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1/9. Implant replacement of congenitally missing lateral incisor: a case report.

    The therapeutic goal of reconstruction dentistry is to provide our patients with a dentition that is in harmony with the patient's musculature and temporomandibular joints. malocclusion can contribute to both muscular and joint dysfunction. This case report demonstrates the reconstruction of a malocclusion caused by a congenitally missing lateral incisor utilizing a combination of orthodontic treatment and a dental implant to replace the congenitally missing tooth.
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2/9. Form and function in cosmetic dentistry.

    The results of the case presented meet the aesthetic requirement of the patient as well as the biomechanical and functional requirements for long-term comfort, function, and stability. If not for the extra time spent with the patient uncovering the relationship between her occlusion and headaches and gaining her confidence by solving that problem first, we never would have had the opportunity to build a relationship that would allow her to proceed confidently with the cosmetic treatment that she described as the "best darn holiday present ever!"
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keywords = dentistry
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3/9. Two- and three-dimensional orthodontic imaging using limited cone beam-computed tomography.

    Considerable progress has been made in diagnostic, medical imaging devices such as computed tomography (CT). However, these devices are not used routinely in dentistry and orthodontics because of high cost, large space requirements and the high amount of radiation involved. A device using computed tomography technology has been developed for dental use called a limited cone beam dental compact-CT (3DX). The aim of this article is to demonstrate the usefulness of 3DX imaging for orthodontic diagnosis and treatment planning. We present three cases: (1) one case shows delayed eruption of the upper left second premolar, (2) the second case shows severe impaction of a maxillary second bicuspid; and (3) the third case shows temporomandibular joint disorder (TMD). In the tooth impaction cases, the CT images provided more precise information than conventional radiographic images such as improved observation of the long axis of the tooth, root condition, and overlap with bone. In the TMD case, clear and detailed temporomandibular joint images were observed and pre- and posttreatment condylar positions were easily compared. We conclude that 3DX images provide useful information for orthodontic diagnosis and treatment planning.
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4/9. iontophoresis: an effective modality for the treatment of inflammatory disorders of the temporomandibular joint and myofascial pain.

    The use of the iontophoresis modality for driving medications through the skin for treatment of certain TM dysfunction and myofascial pain dysfunction syndrome was first suggested by Gangarosa and Mahan in 1982. This paper introduces the iontophoresis technique for treatment of inflammatory and myofascial disorders of the craniomandibular system. The historical aspects of iontophoresis in medicine and dentistry is reviewed. As an aid to understanding the clinical applications of this method, a review of diagnostic classification of temporomandibular disorders and an in-depth review of the role of the inflammatory process are provided. The effect of inflammation on the synovial/lymphatic system is detailed. Reference is made to the advantages of iontophoresis over hypodermic injection. The basis materials and methods of use of the modality are shown along with a protocol for patient treatment. Several case studies are discussed with clinical observations given.
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5/9. Orthopedic/orthodontic therapy for anterior disk displacement: unexpected treatment findings.

    Craniomandibular pain dysfunction (CMPD) is of increasing clinical concern to all fields of dentistry, especially orthodontics. One of the more common manifestations of CMPD is anterior disk displacement. Orthodontic/orthopedic treatment for anterior disk displacement using anterior repositioning of the mandible has been suggested by several clinicians as the treatment of choice. Returning the mandible back toward the original occlusion or habit centric has also been suggested by several reports. Functional jaw orthopedic (FJO) appliances would appear to be ideally suited for the treatment of anterior disk displacement due to the anterior repositioning nature of these appliances. In growing individuals, among other changes, the condyle is supposed to grow back into the fossa (which would serve as the walkback procedure). This article presents three young patients who had anterior disk displacement and posterior condylar displacement before treatment. Each patient was treated using a functional appliance and each patient ended treatment still having a posterior condylar displacement and anterior disk displacement. These findings were unexpected and no explanation is offered. This occurrence is rare in the author's practice (approximately 2-3%), but this is a real concern and the patients should be made aware of this possibility before starting treatment, so that their expectations are realistic. These enigmatic findings also emphasize the complexity of TMJ as well as FJO treatment and indicate the need for further research and study.
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keywords = dentistry
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6/9. thermography and oral inflammatory conditions.

    A brief review of the literature on the use of thermography in medicine and dentistry is presented. This is followed by the presentation of eleven case reports of the use of thermography in dental clinic patients with various oral inflammatory conditions. The results showed that in seven of the eleven cases the thermogram was able to delineate the involved from the noninvolved side. The findings were nonspecific, however, and in its current form thermography cannot be used alone for differential diagnosis.
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7/9. The misdiagnosis of temporomandibular disorders in lateral pharyngeal space infections--two case reports.

    Two cases of lateral pharyngeal space infections which were initially misdiagnosed as temporomandibular disorders (TMD) are presented and discussed. Such symptomatology as chronic facial pain, trismus and decreased inter-incisal opening provide many viable different diagnoses. It is important for the clinician to evaluate these different diagnoses in a logical manner. Conservative therapy is advised in the initial treatment of many TMDs, therefore other diagnoses with a greater potential for morbidity should be ruled in or out before the diagnosis of TMD is considered. The symptomatology of lateral space infections and the relevance of this entity to clinical dentistry are discussed.
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keywords = dentistry
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8/9. Surgical-orthodontic correction of adult facial deformities.

    The use of combined surgical-orthodontic therapy for the correction of skeletal anomalies has moved from the obscure to the routine over the last 25 years. Its use has been extended to treat not only developmental problems in children and adolescents, but also traumatic and temporomandibular joint-related deformities in adults. Its use can be integrated into a comprehensive treatment plan, including prosthodontics, periodontics, and implant dentistry. The advent of rigid internal fixation has made it particularly more appealing for the treatment of adult patients, allowing the patients to return to normal daily activities more rapidly.
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keywords = dentistry
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9/9. chiropractic/dental cotreatment of lumbosacral pain with temporomandibular joint involvement.

    OBJECTIVE: To demonstrate the concept of integrated dental orthopedic and cranio-chiropractic care for treating structural disorders of the jaw, neck and spine. CLINICAL FEATURES: A 33-yr-old woman sought chiropractic care for centralized lumbosacral pain that had persisted for 3 months. She exhibited pain on lumbopelvic extension and marked limitations on lumbopelvic flexion. In addition, cervical rotation and cranial sutural motion in the right malar maxillary suture were restricted. The left temporal mandibular joint also was limited in translation. Based on initial chiropractic sacro-occipital technique, she was diagnosed with Category III lumbopelvic dysfunction. X-ray examination revealed a lumbosacral angle of 39 degrees, with sacral displacement posterior to the weight-bearing line. In conjunction with the beginning of chiropractic care, she was encouraged to seek dental-orthodontic evaluation. After 30 months of chiropractic treatment, she was still experiencing some lower back pain and limited improvement. She finally agreed to see the orthodontist. Orthodontic evaluation revealed a Class I malocclusion with significant loss of vertical dimension, characteristic of bilateral posterior bite collapse. INTERVENTION AND OUTCOME: Initial orthodontic treatment began in September 1991 and was followed by restorative dentistry to replace the missing teeth. This cotreatment approach, which integrated dental orthopedic and craniochiropractic care, ameliorated the pain and improved head, jaw, neck and back function. CONCLUSION: The position of the jaw, head and vertebral column, including the lumbar region, are intricately linked. Orthodontic treatment improved the position of the mandible, which in turn enabled the body to respond to chiropractic care.
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keywords = dentistry
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