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While planning treatment of the 30 patients with a dental and skeletal class II anomaly on which this study is based, the primary treatment goals were correction of the dental and skeletal structures and attenuation of vertical growth by means of influencing the maxillary skeletal structures and the resultant mandibular reaction. The desired treatment results were achieved in all patients. Even so, however, the effects on individual patients in respect to skeletal influences were markedly different. It was especially helpful that during therapy simultaneously with exerting influence on the maxillary base plane, the influencing of the occlusal plane occurred in the same direction. Through the additional application of high-pull headgear, maxillary growth was clearly restrained and the inclination of the maxillary base plane inhibited. Even difficult skeletal discrepancies, sagittal as well as vertical, can be treated with the bite-jump appliance in combination with a high-pull headgear. This also makes it possible to achieve protrusive repositioning of the mandible in patients with a pronounced vertical growth pattern without causing on open bite. In retrospective the patients' treatment plans proved to be completely appropriate, however, the fact should not be overlooked that changing the occlusal plane is essential for the realization of a positive therapeutic result.

This follow-up study evaluates lateral skull radiographs and jaw casts taken prior to treatment, at the end of treatment, and after a control period of one at a minimum of 25 orthodontically treated children, 14 males and 11 females, who had an Angle class II, 1 malocclusion and a deep overbite with the lower incisors impinging upon the palatal gingiva. The study's object of interest was the anterior-posterior relationship of the lower incisor edge to the upper incisor root centroid (i.e., the "edge-centroid relationship", Houston [7]). Its intent was to evaluate the correlation between edge-centroid relationship and an overbite relapse respectively when viewed in relation to the developments which take place in the dental and skeletal variables during the course of overbite reduction. The edge-centroid relationship was found, to present an interesting screening method in diagnosing class II, 1 cases, and, although with some reservations, the relationship is also useful in planning treatment.

In this study 15 patients with abnormalities in dentition and jaws were analysed by computer tomography for the purpose of determining the diagnostic value of dental CT scanning in relation to orthodontic problems. The dental CTs were then compared with conventional panoramic x-rays. After describing principles and methodology, the study discusses the possibilities for clinical applications. The study demonstrated that dental CT scanning is definitely superior for diagnosing dentition disturbances, for metrical analysis of maxillary antrum relations, and for examining bony jaw structures. However, the routine use of dental CT scanning as a diagnostic method is at this time constrained due to the relatively high amount of time and labour the procedure requires with resulting implications for cost factors.

A dynamic B-mode ultrasound technique supported by video recording was employed on 51 patients between the ages of six and 45 years for the purpose of imaging the tongue at rest and in motion during swallowing. All patients either in their case histories or at clinical examination demonstrated orofacial dysfunction of the tongue or an abnormal oral phase during swallowing. The ultrasound sequences of a 5 MHz sector scanner (100 degrees, 30 images/sec) were videotaped for the purpose of analyzing the sagittal and vertical movement components during swallowing. The sagittal sector scan revealed a visceral swallowing pattern in 21 patients. Noticeably often patients with an Angle class III malocclusion also displayed an abnormal swallowing pattern. Ultrasound scanning in the coronal and sagittal plane is a noninvasive imaging technique free of the biological risks associated with radiation. The dynamic ultrasound technique may be employed for early detection and diagnosis of tongue discoordinations and is especially to be recommended for the objective imaging and identification of tongue thrust in orthodontic patients.

The purpose of the study was to analyse and compare deep overbite correction in adult patients carried out by a straight wire appliance and the segmented arch technique as recommended by Burstone. The sample comprised 50 adult, deep bite patients, 25 each treated with straight wire appliance and segmented arch technique. Plaster casts and lateral cephalograms made before and immediately after finishing treatment were analysed. Both techniques were successful in overbite correction; overbite reduction amounted to 3 to 3.5 mm. The straight wire appliance group demonstrated predominantly molar extrusion and as a result posterior mandibular rotation. A slight intrusion of 1 mm was seen in the lower incisor area. The segmented arch technique resulted in an incisor intrusion of 1.5 mm in the upper and 1.7 mm in the lower jaw. No substantiate extrusion in the molar area was found. The advantages of this technique are discussed.

