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Questions and Answers
What is the term given to chemicals and other agents capable of producing embryologic defects if given at the critical time?
Which syndrome is associated with severe maxillary deficiency at birth due to pressure against the developing face prenatally?
What type of fractures are relatively common in children due to falls and impacts, especially affecting the condylar neck of the mandible?
What is the term for a deformity that becomes progressively worse over time?
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What is the term for injuries apparent at birth that result from pressure against the developing face prenatally?
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Which factor is NOT mentioned as a specific cause of malocclusion?
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Which syndrome is associated with defects in cartilage formation and is observed in one-third of Pierre Robin patients?
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What is the term for heavy pressure in the area of the tempromandibular joint (TMJ) resulting in internal hemorrhage and subsequent underdevelopment of the mandible?
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What is the term for the type of fractures that are more frequent in children and are often unilateral rather than bilateral?
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Which type of injury results from an arm being pressed against the face during pregnancy, causing severe maxillary deficiency at birth?
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Study Notes
Conservative Management and Early Mobilization of the Jaw
- The best therapy for TMJ involves conservative management and early mobilization of the jaw.
Destructive Processes Involving TMJ
- Autoimmune diseases, such as rheumatoid arthritis, can eat away at the joints.
- Congenital absence of tissue, as seen in craniofacial microsomia, can also affect TMJ.
Muscle Dysfunction
- Muscle dysfunction can affect jaw growth in two ways:
- Formation of bone at the point of muscle attachment depends on muscle activity.
- Musculature is an important part of the soft tissue matrix, which normally carries the jaws downward and forward.
- Loss of part of the muscles can result from damage to the motor nerve, leading to underdevelopment of the face and deficiency of both soft and hard tissues.
- Muscle contraction can lead to scarring, which can restrict growth and cause facial asymmetry.
- Examples of muscle contraction include torticollis, which can cause twisting of the head due to excessive tonic contraction of the neck muscles.
Decrease in Tonic Muscle Activity
- Decreased muscle activity can allow the mandible to drop downward, away from the rest of the facial skeleton.
- This can result in:
- Increased anterior face height.
- Distortion of facial proportions and mandibular form.
- Narrowing of the maxillary arch.
- Excessive eruption of posterior teeth and anterior open bite.
Disturbances Arising in Adolescence or Early Adult Life
- Hemimandibular hypertrophy (formerly called condylar hyperplasia) can occur, causing unilateral excessive growth of the mandible and facial and skeletal asymmetry.
- Acromegaly, caused by an anterior pituitary tumor, can lead to excessive growth of the mandible, creating a skeletal Class III malocclusion in adult life.
Disturbances of Dental Development
- Disturbances of dental development can contribute to isolated Class I malocclusion.
- Examples include:
- Drift of permanent teeth after early loss of primary teeth.
- Dental problems related to congenital or health problems, such as crowding or missing lateral teeth in patients with cleft palate.
- Congenitally missing teeth, such as tooth agenesis, can occur due to a genetic basis.
- Anodontia, oligodontia, and hypodontia are rare, but hypodontia is a relatively common finding.
- Ectodermal dysplasia, a genetic disorder, can cause anodontia and oligodontia, as well as thin, spare hair and absence of sweat glands.
Malformed and Supernumerary Teeth
- Malformed teeth can result from disturbances during the morphodifferentiation stage of development.
- The most common abnormality is a variation in size, often seen in maxillary lateral incisors, mandibular or maxillary second premolars.
Outline Definitions
- The causes of orthodontic problems can be classified into:
- Genetic influences.
- Environmental influences.
- Etiology in contemporary perspective.
- Specific causes of malocclusion include:
- Disturbances in embryologic development.
- Growth disturbances in the fetal and perinatal period.
- Disturbances arising in adolescence or early adult life.
- Disturbances in dental development.
Disturbances in Embryologic Development
- Defects in embryologic development usually result in the death of the embryo.
- Teratogens, such as chemicals, can affect dentofacial development if given at a critical time.
Growth Disturbances in the Fetal and Perinatal Period
- Fetal molding and birth injuries can occur, leading to distortion of rapidly growing areas.
- Examples include:
- Intrauterine molding, where pressure against the developing face prenatally can lead to distortion.
- Birth trauma to the mandible, where the use of forceps to assist delivery can cause damage to the TMJ.
Progressive Deformaties in Childhood
- Progressive deformaties can worsen over time, such as:
- Childhood fractures of the jaws.
- Muscle dysfunction.
- Childhood fracture of the jaws, where the condylar neck of the mandible is particularly vulnerable to fracture.
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Description
Test your knowledge on conservative management and early mobilization techniques for temporomandibular joint (TMJ) issues, as well as other destructive processes involving TMJ such as autoimmune disorders, congenital absence of tissue, and muscle dysfunction.
