Complications of laser conization versus loop electrosurgical excision procedure in pre- and postmenopausal patients.

Purpose ofinvestigation: The aim of this retrospective study was to compare the results and complications of laser conization and loop electrosurgical excision procedure (LEEP), performed for cervical intraepithelial neoplasia (CIN) or microinvasive carcinoma, between postmenopausal and premenopausal patients. MATERIAL AND METHODS: This study recruited a total of 551 patients. In the laser group (n = 405), there were 361 (89.1%) premenopausal and 44 (10.9%) postmenopausal women. In the LEEP group (n = 146), there were 129 (88.4%) premenopausal and 17 (11.6%) postmenopausal women. The factors investigated in both groups were the length of the tissue cone removed and the presence of positive endocervical cone margins, residual disease, and cervical stenosis. RESULTS: In the laser group, the length of the tissue cone was significantly longer in postmenopausal patients (17.9 ±3.9 mm vs. 15.7 ± 3.6mm; p = 0.002). The rate of positive endocervical margins was significantly higher in premenopausal patients (9.1% vs. 0%; p = 0.037). The rate of cervical stenosis was significantly higher in postmenopausal patients (59.1% vs. 8.3%; p < 0.0001). In the LEEP group, there were no differences in the length of the tissue cone (premenopausal, 11.7 ± 1.9 mm vs. postmenopausal, 11.4 ± 2.7 mm; p = 0.12), the rate of positive endocervical margins (24.0% vs. 17.6%), or the rate of residual disease (13.2% vs. 17.6%). The rate of cervical stenosis was significantly higher in postmenopausal patients (23.5% vs. 4.1%; p = 0.002); however this rate was significantly lower than that seen in the laser group. CONCLUSION: In postmenopausal patients, the rates of positive endocervical cone margins and of residual disease were higher in the LEEP group; however, the rate of cervical stenosis was higher in the laser group. Physicians should be aware of the characteristics of the devices used for cervical conization in postmenopausal women with CIN.

A lip seal study of Japanese children with malocclusion.

The purpose of this study was to clarify the relationship between lip seal and malocclusion in Japanese children. Fifty-three patients aged 7 to 14 years (mean 10.24 +/- 1.93) were selected randomly, and compared with 20 subjects with normal occlusion aged 7 to 14 years (mean 10.50 +/- 2.56). The subjects were divided into a good lip seal group and poor lip seal group by observing the distance between the upper and lower lip at rest. The variables that were analyzed for morphological evaluation included model analysis and cephalometric analysis. Noted for functional evaluation were tongue position, the size of the tonsils and adenoids and the oral muscle force measured by button pulling. In the evaluation of the degree of lip seal, there was no statistical difference between subjects with malocclusion and those with normal occlusion. Within the group with malocclusions, however, there were significant differences in overbite (p < 0.01), overjet (p < 0.01), and oral muscle force by button pulling (p < 0.05) between the good lip seal and poor lip seal groups. These results suggest that there is a need not only to correct malocclusion but also to be aware of lip sealing so that it may be improved in Japanese children.

Occlusal stability after extraction orthodontic therapy in adult and adolescent patients.

In this study we compared the posttreatment stability of occlusion in adults and adolescents treated for crowding or maxillary protrusion with four-premolar extractions and edgewise mechanics at an average of more than 4 years out of treatment. The adolescent sample showed a significantly greater posttreatment increase in mandibular anterior crowding than the adult sample. Posttreatment overjet and overbite remained more stable in the adolescents. We noted a correlation between in-treatment expansion and posttreatment narrowing of mandibular intercanine width in the adults. Differences in postorthodontic occlusal changes were noted between the adult and adolescent samples.

Stability of occlusion after orthodontic treatment with tooth extraction in adult cases.

The purpose of this study was to evaluate stability of occlusion in adult cases at least 4 years after orthodontic treatment and to clarify parameters influencing this stability. The subjects were 25 cases (mean age: 19 y 8 m) who had been treated with Edgewise technique involving first-premolar extraction. During orthodontic treatment, decreases in the maxillary and mandibular incisors' irregularity index (Max.I.I. and Mand.I.I.), posterior movement of the upper and lower incisors, increases in upper incisal height, decreases in lower incisal height, and increases in upper and lower canine width were noted. In the posttreatment period, increases in Max.I.I. and Mand.I.I., anterior movement of incisors, increases in incisal height, and decreases in canine width were observed. The amounts of overjet and overbite decreased during the treatment period and increased during the post-treatment period. Multiple regression analysis was useful to deduce which parameters influenced stability of occlusion after orthodontic treatment.