On the basis of a clinical and functional analysis, the diagnosis of a group of patients with Angle class II/2 malocclusion is compared with a control group with normal occlusion in a statistical study. The present study confirms the tendency revealed in the literature for patients with an Angle class II/2 malocclusion to more frequently show symptoms of a myoarthropathy. However, our results failed to confirm the assumption made in previous studies that class II/2 patients have a steep condylar axis. In particular in patients with relatively vertical upper incisors and a deep bite, a functional analysis should be done at the start of treatment. In the event of problems being found, the primary aim of therapy is the correction of the upper incisor angle.

88 children with a class II/1 malocclusion were analyzed cephalometrically concerning dental and skeletal changes through a period of approximately 10 years. 50 patients were treated with function regulators and 38 cases served as a control group. At the beginning, there were no significant differences between the groups studied but in the end, the patients at the age of approximately 17 treated with function regulators showed a stronger mandibular advancement of 4-4.5 mm.

A prospective follow-up study of 21 class-II patients, who were treated with a combination of orthodontics and orthognathic surgery, revealed typical postoperative changes in opening mobility. Their characteristics were: a strong initial loss of mobility and a regeneration period of about one year. Because the increase of mobility could not completely compensate for the initial reduction, a significantly reduced mobility was detected 25.5 months postoperatively. This reduction was considered as clinically acceptable, since former studies showed more unfavorable developments. However, individual changes of mobility are worth of notice. The comparison of condylar-related axiographic measurements with incisal measurements showed that the reduction of the length of axiographic tracings was more prominent than the "clinical-effective" reduction of the combined condylar rotation and translation.

The results of the study show whether the classification of mandibular growth potential, as proposed by Petrovic, Lavergne and Stutzmann has any influence on the treatment with a function regulator. X-rays of 140 class II patients were analysed after a treatment time of approximately 2 years. In comparison with 133 class II children without any treatment, a significant increase of mandibular length was observed in almost all children treated. There was no significant difference in the increase of mandibular length between category 2 (low growth potential) and category 5 (high growth potential).

The status of temporomandibular joint and muscle function was examined in a group of 22 adult patients, who underwent combined orthodontic and surgical treatment. Even though nearly all patients were very content with the results of the therapy, 2/3 showed a rather reduced movement of the condyle after mandibular sagittal split osteotomy. The causing factors are: arthrosis, permanent displacement of the disc or a change of muscle function after surgery.

A routine investigation of 270 preschool children revealed a high incidence of malocclusion, frequently associated with clinically discovered disturbances of mandibular movement, temporomandibular joint functions, habits or defective speech articulation. The prevalence of malocclusion and of functional disturbances in the deciduous dentition demands not only for a more intensive prevention of dental caries but a careful attention to early functional disturbances in occlusion, in mandibular movement and other numerous functions.

The down-fracture technique enables three-dimensional displacement of the maxilla in the Le Fort-I plane as well as its simultaneous multisegmentation. Using a semirigid technique of fixation with miniplates, a stable result can be obtained in orthodontic follow-up treatment without tendency to vertical and sagittal recurrence. The transverse deviations detected are interpreted primarily as functional adaptations. In cranial displacement of the maxilla by more than 10 mm, there is a risk of esthetic problems involving the region of the upper lip, the soft tissues of the nose and the cheek. The rate of subjective postoperative disorders is small. In the event of damage to the descending palatine artery, areas of necrosis may occur in the region of the anterior lateral teeth. The disorders of sensitivity of the gum and the gingiva typical for such operations do not result in subjective discomfort. The rate of iatrogenic damage to teeth is 5.6% in the patients followed up. Because of high acceptance of therapy and the low incidence of complications on the one hand as well as the various possibilities of therapy on the other hand, the down-fracture technique is regarded as the most important method of operation in orthodontic surgery at present.

