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Hapsburg Jaw
N E W T E C H N IQ U E ?
I do not often w rite this type of letter, b u t I felt th a t the inac curacies in “New Technique Remedies Distorted Ja w s” (News Section, January) necessitate th a t I respond. We are all quite fam iliar w ith the H apsburg jaw. However, I was am azed to find out th a t this m andibular prognathism is caused by the upper jaw which is too recessed, and thus consequently m akes the lower jaw only appear distorted. First, I think it would be nice if we used the correct term s such as m andibular retrognatha, m andibular prognath ism, m axillary retrognathia and m axillary prognathism . Secondly, anybody who has examined the paintings of the Hapsburgs would recognize th a t this is not solely related to a retrognathic maxilla, b u t is
probably a combined deformity involving both m andibular prognathism and m axillary retrognathia. More im portantly, however, Dr. Turley was not the develop er of a new treatm en t for m axill ary retrognathia. The so-called “baseball catcher’s m ask,” which in reality applies an orthopedic force in the anterior direction on the maxilla, was designed by Dr. Je an Delaire, and in fact has been used for a num ber of years in Europe and in America. S tep h en A. S ch en d el, M.D., D.D.S. Stanford, Calif.
H APSBURG JA W
“New Technique Remedies Distorted Ja w ” (News Section, January) is entirely inappro priate for the following reasons. First, Dr. Turley is recommend
ing the correction of an exces sive protruding lower jaw , more commonly known as m andibular prognathia, ra th e r th an “H apsburg jaw ,” by proposing a treatm en t th a t would m ake the midface excessively protrusive to m atch the excessively pro trusive lower jaw. Logic would seem to dictate th a t one would correct the existing deformity ra th e r th an further deforming the face simply to m ake the teeth fit together. Secondly, this is not a new technique. This technique has been used routinely for a t least the last 30 years in special cases. I fail to see the advantage of this particular treatm en t modality. Our prim e purpose in the treatm en t of facial deform ities should be to correct the underlying deformity in the sim plest, quickest and most
Panoramic Corporation Thanks You... . . . for making us the number one panoramic X-ray machine in the USA. For the last four years Panoramic Corporation has been manufacturing the American-made PC-1000 in Fort Wayne, Indiana, and selling direct to the doctor. While we can mention things like our direct-to-doctor approach and our network of more than 250 service personnel nationwide as factors in our success, the bottom line is that you and your fellow doctors have made us number one by placing your trust in us — and for that we thank you! If you are using a PC-1000 now, thank you. If you are thinking about a panoramic X-ray machine, please give us a chance to show you how we have earned the number one position in the panoramic market. If you would like to order a PC -1000 or a Laser-1000 panoramic/cephalometric combination or if you need more information, give us a call at 1-800-654-2027.1
Panoramic Corporation
U S A
SUGARLESS GUM
passes the “acid”test
The CARE*FREE way makes snacks “OK” Studies show that CARE*FREE® Sugarless Gum effectively neutralizes acids after snacks. Interproximal plaque pH with sugarless gum after snack' 8I Q. (1)
Before CAREFREE-'
During CAREFREE-
1V i / 1 / O
S’ 6 Q_ 0 Q.
After CARE-FREE®
7-
5-
“Safety Zone"
Demineralization "Acid Zone"
3Time in minutes
In caries-active patients, a snack can mean 2 hours in the acid “demineralization zone.” However, when patients chew sugarless gum for just 10 minutes immediately after snacking, acid levels return to the normal or “safe” level. When they can’t brush, rinse or floss after snacking, CARE*FREE® Sugarless Gum provides a valuable alternative. Now it’s even easier and faster to order CARE*FREE® Sugarless Gum Charge your order of CARE*FREE® Sugarless Gum, Sugarless BUBBLE YUM® Bubble Gum, and BREATH SAVERS® Sugar Free Mints on VISA or MasterCard and we can even ship it to you overnight. Call 1-800-441-4193 to order, or to receive our free cavity-fighting fact booklet. ’Jensen ME. Effects of chewing sorbitol gum on hum an salivary and interproximal plaque pH. J Clin Dent. 1988;1:6-19.
