ABSTRACT
The aim of this study is to determine the relative movement of the teeth and bone after premaxillary distraction with a tooth-borne device constructed in the authors' centre. To evaluate the effects of this device on the anterior segment and teeth, the space formed between the anterior and posterior segments of the maxilla was measured on computerized tomography images from 10 patients. The average differences were 3.5mm at the apex level, 5.5 mm at alveolar ridge level and 7.4 mm at crown level on the right side. On the left side, the average differences were 3.2, 5.2 and 7.1 mm, respectively. There were statistically significant differences between all these measurements (p<0.05), but the difference between right and left sides was not statistically significant (p>0.05). The ratio between the movements at apex and crown levels was 46%. These results showed that the tooth-borne distractor was able to distract the anterior segment of the maxilla but it also caused anchorage loss of the maxillary incisors.
Subject(s)
Dental Arch/surgery , Maxilla/surgery , Orthodontic Anchorage Procedures/instrumentation , Osteogenesis, Distraction/instrumentation , Adolescent , Alveolar Process/diagnostic imaging , Cephalometry/methods , Child , Dental Arch/abnormalities , Dental Arch/diagnostic imaging , Equipment Design , Female , Humans , Incisor/diagnostic imaging , Incisor/pathology , Male , Malocclusion/surgery , Malocclusion/therapy , Maxilla/abnormalities , Maxilla/diagnostic imaging , Orthodontic Anchorage Procedures/methods , Orthodontic Appliance Design , Osteogenesis, Distraction/methods , Tomography, X-Ray Computed , Tooth Apex/diagnostic imaging , Tooth Apex/pathology , Tooth Crown/diagnostic imaging , Tooth Crown/pathology , Tooth Movement Techniques/instrumentation , Tooth Movement Techniques/methods , Treatment Outcome , Young AdultABSTRACT
The aim of this paper is to investigate the anatomical topography and the relationship between the ligaments, malleus and temporomandibular joint (TMJ) and to determine the role of these ligaments on the movement of the malleus. The malleus, incus, petrotympanic fissure (PTF), chorda tympani, anterior malleolar ligament (AML), discomallear ligament (DML), malleomandibular ligament, sphenomandibular ligament and articular disc were explored in 15 skulls. Traction and tension tests were carried out to clarify their role in malleolar movement. In 12 of the cases, two separate ligaments were connected to the anterior of the malleus, whereas a single ligament from the anterior of the malleus to the PTF was observed in 3 cases. In 12 cases, the DML united the retrodiscal tissues. In the other 3 cases, the medial and the lateral parts of the ligament were connected to the retrodiscal tissue after passing through the PTF. The thickness of the ligaments differed among specimens. When tension was applied to the DML no malleolar movement occurred, but when the AML was overstretched, significant movement was observed in 5 cadavers; little movement in 6 cadavers, and no movement in 4 cadavers. This study suggests that extreme stretching of the condyle in conjunction with the ligaments between the ossicles of the inner ear and the TMJ could be the reason for unexplained otological problems.