The purpose of this longitudinal cephalometric study was to evaluate the influence of growth changes at nasion (N) on the position of the reference line NSL and consequently on the measurements of the angles SNA, SNB and ANB. Lateral head films from 46 orthodontically treated patients were evaluated over an average period of 3.7 years. The NSL reference line was defined with respect to growth changes at the N-point: A: no consideration of growth; B: consideration of growth in the sagittal plane; C: consideration of growth in the sagittal and vertical planes. The results showed that growth changes at nasion had a decisive influence on the position of the reference line NSL and thus also on the angles SNA, SNB and ANB. In order to avoid misinterpretations in the evaluation of orthodontic treatment results the growth changes at nasion must be taken into consideration.

In order to estimate the influence of fluorine (in drinking-water and air) on the occlusion 372 twelve-year-old children have been examined in four different localities with differing fluorine concentrations of drinking water and air. Apart from the determination of the fluorosis frequency and of the DMFt index, the number of children who do not require any orthodontic treatment according to the WHO recommendation has been determined. The degree of malocclusion has been defined by means of the Eismann-Masztalerz's method. There was observed that the optimal fluorine concentration in drinking water (0.7-0.9 mg/l) decreases the degree of malocclusion except for the crowding of the teeth whereas its concentration above the optimum (4.0-7.0 mg/l) as well as fluorine polluted air are one of the causes of crowding.

In our study of 107 patients, for whom data derived from clinical functional analysis, axiography and, in part magnet resonance imaging, were present, we were able to show that in routine orthodontic diagnosis the use of panoramic X-ray in the normal course of a general examination of the mandibular joint can also provide important indications of the presence of cranio-mandibular disorders. The panoramic X-ray revealed that in patients with Angle class II and front deep and open bite there were significantly mor changes in the form of the condyles. A definite morphologic finding of a retracted fovea pterygoidea was found frequently in patients with anterior disk replacement with or without reduction. Lastly, the panoramic X-ray showed that a change in form of the condyles, with in some cases a serious arthrosis, occurs significantly most frequent in patients with anterior displacement without reduction.

In the following study 20 adult skeletal open-bite patients were analysed after they had undergone dental compensation to camouflage the underlying skeletal discrepancy. The initial and final cephalometric records were analysed to determine the factors that led to the desired goal. The results showed no significant difference in the skeletal relationship. Molar intrusion was not recorded. The open-bite was correct mostly by reclining the upper incisors and by changing their position. Significant differences existed between the obtained results and the mechano-therapy employed. The geometrical model developed on the of the above makes it possible to predict and predetermine the targeted vertical dimension. Furthermore the results show extrusion of the front teeth as another dominant factor.

This study demonstrates the importance of X-rays of the hand in assessing skeletal changes in jaw relationships. The study is based on a follow-up examination of 53 patients with skeletal class II,1-, skeletal class II,2-, class III and skeletal open bite malocclusions who had been treated orthodontically. Statistical analysis of the growth parameters found a significant correlation between chronological age and skeletal age with considerable deviations depending on sex. At the end of the treatment period it was observed that 34% of all patients had not reached the end of puberty and had not achieved a mature level of growth. During the post-therapeutical period, growth was found on average to be 2.4% in the girls and up to 4.7% in the boys. When looking at the influence of growth and therapy, the patient group with skeletal class II,1 malocclusion exhibited at both therapeutical and post-therapeutical examinations a very positive development both in the horizontal and vertical basal relation of the jaw with a significant increase in mandibular length and in anterior lower facial height. On the other hand the class II,2 cases exhibited significantly reduced lower facial height, which can probably be considered to be a causal factor in the 70% relapse rate after completion of orthodontic treatment. In class III malocclusions the horizontal jaw relationship was stabilized throughout the orthodontic treatment period, however, following treatment a progressive alteration became apparent. The results achieved in this study add weight to the importance of taking skeletal maturation factors into consideration in patients with skeletal jaw discrepancies. These factors are useful in prognosticating the therapeutical goal to be achieved, the degree of stability during treatment, and the chances of relapse following treatment.