T h e S u g a rle ss A ll-S ta r T eam © 1991, Planters LifeSavers Company
potentially stable m eans as we possibly can. It is truly a disservice to sacrifice facial esthetics when there is absolutely no reason to do so. Surgery would avoid prolonged orthodontic treatm en t and the social stigm a of the facial deformities. This is of the utm ost importance to the adolescent during this formative period in their life. In short, why prolong the agony of the treatm en t for the p atien t and a t the sam e tim e tu rn a one-jaw deformity into a two-jaw deformity? B ruce H. M cCullar, D.D.S. M em phis, Tenn. LOCAL. A N E S T H E S IA F A IL U R E S
I enjoyed the article “Reasons for local anesthesia failures,” by Drs. Wong and Jacobsen (January). I expected to miss an occasional m andibular block my first few years of practice after dental school. However, I still miss some blocks. As Drs. Wong and Jacobsen pointed out, this can be frustrating for the dentist and painful for the patient. I need to occasionally review my anatom y by looking a t a skull model. The article was an excellent review. I especially liked it because it focuses on why the block failed and not on different techniques. I will need to occasionally review th a t article. Thanks. E dw ard A. L aga Jr., D.D.S. M ission, Kan. O R A L C A N D ID A L IN F E C T IO N
Drs. Iacopino and W athen are to be commended on their fine review of oral candidal infection and denture stom atitis (January). However, their
discussion of benzoic acid as a denture-soak solution failed to m ention the allergic potential of this agent. This is of concern because absorption of benzoin by the resin denture base can result in prolonged mucosal contact w ith a drug th a t has a well-documented history of causing hypersensitivity reactions in hum ans. In particular, benzoin and its derivatives have been im pli cated in orofacial hypersensi tivity reactions including angioedema, mucositis, burning m outh syndrome, aphthous ulceration, and erythem a multiforme. The high frequency of hypersensitivity to benzoin in aphthous stom atitis patients (55 percent) reported by Nolan and Lamey (1991) suggests th a t the prevalence of this problem may have been overlooked until recently. C raig S. M iller, D.M.D., M.S. D on ald A. F a lace, D.M.D. D ou glas D. Dam m , D.D.S. U n iv e r sity o f K entucky L exington, Ky. C O R R E C T IO N
In the article on oral candidal infection by Drs. Anthony Iacopino and William W athen (January), the legend for Figure 3 should have read: A maxillary removable partial denture in place shows relatively normal tissue. The authors also would like to thank Dr. William H. Dinnie, chairm an of Baylor’s Oral Pathology D epartm ent for the illustrations. The product mentioned for use in overnight soaks is Oral Safe (Great Lakes Orthodontic Laboratories, Tonawanda, N.Y.).
I do not often w rite this type of letter, b u t I felt th a t the inac curacies in “New Technique Remedies Distorted Ja w s” (News Section, January) necessitate th a t I respond. We are all quite fam iliar w ith the H apsburg jaw. However, I was am azed to find out th a t this m andibular prognathism is caused by the upper jaw which is too recessed, and thus consequently m akes the lower jaw only appear distorted. First, I think it would be nice if we used the correct term s such as m andibular retrognatha, m andibular prognath ism, m axillary retrognathia and m axillary prognathism . Secondly, anybody who has examined the paintings of the Hapsburgs would recognize th a t this is not solely related to a retrognathic maxilla, b u t is
probably a combined deformity involving both m andibular prognathism and m axillary retrognathia. More im portantly, however, Dr. Turley was not the develop er of a new treatm en t for m axill ary retrognathia. The so-called “baseball catcher’s m ask,” which in reality applies an orthopedic force in the anterior direction on the maxilla, was designed by Dr. Je an Delaire, and in fact has been used for a num ber of years in Europe and in America. S tep h en A. S ch en d el, M.D., D.D.S. Stanford, Calif.
H APSBURG JA W
“New Technique Remedies Distorted Ja w ” (News Section, January) is entirely inappro priate for the following reasons. First, Dr. Turley is recommend
ing the correction of an exces sive protruding lower jaw , more commonly known as m andibular prognathia, ra th e r th an “H apsburg jaw ,” by proposing a treatm en t th a t would m ake the midface excessively protrusive to m atch the excessively pro trusive lower jaw. Logic would seem to dictate th a t one would correct the existing deformity ra th e r th an further deforming the face simply to m ake the teeth fit together. Secondly, this is not a new technique. This technique has been used routinely for a t least the last 30 years in special cases. I fail to see the advantage of this particular treatm en t modality. Our prim e purpose in the treatm en t of facial deform ities should be to correct the underlying deformity in the sim plest, quickest and most
Panoramic Corporation Thanks You... . . . for making us the number one panoramic X-ray machine in the USA. For the last four years Panoramic Corporation has been manufacturing the American-made PC-1000 in Fort Wayne, Indiana, and selling direct to the doctor. While we can mention things like our direct-to-doctor approach and our network of more than 250 service personnel nationwide as factors in our success, the bottom line is that you and your fellow doctors have made us number one by placing your trust in us — and for that we thank you! If you are using a PC-1000 now, thank you. If you are thinking about a panoramic X-ray machine, please give us a chance to show you how we have earned the number one position in the panoramic market. If you would like to order a PC -1000 or a Laser-1000 panoramic/cephalometric combination or if you need more information, give us a call at 1-800-654-2027.1
Panoramic Corporation
U S A
SUGARLESS GUM
passes the “acid”test
The CARE*FREE way makes snacks “OK” Studies show that CARE*FREE® Sugarless Gum effectively neutralizes acids after snacks. Interproximal plaque pH with sugarless gum after snack' 8I Q. (1)
Before CAREFREE-'
During CAREFREE-
1V i / 1 / O
S’ 6 Q_ 0 Q.
