[Legend, art and medicine]. / Légende, art et medicine.

The study of the heredity of mandibular proganthism has curiously been initiated by a legend and by the examination of a Brussels tapestry. The hereditary condition of mandibular prognathism was recognized by the study of numerous iconographic documents concerning the Habsburger family. Charles V was the most representative of this anomaly of the lower jaw. Numerous members of the Spanish House and of the Austrian House were afflicted with mandibular prognathism. Family intermarriages promoted the multiplication of mandibular anomaly in those important families.

L'étude de l'hérédité de la prognathie mandibulaire a curieusement été initiée par une légende et par l'examen d'une tapisserie de Bruxelles. L'étude de documents iconographiques de la famille des Habsbourg a permis de démontrer le caractère héréditaire de cette malformation. Charles Quint fut le représentant le plus caractéristique. De nombreux membres des Maisons d'Espagne et d'Autriche étaient prognathes. Les mariages consanguins ont permis la multiplication de cette hypertrophie de la mâchoire inférieure dans ces familles importantes.

Retrognathic maxilla in "Habsburg jaw". Skeletofacial analysis of Joanna of Austria (1547-1578).

OBJECTIVE: To evaluate the dentoskeletal features of the "Habsburg jaw" by analyzing the skull of Joanna of Austria. MATERIALS AND METHODS: The skull, the panoramic radiograph, and the lateral cephalogram of Joanna of Austria were analyzed. The cephalometric values of Joanna were compared to cephalometric standards for adult female subjects. RESULTS: The analysis of the dentition on the dry skull and on the panoramic radiograph showed a generalized horizontal alveolar bone resorption with severe bone loss that was interpreted as a sign of severe periodontal disease with respect to the young age (31 years). The cephalometric analysis revealed the presence of a skeletal Class III disharmony associated with maxillary retrusion and normal sagittal position of the mandible. The maxilla exhibited a reduction in the sagittal dimension while the mandible presented with increased dimensions both in total mandibular length (Co-Gn) and in the mandibular body (Go-Gn). The skeletal open bite contributed to the lack of mandibular protrusion though in presence of increased mandibular sagittal dimensions. CONCLUSION: Joanna of Austria appeared to be affected by a peculiar type of "Habsburg jaw" as the Class III skeletal disharmony was due to a retrognathic maxilla rather than to a prognathic mandible.

Má oclusão Classe III de Angle, subdivisão direita, tratada sem exodontias e com controle de crescimento / Angle Class III malocclusion, subdivision right, treated without extractions and with growth control

A Classe III de Angle é uma má oclusão caracterizada por discrepâncias anteroposteriores dentárias e faciais, normalmente acompanhadas por alterações esqueléticas, com componente genético associado. O diagnóstico precoce e correto e o tratamento adequado são de suma importância para promover o controle do crescimento e evitar recidivas. Este artigo relata o tratamento, executado em duas fases, de uma paciente do sexo feminino de 12 anos de idade, apresentando uma má oclusão de Classe III de Angle, subdivisão direita, com mordida cruzada anterior em máxima intercuspidação habitual (MIH) e topo em relação cêntrica (RC), apresentando, ainda, falta de espaço na maxila, que foi tratada sem exodontias e com controle de crescimento. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), representando a categoria 1, ou seja, uma má oclusão Classe III de Angle, tratada sem exodontias e com controle de crescimento, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Angle Class III malocclusion is characterized by anteroposterior dental and facial discrepancies usually accompanied by skeletal changes associated with a genetic component. Early, accurate diagnosis and appropriate treatment are of paramount importance to promote growth control and prevent relapse. This article reports the two-phase treatment of a female patient, aged 12 years, with an Angle Class III, subdivision right malocclusion with anterior crossbite in maximum intercuspation (MIC) and end-on bite in centric relation, further presenting with lack of maxillary space. The case was treated without extractions and with growth control. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as representative of Category 1, i.e., Angle Class III malocclusion treated without tooth extractions, as part of the requirements for obtaining the BBO Diploma.

Evolución del tratamiento quirúrgico en las clases III esqueletales / The evolution of surgical treatment of skeletal class III

Se presentan los cambios de tendencia en los últimos 25 años, en el tratamiento quirúrgico de las clases III esqueletales (prognatismos mandibulares). Los datos acumulados por quinquenios, demuestran el cambio desde osteotomías únicas en el cuerpo de la mandíbula, luego osteotomías de ramas extraorales e intraorales, hasta llegar a las osteotomías múltiples, maxila, mandíbula y mentón. Esto como respuesta a un mejor entendimiento de los cuadros clínicos, mejor diagnóstico, mejores sistemas de planificación, experiencia quirúrgica y de los equipos quirúrgico-ortodónticos y a la evolución de las técnicas y conocimientos

Roentgencephalometric analysis of the skulls of the Luxemburgs, the second Bohemian Royal Dynasty.

X-ray films of the skull of the king and emperor Charles IV and his four wives and two sons were made under standard conditions with the mandibles fixed in a centric occlusion. The results of roentgenocephalometric analysis were compared with norms valid for the contemporary Czech population. Consistent with the somatic condition of Charles IV, the findings indicate an above-average large face with the usual anteriorotational developmental type. The facial skeleton is structurally harmonious, but the sagittal intermaxillary relations belong into skeletal class II with a relatively retruded lower jaw in relation to the upper one. This is associated with a greater maxillary overjet of the upper incisors. The disharmony was caused by a fracture of the mandibular condyles. Reconstruction of the condition before the injury revealed an originally normal anteroposterior relationship of the jaws (skeletal class I) and occlusion of the incisors. As to the shape of the cranium, Charles IV's wives differ in basic features. In two, for different reasons, we find skeletal class II (retrogenia), in one skeletal class III (progenia) and only in Elizabeth of Pomerania, with marked flattening of the cranial base and posteriorotation of the face are the anteroposterior relations of the two jaws normal (skeletal class I). Wenceslas IV differs from his parents Charles IV and Anne of Svidnic by a flat cranial base which pushes the lower jaw backwards, however, it does not cause its posteriorotation; we find, similarly as in the father and mother, an anteriorotational growth type of the face. In the other basic parameters of the cranium there are no marked differences between son and parents. In evaluating the similarity of the facial structure of John of Görlitz to that of his parents, disagreement is caused by the flat cranial base of the mother Elizabeth of Pomerania associated with posteriorotation of the face. In the son we find, conversely, an even more marked anteriorotation than in the father and also other parameters of the facial configuration indicating plausible agreement with the findings in Charles IV. The curving of the cranial base has an impact on the shape of the whole cranium, but the results indicate that the heritability of the rotational growth type of face and the degree of cranial base curvature probably is not very marked.