A study was undertaken to compare the psychosocial aspects of orthodontic treatment or non-treatment of female adults, 25 of whom underwent treatment and 25 of whom did not, with similar, visible malocclusion. Interviews, for which 52 standardized questions were prepared in collaboration with a graduate psychologist, served as the methodological basis of the study. The results of the study indicate that in relation to the aesthetic aspects of orthodontic treatment, the treated group showed a high degree of sensitivity and self perception. Following orthodontic treatment members of this group exhibited a highly significant improvement in their subjective perception of the aesthetic aspects of their dental and facial appearance. In spite of the differences observed in the 2 groups, it nevertheless remains difficult to draw general conclusions or to recommend guidelines which would cover all cases. When the question is to orthodontically treat or not treat female adults, the answer rests with the individual patient.

If the home-made cushioning appliance presented here is placed during ultrasonic examinations between the submental region and the probe head, then the problems caused by probe head movement and pressure on the submental region, as have been encountered in the past, can be solved. The use of such a cushioning appliance makes possible a more accurate B-mode ultrasonic evaluation of tongue function. The prevailing method and the cushioning method presented here were studied on 50 test patients. Comparison of the 2 methods revealed that in fact the use of the cushioning method prevented movement in the ultrasonic probe and also its use hardly impaired the patient's ability to swallow. We therefore recommend that this cushioning method be routinely applied during ultrasonic examinations of tongue function.

The purpose of this study was to examine functional occlusion of impacted maxillary canines which had been moved orthodontically into the line of occlusion. Examinations were performed on both patients and on an articulator, which was adapted to correspond to the axiographical findings. Functional contacts on the working side during lateral movement of the mandible were found in all orthodontically aligned impacted canines. Half the aligned teeth were involved in canine guidance, half in group function. Balancing side interferences were detected in 22% of the cases. The result of this study revealed a nearly identical function in the aligned canines when compared with the spontaneously erupted canines on the other side of the same maxilla. This became apparent during lateral excursion of the mandible. The angle of mesiodistal inclination of the tooth central axis with an occlusal plane was 84 degrees for aligned and 82 degrees on average for the spontaneously erupted canines.

Predicting the course of treatment for the individual case on the basis of traditional, morphological diagnostic records only, is at best uncertain. Current literature and clinical observations indicate that genetics and the individual's potential of adapting oro-facial functions to morphological changes play a crucial role. The problem of predictability obviously is multifactorial, and should be studied accordingly. In part 1 of this study, based on conventional documentation of two treated cases, the inadequacy of traditional diagnostic documentation limited to morphology and the subsequent uncertainty of predictions based thereon are demonstrated and discussed.

In this study 15 patients with abnormalities in dentition and jaws were analysed by computer tomography for the purpose of determining the diagnostic value of dental CT scanning in relation to orthodontic problems. The dental CTs were then compared with conventional panoramic x-rays. After describing principles and methodology, the study discusses the possibilities for clinical applications. The study demonstrated that dental CT scanning is definitely superior for diagnosing dentition disturbances, for metrical analysis of maxillary antrum relations, and for examining bony jaw structures. However, the routine use of dental CT scanning as a diagnostic method is at this time constrained due to the relatively high amount of time and labour the procedure requires with resulting implications for cost factors.

The purpose of orthodontic treatment of the deciduous dentition is to prevent the skeletal manifestation of anomalies. Anterior open bites, abnormal posterior occlusions, lateral cross-bites and negative (reverse) overjets, may be preserved in the permanent dentition. Early recognition of the anomalies and their aetiology makes it possible, by eliminating bad habits and through the use of simple appliances, to normalise occlusion and ensure physiological development of the permanent dentition.

The aim of this study was to determine the constancy and the extent of the dentoalveolar adaptation in subjects with disharmonious vertical jaw base relationships. Lateral head films in centric occlusion of 66 untreated adults were analysed. The subjects were divided in three facial type groups on the basis of the mandibular base angle (ML/NSL): hypodivergent (n = 23), normodivergent (n = 18), and hyperdivergent (n = 25). The relationships between maxillary and mandibular anterior and posterior dentoalveolar heights and vertical jaw base relationship were ascertained. The study revealed the following: an increase in vertical jaw base angle resulted in 1. an increase in maxillary and mandibular anterior and posterior dentoalveolar heights, 2. a larger increase in maxillary than in mandibular dentoalveolar height, and, 3. a larger increase in anterior than posterior dentoalveolar height. The study divulged the presence of dentoalveolar adaptation in subjects with a divergent vertical jaw base relationship. This adaptation, however, was inconsistent and in some cases incomplete.

