Richard P. McLaughlin

A comparative study of Caucasian and Japanese mandibular clinical arch forms.

The purpose of this study was to clarify morphological differences between Caucasian and Japanese mandibular clinical arch forms in Class I, II, and III malocclusions. The study included 60 Class I, 50 Class II, and 50 Class III cases from each ethnic group. The most facial portion of 13 proximal contact areas was digitized from photocopied images of the mandibular dental arches. Clinical bracket points were calculated for each tooth based on mandibular tooth thickness data. Four linear and 2 proportional measurements were taken. The dental arches were classified into square, ovoid, and tapered forms to determine and compare the frequency distributions between the 2 ethnic groups. The Caucasian population had a statistically significant decreased arch width and increased arch depth compared with the Japanese population. When the subjects were regrouped by arch form, no statistically significant difference in arch dimension was observed between the 2 ethnic groups in any of the arch form samples. Our results suggest that there is no single arch form specific to any of the Angle classifications or ethnic groups. It appears to be the frequency of a particular arch form that varies among Angle classifications or ethnic groups.

Comparison of arch forms between Israeli and North American white populations

INTRODUCTION The aim of this study was to evaluate the morphologic differences in the mandibular arches of Egyptian and North American white subjects. METHODS The sample included 94 Egyptian subjects (35 Class I, 32 Class II, and 27 Class III) and 92 white subjects (37 Class I, 29 Class II, and 26 Class III). The subjects were grouped according to arch form types (tapered, ovoid, and square) to compare their frequency distribution between ethnic groups in each Angle classification. The most facial portions of 13 proximal contact areas were digitized on scanned images of mandibular casts to estimate the corresponding clinical bracket point for each tooth. Four linear and 2 proportional measurements were taken. RESULTS In comparing arch dimensions, intermolar width was narrower in Egyptians than in the whites (P = 0.001). There was an even frequency distribution of the 3 arch forms in the Egyptian group. On the other hand, the most frequent arch form was ovoid followed by tapered and square in the white group; the square arch form was significantly less frequent than the tapered and ovoid arch forms (P = 0.029). CONCLUSIONS The arch forms of Egyptians are narrower than those of whites. The distribution of the arch form types in Egyptians showed similar frequency, but the square arch form was less frequent in whites. It is recommended to select narrower archwires from the available variations to suit many Egyptian patients.

The extraction–nonextraction dilemma as it relates to TMD

Extraction has been a controversial subject for as long as the specialty of orthodontics has existed. Some authors believe that the extraction of premolars leads to temporomandibular disorders. This occurs, they say, because the vertical dimension collapses. Concomitantly, over-retraction and retroclination of the incisors cause the facial profile to flatten, bring about premature anterior contacts, and distally displace the mandible and mandibular condyle. Numerous correlation studies in the dental literature do not support this contention. There appears to be no higher incidence of temporomandibular disorders in patients treated with the extraction of premolars than in nontreated patients or those treated without extractions. Analysis of premolar extraction cases reveals that there is no collapse of the vertical dimension; on the contrary, the vertical dimension is either maintained or slightly opened. Similarly, there is no evidence that premolar extraction causes undesirable flattening of the facial profile. The facial profile established during treatment is primarily the result of diagnosis and treatment mechanics. Excessive anterior interferences resulting in possible posterior condyle displacement are the result of treatment mechanics. When arches are leveled properly and space closure and overjet reduction are adequately controlled, there is no reason that such interferences should occur.

Finishing with the preadjusted orthodontic appliance

Abstract With the preadjusted orthodontic appliance, there is a gradual progression toward finishing, rather than an abrupt stage of tedious wire bending. Therefore, the fewer the errors made as treatment progresses, the less work required during finishing. There are horizontal, vertical and transverse factors to be considered relative to finishing, as well as dynamic, cephalometric and esthetic factors. Horizontally, it is important to establish the correct tip of the anterior and posterior teeth. Adequate torque of the incisors must be controlled and all spaces should be closed, unless restorations are indicated. Vertically, crown lengths, marginal ridge relationships and contact points must be adjusted. Final correction of the curve of Spee must be established. Transversely, arch form and arch wire coordination must be set up, and posterior torque must be corrected. From a dynamic standpoint, the condyles should be in centric relation when the teeth occlude, and functional movements should be established. By this stage, habits should be corrected. And finally, cephalometric objectives should be reviewed, as well as esthetic objectives.