After CARE-FREE®
7-
5-
“Safety Zone"
Demineralization "Acid Zone"
3Time in minutes
In caries-active patients, a snack can mean 2 hours in the acid “demineralization zone.” However, when patients chew sugarless gum for just 10 minutes immediately after snacking, acid levels return to the normal or “safe” level. When they can’t brush, rinse or floss after snacking, CARE*FREE® Sugarless Gum provides a valuable alternative. Now it’s even easier and faster to order CARE*FREE® Sugarless Gum Charge your order of CARE*FREE® Sugarless Gum, Sugarless BUBBLE YUM® Bubble Gum, and BREATH SAVERS® Sugar Free Mints on VISA or MasterCard and we can even ship it to you overnight. Call 1-800-441-4193 to order, or to receive our free cavity-fighting fact booklet. ’Jensen ME. Effects of chewing sorbitol gum on hum an salivary and interproximal plaque pH. J Clin Dent. 1988;1:6-19.
T h e S u g a rle ss A ll-S ta r T eam © 1991, Planters LifeSavers Company
potentially stable m eans as we possibly can. It is truly a disservice to sacrifice facial esthetics when there is absolutely no reason to do so. Surgery would avoid prolonged orthodontic treatm en t and the social stigm a of the facial deformities. This is of the utm ost importance to the adolescent during this formative period in their life. In short, why prolong the agony of the treatm en t for the p atien t and a t the sam e tim e tu rn a one-jaw deformity into a two-jaw deformity? B ruce H. M cCullar, D.D.S. M em phis, Tenn. LOCAL. A N E S T H E S IA F A IL U R E S
I enjoyed the article “Reasons for local anesthesia failures,” by Drs. Wong and Jacobsen (January). I expected to miss an occasional m andibular block my first few years of practice after dental school. However, I still miss some blocks. As Drs. Wong and Jacobsen pointed out, this can be frustrating for the dentist and painful for the patient. I need to occasionally review my anatom y by looking a t a skull model. The article was an excellent review. I especially liked it because it focuses on why the block failed and not on different techniques. I will need to occasionally review th a t article. Thanks. E dw ard A. L aga Jr., D.D.S. M ission, Kan. O R A L C A N D ID A L IN F E C T IO N
Drs. Iacopino and W athen are to be commended on their fine review of oral candidal infection and denture stom atitis (January). However, their
discussion of benzoic acid as a denture-soak solution failed to m ention the allergic potential of this agent. This is of concern because absorption of benzoin by the resin denture base can result in prolonged mucosal contact w ith a drug th a t has a well-documented history of causing hypersensitivity reactions in hum ans. In particular, benzoin and its derivatives have been im pli cated in orofacial hypersensi tivity reactions including angioedema, mucositis, burning m outh syndrome, aphthous ulceration, and erythem a multiforme. The high frequency of hypersensitivity to benzoin in aphthous stom atitis patients (55 percent) reported by Nolan and Lamey (1991) suggests th a t the prevalence of this problem may have been overlooked until recently. C raig S. M iller, D.M.D., M.S. D on ald A. F a lace, D.M.D. D ou glas D. Dam m , D.D.S. U n iv e r sity o f K entucky L exington, Ky. C O R R E C T IO N
In the article on oral candidal infection by Drs. Anthony Iacopino and William W athen (January), the legend for Figure 3 should have read: A maxillary removable partial denture in place shows relatively normal tissue. The authors also would like to thank Dr. William H. Dinnie, chairm an of Baylor’s Oral Pathology D epartm ent for the illustrations. The product mentioned for use in overnight soaks is Oral Safe (Great Lakes Orthodontic Laboratories, Tonawanda, N.Y.).