The purpose of the present study was to discern possible relationships between dental parameters and the horizontal inclination of the condyle path. Two test groups of orthodontically untreated individuals with non-physiological incisor relationships, one group with enlarged and the other with reverse overjet, were selected for the study. An opto-electronic apparatus was employed to measure the horizontal inclination of the condyle path. The dental parameters were set by clinical examination and by measuring plaster casts. Both groups exhibited significant distribution deviations in the inclination of the condyle path and in the following parameters: "occlusal contacts of the front teeth during protrusion", "overbite", "resulting overjet", and "sagittal and vertical distance of the incisal edge of the lower incisors to the zero point of the upper incisors". Statistically no correlation between the dental parameters and the inclination of the condyle path was discerned. The influence of muscular guidance is in large measure the determining factor for the large variations in the TMJ registrations, and especially in their quantitative evaluation. The results were the same even when tracings were repeated a number of times with the same patient.

The amount of overbite reduction and the stability of the results three to 14.5 years post-retention were analysed in a follow-up study of 60 patients who had been treated with functional appliances. To establish therapeutic and posttherapeutic changes in dento-facial relationships, plaster casts and lateral cephalograms were evaluated at the beginning, at the end of treatment and at the follow-up examination. Posttherapeutic deepening of the overbite (0.8 mm) was found in 54.2% of the cases, while overbite reduction remained stable in 39%. A number of skeletal and dental factors were found to be involved in overbite reduction and posttreatment deepening. In this connection, changes in the ML-NSL angle, the ML-NL angle and the gonion angle were found to be just as important as the therapeutic and posttherapeutic changes in anterior and posterior facial height and changes in the skeletal pattern. It is emphasized that strict application of retention is of the greatest importance to minimize vertical relapse.

A link between the way of feeding on the one hand, and the Angle class findings, the spacing of deciduous incisors, malocclusion-normal occlusion and overjet and overbite on the other hand, has been examined on 272 children aged three years +/- two months who have been divided into two groups according to the way they were fed in the post-natal period (one group was not breast-fed and the other was breast-fed for the first six months). A chi 2-test has confirmed a statistically significant link between the variables such as the way of feeding in the post-natal period and malocclusion-normal occlusion, Angle class and overjet.

The purpose of the study was to analyse and compare deep overbite correction in adult patients carried out by a straight wire appliance and the segmented arch technique as recommended by Burstone. The sample comprised 50 adult, deep bite patients, 25 each treated with straight wire appliance and segmented arch technique. Plaster casts and lateral cephalograms made before and immediately after finishing treatment were analysed. Both techniques were successful in overbite correction; overbite reduction amounted to 3 to 3.5 mm. The straight wire appliance group demonstrated predominantly molar extrusion and as a result posterior mandibular rotation. A slight intrusion of 1 mm was seen in the lower incisor area. The segmented arch technique resulted in an incisor intrusion of 1.5 mm in the upper and 1.7 mm in the lower jaw. No substantiate extrusion in the molar area was found. The advantages of this technique are discussed.

Posttreatment and seven to 28-year postretention records and actual questionnaires of 240 orthodontically treated patients were assessed to evaluate dental awareness and the patients evaluation of posttreatment changes. 80% have regular dental visits and 44% of them have periodontal disease whereas 60% of those who responded having irregularly or no dental controls. 38% were aware of posttreatment changes, only increased and decreased overjet showed a significance in patients evaluation and objective situation.

Until recently, surgical correction of the jaws has been widely regarded as the most effective treatment of open bites in the permanent dentition. In the following case report an open bite was treated non-surgical by intrusion of the molars with a magnet appliance. The forces of repelling magnets, fixed opposite in the upper and lower jaw were used to intrude the first and second molars. This intrusion allowed an autorotation of the mandible upward and forward to close the open bite. By reduction of the open bite of about 3 mm a surgical intervention could be avoided.