Case report of lateral crossbite. Part I. Mixed dentition.

Lateral crossbite on mixed dentition does not always cause facial asymmetry or functionally abnormal movement of the mandible in children. However, it is often observed that facial asymmetry will worsen during growth in the absence of orthodontic treatment. In adult cases, lateral crossbite is one of the etiological factors of temporomandibular joint disorder. This case report presents two cases of lateral crossbite of mixed dentition. The terms of treatment were shorter than those in cases with permanent dentition. Also, methods of treatment were simpler, and the patients developed favorably. The opposite results were obtained in cases of permanent dentition.

An orthodontic study of temporomandibular joint disorders. Part 2: Clinical research in orthodontic patients.

The purpose of this survey was to investigate the symptoms of temporomandibular joint disorders (TMD) in orthodontic patients and to define the relationships between symptoms and malocclusion and/or orthodontic treatment. The subjects were 532 patients, 6 to 38 year old Japanese, in the orthodontic department of Tokyo Dental College Hospital. They were examined for past or recent TMJ sounds, pain in the TMJ area, and abnormal jaw movements. The prevalence of TMJ symptoms was 33.8%. Sex differences were not statistically significant. The prevalence of TMD symptoms increased with age. TMD symptoms in young orthodontic patients (6-18 years old) were more common than in untreated subjects. Posterior crossbite and open bite patients had a high prevalence of symptoms.

An orthodontic study of temporomandibular joint disorders. Part 1: Epidemiological research in Japanese 6-18 year olds.

Malocclusion is considered one of the etiological factors of temporomandibular joint disorder (TMD). The purpose of this study was to investigate the prevalence of TMD and the relationship between TMD and the type of occlusion. The sample consisted of 7337 Japanese children, 6-18 years old, 3219 boys and 4118 girls. TMD symptoms were recorded as well as the type of occlusion in children with TMD. The prevalence of TMD overall was 12.2%. The prevalence increased with age and was slightly higher in girls (13%) than in boys 11.1%. This difference was not statistically significant. Joint sound as the only symptom was more common in younger subjects. TMD symptoms seemed more complicated with age when pain and abnormal jaw movement combined with sound. Joint sound was the most common symptom (89.3%), followed by the combination of sound and pain (2.2%). The incidence of other symptoms was under 1%. In subjects with TMD, 24.9% exhibited crowding, 20.1% had excessive overjet, 6.8% deep bite, 6.3% edge-to-edge bite, 5.6% anterior crossbite, 5.4% open bite, and 3.8% posterior crossbite. Morphologically normal occlusion was observed in 27.1%. In this study, many subjects with TMD had malocclusions. Early treatment may be important in the prevention of severe TMD. Although those with morphologically normal occlusions were included, a more detailed study concerning other causes of TMD is needed also.

[Longitudinal observation of condylar position in anterior crossbite at the mixed dentition during orthodontic treatment].

We investigated the condylar position by transcranial radiography which can be put daily clinical use easily. The patients are 8 anterior crossbite at the mixed dentition (4 functional crossbite and 4 skeletal crossbite). We observed their condylar positions before treatment (average age is 9.3 years old), after correction of overbite (average age is 10.0 years old) and 3-4 years after correction of overbite (average age is 14.0 years old). The results were as follows: 1. Condylar position of 7 cases changed after correction of overbite. The differences between right and left condylar position of six in seven cases had been recognized before treatment decreased after correction of overbite. Their condylar position were stable during the observation period of 3-4 years after correction of overbite. The condylar position of the other one case closed to fossa and then relapsed 3-4 years later. 2. Condylar position of only one case hasn't changed during the observation. 3. In functional crossbite cases, there were some differences between right and left condylar position before treatment, but no differences after crossbite correction. In skeletal crossbite cases, there was no tendency of the changing on their condylar position through treatment. 4. The changing to same direction was observed in the decrease of differences on condylar position and in the result of frontal cephalogram analysis. 5. There wasn't special relationship between changing of condylar position and orthodontic appliances. 6. TMJ dysfunction was observed in the case which has significant difference in its condylar positions before treatment and in the other case in which difference was not corrected after treatment. We recognized the usefulness of transcranial radiography for orthodontic treatment.