagnosis, the mandibular morphology classified into the unilateral hybrid forms was presumed to vary from case to case even in the same classification.

Anchorage Effects of a Palatal Osseointegrated Implant with Different Fixation: A Finite Element Study

The purpose of this study was to compare the anchorage effect of the osseointegrated implant with different fixation types using finite element analysis. Three fixation types were investigated. fixation type 1: implant neck in the oral-palatal cortical bone and implant tip in the cancellous bone; fixation type 2: implant neck in the oral-palatal cortical bone and implant tip in the nasal-palatal cortical bone; fixation type 3: implant neck in the oral-palatal cortical bone and implant tip projecting into the nasal cavity. Three finite element models were constructed. Each consisted of two maxillary second premolars, their associated periodontal ligament (PDL), alveolar bones, palatal bone, palatal implant, and a transpalatal arch. Another model without an implant was used to compare with the previous models. The horizontal force (mesial five N, palatal one N) was loaded at the buccal bracket of each second premolar. The stress was calculated in the PDL and implant surrounding bone. The result showed that the palatal implant could significantly reduce von Mises stress (maximum von Mises stress was reduced 30%) and evenly distribute stress in the PDL. The stress magnitude and distribution in the PDL was almost the same in the three implant models. These results suggest that different implant fixation types have almost the same anchorage effects.

A New Method of Predicting Mandibular Length Increment on the Basis of Cervical Vertebrae

The purpose of this study was to establish an equation to predict incremental mandibular length on the basis of the analysis of the cervical vertebrae in a single cephalometric radiograph and to compare the predictive accuracy with other methods. Data comprised two groups of 23 Japanese girls between CVMS I and CVMS V. Group A was examined to construct the predication equation. Group B served to compare the predictive accuracy with the growth potential method and the growth percentage method. The following results were obtained: (1) an equation was determined to obtain mandibular length increments on the basis of the measurements in the third and fourth cervical vertebral bodies, and (2) the average error between the predicted increment and the actual increment was 1.5 mm for the equation method, 2.4 mm for the growth potential method, and 2.8 mm for the growth percentage method. These results suggest that with the use of cervical vertebral measurements, it may be possible to evaluate the mandibular growth potential.

A Special Method of Predicting Mandibular Growth Potential for Class III Malocclusion

The purpose of this study was to establish an equation to predict the mandible growth potential (GP) for Class III malocclusion on the basis of the analysis of the cervical vertebrae in a single cephalometric radiograph and to compare its predictive accuracy with other methods. Data comprised two groups each with 22 Japanese girls. Group A was examined to construct the prediction equation. Group B served to compare the predictive accuracy with the GP method and the method of Mito et al (MM). The following results were obtained: (1) an equation was determined to obtain mandible GP on the basis of measurements in the third and fourth cervical vertebral bodies and (2) the average errors between the predicted increment and the actual increment for each method were 1.45 mm for the equation, 2.91 mm for the GP method, and 2.48 mm for the MM. These results suggest that using cervical vertebral measurements might allow predicting the mandible GP length for Class III malocclusion.

Anchorage Effect of Various Shape Palatal Osseointegrated Implants: A Finite Element Study

The purpose of this study was to compare the anchorage effects of different palatal osseointegrated implants using a finite element analysis. Three types of cylinder implants (simple implant, step implant, screw implant) were investigated. Three finite element models were constructed. Each consisted of two maxillary second premolars, their associated periodontal ligament (PDL) and alveolar bones, palatal bone, palatal implant, and a transpalatal arch. Another model without an implant was used for comparison. The horizontal force (mesial 5N, palatal 1N) was loaded at the buccal bracket of each second premolar, and the stress in the PDL, implant, and implant surrounding bone was calculated. The results showed that the palatal implant could significantly reduce von Mises stress in the PDL (maximum von Mises stress was reduced 24.3-27.7%). The von Mises stress magnitude in the PDL was almost same in the three models with implants. The stress in the implant surrounding bone was very low. These results suggested that the implant is a useful tool for increasing anchorage. Adding a step is useful to lower the stress in the implant and surrounding bone, but adding a screw to a cylinder implant had little advantage in increasing the anchorage effect.

Dental Arch Widths and Mandibular-Maxillary Base Width in Class III Malocclusions with Low, Average and High MP-SN Angles

OBJECTIVE To analyze the development of the dental arches and skeletal mandibular-maxillary bases in untreated Class III malocclusions with low averages and high mandibular plane angles in subjects aged 10 to 14. MATERIALS AND METHODS The records of 50 untreated Japanese girls with Class III malocclusions at age 10 were selected from the files of patients pending orthodontic surgery. The patients included those with low (< or =27 degrees), average (27 degrees through 37 degrees) and high (>37 degrees) mandibular plane angles. The maxillary skeletal base width, biantegonial width, and maxillary and mandibular intermolar width were determined on posteroanterior cephalograms obtained at annual intervals when subjects were between 10 and 14 years of age. The difference between the maxillary and mandibular intermolar width was also calculated and reported. RESULTS All skeletal and dental transverse widths in the high-angle group were significantly smaller than those in the low-angle group (P < .05) from ages 10 to 14. On the other hand, the maxillary to mandibular molar difference was the same for the three groups (P > .05) at each age. The deviations in molar differences did increase from age 10 to age 14 in all three groups. CONCLUSION Mandibular plane angles might play a stronger role in the transverse skeletal growth of the maxilla and the mandible than the transverse dental growth of the maxilla and the mandible.

