Journal of Orthodontics

Three children suffering from facial asymmetry were observed annually using facial stereophotogrammetry before, during, and after their general skeletal adolescent growth spurt. Stereophotogrammetry allows accurate three-dimensional measurements between identifiable facial landmarks. Five pairs of bilateral parameters connecting external canthi and angles of the mouth to alae and tip of nose, and to each other, allowed a positive sign (right-side larger) or a negative (left-side larger) assessment of parameter asymmetry, Their total, taking sign into account, assessed mid-facial asymmetry. Serial observation showed that: (1)

in patient no. 1 suffering from post-traumatic condylar hypoplasia, the facial asymmetry resolved;

The subjective need and demand for orthodontic treatment amongst 955 12-year-old Sheffield children has been assessed using the aesthetic component of the Index of Orthodontic Treatment Need and by a fixed choice questionnaire. When answering the questionnaire a greater proportion of females perceived themselves as having less attractive dentitions and greater treatment need despite any objective evidence to support this view. Of the children at the attractive end of the aesthetic component scale 84ṃ5 per cent were prepared to accept orthodontic treatment of an unspecified nature.

Thirty-four children with lower premolar crowding were treated by extraction of second molars. Thirteen cases had mechanical lower arch treatment started not less than 6 months after extractions. The remainder had no treatment in the lower arch. The change in premolar crowding was measured, and the reasons why spontaneous alignment occurred in some cases and not in others were examined.

The use of ceramic brackets in fixed appliance orthodontics has highlighted several problems, amongst which are the problems of enamel damage and possible trauma to the patient during debonding. A ceramic bracket has recently been developed with a polycarbonate laminated base (Ceramaflex^®) claiming to make debond much easier, although there are no independent data to substantiate this claim. The in-vitro bond strength of these ceramic brackets to enamel was tested and compared with metal standard Edgewise brackets. The bond produced with the Ceramaflex^® bracket was similar in magnitude, but less reliable. No fracture of the bracket or damage to enamel was seen during debonding. Debonding of these brackets was easy to carry out, but it is possible that more debonds may occur during treatment than with the use of metal brackets.

Alongside orthodontic treatment, tooth shape modification may he indicated Jar teeth associated with clefts of the lip and alveolus, and in non-carious teeth, minimal tooth preparation techniques appear to be most appropriate. Two methods of tooth shape modification are described. In one, hybrid composite materials, bonded to tooth enamel using the acid-etch technique, may be considered to provide a permanent, low cost, aesthetically satisfactory result, often without tooth preparation and with minimal operating time. Alternatively, indirect veneers may be appropriate for treatment of more severely malformed teeth.