Facial skeletal malformations may not only lead to impaired function, but also diminish psychosocial well-being. Negative social experiences often arise from stereotyped character judgments such as those connected with the profile of the jaw. In this study, 146 orthodontic patients aged between nine and 14 years and student control subjects judged silhouettes of typical Angle class I, II/1 and III profiles on the basis of semantic differential and sociometric choice techniques. Moreover, the satisfaction of the subjects with the appearance of their heads and bodies, as well as their self-perceived personalities, were assessed with the aid of psychological inventories. Class II/1 profiles were characterised as rather shy, reserved, and melancholic, while to class III profiles were attributed reduced social acceptance and less popularity at school. In general, judgement of the silhouette profiles proved to be independent of the judge's own profile. Thus, the existence of trait stereotypes vis-á-vis class II/1 and class III profiles can be confirmed experimentally in children, too. The impact of social stereotypes on psychological well-being, however, is likely to be modified by numerous factors, in particular by social interaction.

A new method for the in vivo measurement of the movements of teeth is described. Measuring blocks are attached to brackets and tubes. Calibrated holes are drilled in each side of the blocks. Using an electronic sliding caliper, measurements are made in all three dimensions between moving teeth and blocks of anchored segments. With the aid of a computer programme, these measurements can be used to construct pictures of various teeth. By taking measurements at different stages of treatment, the movements of the teeth can be shown in three-dimensional images.

In an epidemiological study of 370 recruits, the need for orthodontic treatment was investigated. Subjects who had previously received orthodontic treatment (n = 135) were compared with untreated subjects (n = 234). An unequivocal need for orthodontic treatment was ascertained in 50% of the recruits. Differences between previously treated subjects and untreated subjects were not Some 60% of the orthodontic measures had been carried out by an orthodontist, and 40% by a nonspecialist dentist. The results of treatment were generally unsatisfactory, although the success rate achieved by the orthodontists did appear somewhat higher than that seen with nonspecialist dentists.

The purpose of this study was to examine the efficiency of intrusion mechanics as described by Burstone. Thirty-one cases of deep bite with an overbite equal to or more than 4 mm were analysed by means of cast models, lateral cephalometric views and dental films of the front teeth prior to and after intrusion. The following parameters were considered: 1. Extent of the intrusion relative to a selective point of force application, 2. duration of the intrusion, and 3. amount of root resorption. The average extent of the intrusion in the case of the upper front teeth was 2.3 mm, and in the case of the mandible 3 mm. The rate of intrusion per month was 0.53 mm in the maxilla, and 0.54 mm in the mandible. Analysis of the point of force application showed that the centre of resistance must be presumed to be more distal than previously assumed. For an average treatment time of 4.3 months in the maxilla, and 5.5 months in the mandible, the apical root resorption was minimized by applying dosed force using a calculable force system. A buccal root torque arch employed in three cases permitted, in class II/1 cases, a combined movement comprising lingual tipping of the crown and intrusion, the intrusion component being clearly delayed in comparison with tipping. The segmented arch technique allows an objective intrusion of anterior teeth. This depends on choosing the appropriate point of force attachment and the correct amount of force.

Objective data are required for assessing the influence of movements of the tongue on the position of the teeth. Electromagnetic articulography (EMA) makes it possible to track movements of the tongue using the principle of inductive distance measurement. A helmet made of light but robust acrylic material serves as a carrier for three transmitter coils; these latter are located in front of the forehead, in front of the chin, and at the back of the neck. Receiver coils are fixed to the tip of the tongue and at various points on the dorsum of the tongue. The distance between the receiver coils and the transmitter coils is calculated in real time by means of a personal computer. The movement trajectories are displayed on the computer screen in different colors in X-Y coordinates. The movements of the tongue are recorded in patients with correctly positioned front teeth and compared with those in patients with a frontal open bite. The significance of electromagnetic articulography for dental research and functional treatment is demonstrated.