Anchorage effect of osseointegrated vs nonosseointegrated palatal implants.

Palatal implants can be used with a transpalatal arch (TPA) connected with the second premolar to provide anchorage. The purpose of this study was to compare the anchorage effects of an osseointegrated palatal implant (OPI) with a nonosseointegrated palatal implant (NOPI), using finite element analysis. One model, which was composed of two maxillary premolars, periodontal ligament (PDL), alveolar bone, a palatal implant, palatal bone, a bracket, band, and TPA, was created on the basis of the clinical situation. The palatal implant was treated as either NOPI or OPI. The force on the premolars was investigated under three conditions: a distomesial horizontal force, a buccolingual horizontal force, and a vertical intrusive force. The PDL stress was calculated and compared with a model without an implant. The result showed that OPI could reduce PDL stress significantly. (The average stress was reduced by 14.44% for the distomesial horizontal force, 60.28% for the buccolingual horizontal force, and 17.31% for the vertical intrusive force.) The NOPI showed almost the same anchorage effect as OPI. The stress on the NOPI surface was higher than that on the OPI surface, but the stress was not high enough to result in failure of the implant. These results suggested that waiting for osseointegration might be unnecessary for an orthodontic implant.

Dental arch widths and mandibular-maxillary base widths in Class III malocclusions from ages 10 to 14

INTRODUCTION Evaluations of the dental arch widths and mandibular-maxillary base are needed for a comprehensive dentofacial analysis in subjects with Class III malocclusion. The aim of this study was to analyze the development of the dental arches and the skeletal mandibular-maxillary bases in untreated subjects with Class III malocclusions. METHODS Two groups of subjects, 1 with Class III malocclusion and the other with Class I malocclusion, were examined. Maxillary skeletal base width, biantegonial widths, and maxillary and mandibular intermolar widths were determined on posteroanterior cephalograms at annual intervals between the ages of 10 and 14 years. RESULTS Maxillary skeletal base widths and intermolar widths in the Class III subjects were significantly smaller than those in the Class I subjects (P <.05). No statistically significant differences were found among the groups for skeletal mandibular width or intermolar width for the total observation period. The deviations in molar differences increased from ages 10 to 14 in the Class III group. CONCLUSIONS The main transverse deficiencies in the Class III group were maxillary deficiencies in both skeletal and dental widths. The deviations in molar differences appear to become larger from age 10 to age 14.

Longitudinal evaluation of the intermaxillary relationship in Class III malocclusions.

OBJECTIVE To analyze the sagittal, vertical, and transverse relationship of the maxilla and mandible in Japanese girls with Class III malocclusions. MATERIALS AND METHODS This longitudinal study utilized biannual posteroanterior and lateral cephalograms of 44 untreated subjects from age 8 to 14 years (Class I, 23 girls; Class III, 21 girls). Sagittal and vertical growths were analyzed on the basis of lateral cephalograms, and transverse growth was analyzed on the basis of posteroanterior cephalograms. RESULTS There was no significant difference in sagittal intermaxillary relationships in Class III malocclusion from age 8 to 14 years, whereas significant difference in vertical and transverse intermaxillary relationships appeared with ages during this period. When comparing Class III to Class I malocclusions at the same age point, there were significant differences in sagittal and transverse intermaxillary relationships, whereas significant difference in vertical intermaxillary relationship appeared after 12 years of age. CONCLUSION The results suggest that the sagittal intermaxillary relationships in Class III malocclusions were established before 8 years of age and remained through puberty and that the vertical and transverse intermaxillary relationships in Class III malocclusions changed with ages from 8 to 14 years.

Suppression of the nociceptive jaw-opening reflex by stimulation of the red nucleus

We studied the effect of stimulation of the red nucleus (RN) on the jaw-opening reflex (JOR) in anesthetized rats. The JOR was evoked by electrical stimulation of the tooth pulp of a lower incisor, and was recorded as the electromyographic responses of the anterior belly of the digastric muscle, bilaterally. Conditioning electrical stimulation of the RN was found to suppress the JOR bilaterally. Microinjection of monosodium glutamate into the RN also suppressed the JOR bilaterally. The suppressive effect of the magnocellular part of the RN was significantly larger than that of the parvicellular part of the RN. These results imply that the RN is involved in control of the JOR evoked by noxious stimulus.