A bilateral distoclusion in which developmental exercises were used advantageously

,4 BILATERAL 11ISTOC!LUSION IN WHICH l)EVET,OPMII:NTAL EXERCISES WERE I!SET) I\I)VAr\jTX(:EOT:SI,~-~

T growth HIS

case is prcsc>ntcd to illustrate that it is possible to employ natural forces in the treatment of distoclusion casts, and also somcltimes rubbers. wit,hout the use or with less use of the intermasillary

Fix.

2.

Fig.

3.

Fig.

1.

Fig. 1 is of the patient at the bcginnin, Q of trcatmcnt, a girl thirteen years of age. Figs. 2, 3, and 4 are the models, and I hope will illustrate that the points of interference were the mandibular canines and t,hc maxilIar- centrals.

Fig.

Fig.

(i.

5.

Fig.

8.

the rotation of the maxillary centrals which previously had been the major points of interference. About t,his t,imc it was suggested to the patient thilt sht att,empt to form the habit of placing her mandibular t&h in their correct. anterior posterior relationship to the maxillary teeth. She was carefully shown why and how this should be done. Masscter temporal exercises of scvcral hundred contractions daily were next prescribed for her. Arch symmctr\- and the removal of cusp interference made the position of mechanical advantage possible.

and II2lWlP~ I*t~tilillt~~S The appliances were removed in November, 1929, were substituted for them. No intrrmasillarg elastics were worn at any time during t,hc course of treatment,. E’igs. 5! 6, 7> and S show the results obtained. The patient is now wearing the mandibular Ilawlc;\- rctaincr at Iright and is continuing to do the mass&r temporal cxcrcisrs. It has been our observation that unilateral and bilateral casts of distoclusion that improve upon the removal of interfcrencc i\r(’ gct~crally those which arc not complicated by lack of vertical dcvclopmcnt.

A NOTE

ON CONE-SIIAl’EI>

‘l’EE’l’II*

I

BRING to your notice two cases of teeth the cro\vns of which are simple cones. The first was referred to me bp Mr. Senior, of C‘roydon. The rlclcr of two brothers was seen by me in April, 1928, and was then twelve years old. He was about average height and weight, ant1 was reported to he “tloing well” at school. Inspection showed : In the right maxillary dentition : Two small molar-shaped t,eeth, a conical tooth at the site of t,he first, premolar, a small “canine,” then a large concshaped central. Then came a large ditstema, and the left maxillary dcntition-exactly similar to the right side. In the mandibular dent,ition : TWO molar-shaped tcet.h ; a pointed premolar, and a ” canine ” (deciduous). Then a large diastema to the Icft deciduous canine; followed by two premolars, one (posterior) having two minute vestiges of cusps, the other anteriorly being again a, conical toot,h. There was no history of wnp serious illness, nor of syphilis. The child showed very slight signs of ricket,s-a trace of bending of the ribs only. The deciduous canines showed a considerable deprce of atjtrition. Radiographs taken of the child showed a rudimentary premolar-like tooth merupted on the right side; the molar teeth were apparently of the permanent series. Xo other teeth were present nneruptcd in the maxilla. Similarly in the mandible no other teeth WPI‘C prcsrnt than those seen clinically. The younger brot,her bring present (aged t\vo years), I examined him also. Of the child’s decidttous dentition only one arca TVNSabnormal--&c Icft mandibular second incisor and the neiphborinp canine bring geminatrd almost entirely, having two crowns fused at the neck and one root and pulp chamber. This child showed, on radiograph;r-, apparently normal maxillary incisive teeth developing well. Slight signs of rickets were present, the sternum being a litt,le keel-shaped ; the child was bright, and health\-, no s>.philitic stigmata being present. *Transactions of British

Society for the Study of Ortlloclontics.