Comparisons of lateral X-rays obtained in 126 patient prior to and after orthodontic treatment showed that in cases in Angle's classes I and II hyperlordosis of the cervical spine is often found. This is seen to be corrected to a statistically significant extent by the end of treatment; Angle's class III patients did not reveal any clear tendency.

Adaptive changes in the condylar cartilage of the temporomandibular joint resulting from an experimentally induced lateral occlusal disturbance, were examined in ten juvenile domestic pigs. For the first time, in addition to histological methods for the objectification of changes in the matrix, biophysical methods such as 1H-NMR spectroscopy, electrical impedance spectroscopy and the measurement of mechanically induced potentials were used. Changes in the water-binding behavior of the matrix of cartilage were found, which we interpreted as a sign of a responsive initial reaction to a new biomechanical loading situation.

We investigated the fully developed deciduous dentition in 408 children, and re-examined the situation four years later. The nature of the milk teeth (spaced, unspaced, crowded) has a considerable influence on subsequent development. Orthodontic treatment of the mixed dentition is most likely (76,7%) if there has been crowding of the milk teeth. Frontal crowding, distal occlusion, increased overjet, lateral cross-bite and prognathism of the lower jaw are most frequently retained in the mixed dentition. However, individual development follows this trend to a varying degree. On the basis of the situation in the primary dentition it is not possible to make a definitive prediction of the vertical relationships of the upper and lower front teeth in the permanent dentition.

There is a present trend towards so-called alternative methods in medicine and dentistry, which is increasing despite the undeniable successes of established "scientific" medicine. The neglect of psychological and psychosomatic aspects of diseases by established medicine since the second half of the last century is identified as one of the major causes of this development.

A cervico-cephalometric examination of 61 yet untreated orthodontic patients was performed in order to analyze differences in head posture between standardized cephalograms and lateral cephalograms taken in natural head position. Additional x-rays were taken in extreme flexion and extention of the head in 48 patients examining the mobility of the upper cervical spine. Finding partly large differences in cranio-vertical and cranio-cervical parameters between the two methods of registration it could be shown, that head posture on the average was more proclined in natural than in fixed standardized position. Subjects with class III malocclusion tended to a more extended head posture relatively to those with class I or class II malocclusion. Judging the atlas position with regard to the functional mobility of the upper cervical spine, a superior and inferior atlas position was not thought to be a pathologic fixed malposition.

The serial records of 21 patients were analyzed to study the stability of genioplasty performed in the course of orthognatic surgery and to describe its effect on the soft tissue profile. A pre-operative and a post-operative cephalogram as well as a cephalogram one year after surgery of each patient were available. Sagital correction of the chin from 16.5 mm advancement to 1.1 mm reduction and vertical movements between 4.8 mm lengthening and 9.3 mm shortening remained nearly unchanged during the control period. No post-operative movements of the chin fragment were observed except for minor resorptions that can be attributed to an osseous remodelling and rounding of sharp edges. In cases of a long face syndrome a bone apposition from 1 mm to 5.5 mm appeared at the lower edge of the chin. The average of sagittal soft tissue change in relation to the correction of the bony chin was 71%. The individual values ranged from 4% to 145% and the standard error of the estimate was 3 mm. Therefore the planning of the soft tissue profile is rather unreliable. A genioplasty performed with rigid fixation by compression screws or mini plates, preservation of vascular supply and re-fixation of the soft tissue of the chin results in accurately predictable and stable bony contours. On the other hand, the planning of surgery procedures related to the soft tissue profile is--if at all possible--very insecure.

Burstone's intrusion mechanics has been found to be effective in the treatment of a deep bite due to intrusion of the anterior teeth. The pre-activation of the intrusion arch by a tip-back bending shows a shortening in the activation. Measurements objectified the extent of the shortening and the resulting horizontal forces for TMA arches of a dimension of 0.017 x 0.025 inch relating to different distances between molars and anterior teeth and pre-activation by means of tip-back bending or curvature. The change of the vertical force in connection with a simulated intrusion of 5 mm was also registered. Clinical consequences of the therapy are discussed.

