Analysis of condylar differences in functional unilateral posterior crossbite during early treatment--a randomized clinical study.

OBJECTIVE: The analysis of potential discrepancies in condyle position among different occlusal relations (centric relation and maximum intercuspidation) is a key diagnostic component when treating children with unilateral posterior crossbite. Due to strict requirements imposed by ethics committees, and new regulations regarding the use of X-rays, radiological examinations (axial cephalometric radiographs or postero-anterior cephalometric radiographs) are not feasible. Thus the aim of this study was to apply an alternative procedure for the assessment of condylar deviations. PROBANDS AND METHODS: : We employed ARCUS digma, a measuring system based on ultrasound technology, to record condylar differences occurring in 65 children (6.9+/-2.0 years of age) with functional unilateral posterior crossbite in late deciduous and early mixed dentition. After randomization, 31 patients underwent early orthodontic treatment (bonded palatal expansion appliance and U-bow activator), whereas 34 patients remained untreated. Examinations were carried out at the beginning (T1) and after 12 months of treatment (T2). A three-dimensional (3D) assessment of deviations between maximum intercuspidation and centric position was carried out. Statistical analysis was performed using the SPSS 12.0 software program. RESULTS: Initially, the electronic position analysis revealed no significant differences between the control and therapy groups. A mean condylar deviation of > 2 mm was noted at T1 in the sagittal, frontal and transversal planes for crossbite and the noncrossbite sides. This difference was reduced in the therapy group, a finding that proved statistically highly significant (p<0.001). We also observed a highly significant (p<0.001) difference between the control and therapy groups at T2. CONCLUSION: The Münster concept for early treatment of functional unilateral posterior crossbites in late deciduous and early mixed dentition significantly improved the treated patients' occlusion in comparison to a randomized control group, which exhibited no spontaneous self-healing tendencies.

Trunk inclination, pelvic tilt and pelvic rotation in relation to the craniofacial morphology in adults.

OBJECTIVE: To relate the differences in the posture of patients with different craniofacial morphologies. SUBJECTS AND METHODS: Fifty-three adult patients with Class II and III malformations were examined by cephalometric analysis and rasterstereography. The facial depth, maxillary position, mandibular plane angle, inner gonial angle, facial axis, and lower facial height were evaluated and classified into a basal distal-mesial group and a horizontal-vertical group by means of threshold parameters. Analyzing the results of the rasterstereography, the spine's lateral perpendicular deviation, the pelvic tilt, and the pelvic rotation were calculated by means of mathematical algorithms on the basis of the three-dimensional spine profile. To determine the statistically significant correlations between the studied parameters, the t-test was applied in groups with a normal distribution, and the Mann-Whitney U-test was used in the cases of abnormally distributed variables (significance level P < .05). RESULTS: Statistically significant differences (P < .05) in pelvic torsion were documented with respect to the facial axis and facial depth. Moreover, the differences (P < .05) between patients with a skeletal horizontal-vertical facial axis and patients with a basal distal-mesial position for the facial depth could be determined for the pelvic torsion. CONCLUSIONS: As a clinical consequence of the results, an extension of the interdisciplinary concepts within the sense of an orthopedic examination can be considered for patients undergoing a combined orthodontic-operative therapy.

Sagittal spinal posture in relation to craniofacial morphology.

OBJECTIVE: The aim of this study is to determine correlations between the parameters of body posture in the sagittal profile and sagittal jaw position by obtaining objective and valid three-dimensional measurements of the dorsal profile by means of rasterstereography. MATERIALS AND METHODS: Fifty-three adults with Class II or III malocclusions were examined, and six angular parameters were determined. For the sagittal analysis of body posture, the Fleche Cervicale and Lombaire as well as trunk inclination were evaluated. RESULTS: Statistically significant correlations (P < .05) were found between Facial Axis and Fleche Cervicale, Mandibular Plane angle and Fleche Cervicale, and Facial Depth and the Fleche Cervicale. CONCLUSIONS: It can be concluded that the mandible seems to have a greater effect on body posture than other craniofacial parameters. As a clinical result of this study, patients with severe malocclusions should be examined interdisciplinarily before orthognathic surgery is performed to minimize postural influence on the altered jaw relationship after surgery.