A posttreatment evaluation of 72 patients, who are approximately 5.8 years out of retention, showed only little changes between the last appointment and the follow-up examination. The results can be considered stable. The statistic analysis indicated a correlation among some changes, which are important for treatment and therapy planning. For the stability in transversal and sagittal direction a maximal intercuspidation of the premolars and molars is as important as the exact positioning of the canines with lateral contacts in the dental arch. Transversal over-expansion should be avoided, because those results cannot be stabilized in the postretention period. The functional adaptation of muscles, the abolishment of habits and the duration of retention are essential preconditions for a stable treatment result.

A routine investigation of 270 preschool children revealed a high incidence of malocclusion, frequently associated with clinically discovered disturbances of mandibular movement, temporomandibular joint functions, habits or defective speech articulation. The prevalence of malocclusion and of functional disturbances in the deciduous dentition demands not only for a more intensive prevention of dental caries but a careful attention to early functional disturbances in occlusion, in mandibular movement and other numerous functions.

Progress in orthognathic surgery as well as the special methods now available for proper setting of osteotomic segments, diagnostic aids and therapeutic possibilities of orthodontics have considerably strengthened the case today for giving adults a combined treatment. The treatment provides patients with the requisite sense of functional and aesthetic rehabilitation. Follow-up studies confirm the success of treatment combining therapy and surgery.

In the combined surgical orthodontic treatment the essential task is to eliminate the dentoalveolar adaptations of maxillofacial disorders. Additional segmental osteotomies can be considered if these adaptations are excessive or if complications are to be expected during the orthodontic treatment. Possibilities and indications as well as complications and limits of this approach are described.

The down-fracture technique enables three-dimensional displacement of the maxilla in the Le Fort-I plane as well as its simultaneous multisegmentation. Using a semirigid technique of fixation with miniplates, a stable result can be obtained in orthodontic follow-up treatment without tendency to vertical and sagittal recurrence. The transverse deviations detected are interpreted primarily as functional adaptations. In cranial displacement of the maxilla by more than 10 mm, there is a risk of esthetic problems involving the region of the upper lip, the soft tissues of the nose and the cheek. The rate of subjective postoperative disorders is small. In the event of damage to the descending palatine artery, areas of necrosis may occur in the region of the anterior lateral teeth. The disorders of sensitivity of the gum and the gingiva typical for such operations do not result in subjective discomfort. The rate of iatrogenic damage to teeth is 5.6% in the patients followed up. Because of high acceptance of therapy and the low incidence of complications on the one hand as well as the various possibilities of therapy on the other hand, the down-fracture technique is regarded as the most important method of operation in orthodontic surgery at present.

The osteotomy of the maxilla using the Le Fort I technique, today routinely performed in the down-fracture-technique, has changed surgical corrections of dentofacial deformities fundamentally. It offers a three-dimensional correction of the maxilla and also of the whole facial skull. Furthermore the upper dental arch can be expanded, intruded and shortened using a sagittal or transversal osteotomy in addition to a complete transposition of the maxilla. Planning of a maxillary osteotomy is performed under consideration of the clinical situation, the casts and the lateral cephalogram. The mandible must be considered at an early stage of the preoperative planning, since the mandible will follow all transpositions of the maxilla by rotating with the TMJ. Only by performing a simultaneous osteotomy of the mandible, a broad spectrum of indications for maxillary osteotomy will result and practically every desired profile of the lower third of the face can be achieved using combined maxillary and mandibular osteotomies.

A sample of class-II-cases, who refused orthodontic treatment, was examined cephalometrically before, during and after the pubertal growth spurt. The profile of the individuals examined became more retrognathic inspite of the enormous growth of the chin. The growth pattern of the facial soft tissue emphasized nose and chin prominence. The nose lengthened and thickened, the nasolabial angle decreased. The relation of upper and lower lip worsened.

In an experimental study we examined the function of the TMJ of patients with a considerable aberration from ideal dynamic occlusion and with obvious symptoms of frontal dysgnathia. Using a measuring seat for the simultaneous recording of opening and closing movements without occlusal interference and the sounds produced by the TMJ, we could not find any significantly impaired TMJ function compared with an orthognathic control group of similar age.