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Functional jaw orthopedics and the oral vestibule as basis for the appliance
Volume Number
54 4
Reviews and abstracts
305
psychologic handling of young children. The pedodontist who is familiar ‘with the German language will profit from this text. The illustrations are clear, and almost all are self-explanatory. J. A. Salzmann
Functional
jaw
orthopedics
and the oral vestibule
as basis for the appliance
By R. Priinkel. Berlin (German Democratic Republic), 1967, VEB Verbg Volk und Gesundheit. 265 pages, no index, 195 illustrations, no tables. Focus on function to explain the etiology of malocclusion and on design of appliances aimed at modifying functional patterns classifies this book as an original contribution. The author is not primarily concerned with the fact that functional appliances can induce favorable treatment results but, rather, with how these results have been obtained. The author confronts the reader essentially with an application of the functional matrix concept of Moss to explain disharmonious relations of the two jaws, alveolar processes, and dental arches. This thesis is developed even further, and the references cited indicate considerable familiarity wit,h publications in the British and American literature. Frlnkel attempts to modify the functional matrix of a patient by means of a skeletal appliance, not attached to the teeth, consisting of labial and buccal screens that are joined together by stainless steel wires. In Class II malocclusions the cheeks are kept away from the maxillary posterior teeth and alveolar process, and a lip plumper likewise affects the posture and behavior of the lower lip. This “function regulator” leaves the oral cavity proper free for unihibited tongue movement. It influences physiologic activity and rest, posture of the lips. and cheeks and, in fact, the entire facial and chewing musculature. A fairly continuous stimulus is thereby provided to modify existing muscular patterns which, in turn, elicit changes in form (alveolar processes and dental arches). A basically similar approach is used for treatment of Class III malocclusions, except that a labial screen or lip plumper is provided for the upper lip. Labial bows are added to retrude incisors, and lingual bows are used to procline them. They may be activa,ted whenever desirable, for shorter or longer time periods as needed. Three basic types of function regulator are described, together with adaptations for specific objectives dictated by the malocclusion of the individual patient. Case presentations deal in general wit,h problems of no more than medium severity but establish beyond question that excellent results can be obtained. As stated, these results are to be interpreted as experimental evidence of the correctness of the etiologic concept. This reviewer is tempted to argue with many interpretations and applications of the functional matrix concept as used by the author to explain the genesis of different malocclusions. Yet, in raising questions, one is immediately confronted with a general lack of understanding about the exact mechanisms of growth. Thus, the author’s views can remain for the time being as a working
hypothesis. Wis results support the g~nc~r’al thesis hut MI nc~wss;lriIy 111(, sp+ cific detail in which he indulges. The method itself is limited because crowding and rotations of tcacth cannot be efficiently corrected ; nor are t>he function regulators indicatchd to achicvo controlled tooth movements required in c>xtraction therapy. ~E’r~nkcl recognizes t,he need to institute certain corrective measures by means of conventional procedures eiLher before or after the USC ol’ his appliances. Yet t,heir use, as prcscribed at approximately 8 years of age, may well be advantageous for treatment of sagittal, transversal (narrow arch), and vertical (deep bitt ) aspects of Class II malocclusions, and final correction of tooth position at a later stage is thereby facilitated. Special mention should be made of the chapter on psycholou and orthodontics because it. adds a dimension to diagnosis that is too often lacking in clinical practice. This reviewer can well understand that many colleagues ha~r returnrd from a visit to the orthodontic department o-c’the county hospital “Heinrich Braun“ in Zwickau, like pilgrims returning from Mecca, with a spiritual enlightenment t,hat broadens their outlook, although it may not immediately change their established clinical routine. The book is recommended as a ne\v and fresh approach to orthodontics, further development of which will be interesting to observe. C’. F. il. ~~IoorrPPs In Vivo Implantation of the Mandibular Condyle investigation of the growth of the lower jaw
of the
Rat; an experimental
By H. S. Duterloo, School of Dentistry, i?aiversity of Nijmegen, lands, Translated from the Dutch by Louis Groaten, 1967.
Nethe]*-
This investigation was intended to determine mhtxther the in viva transplanted mandibular condyle is capable of perceptible growth and how such growth differs from normal condylar growth. The author reports that the implants all showed endochondral ossification. This indicates that chondrogenesis and endochondral ossification can occur independently of their normal sites. The author of this significant contribut.ion to our knowledge of mandibular growth concludes that it is chondrogenesis in the mandibular condyle which is largely responsible for the increase in length of the ramus. However, the extent of longitudinal growth and the change in shape of the mandibular condyle are largely dependent on extrinsic functional factors.
54 4
Reviews and abstracts
305
psychologic handling of young children. The pedodontist who is familiar ‘with the German language will profit from this text. The illustrations are clear, and almost all are self-explanatory. J. A. Salzmann
Functional
jaw
orthopedics
and the oral vestibule
as basis for the appliance
By R. Priinkel. Berlin (German Democratic Republic), 1967, VEB Verbg Volk und Gesundheit. 265 pages, no index, 195 illustrations, no tables. Focus on function to explain the etiology of malocclusion and on design of appliances aimed at modifying functional patterns classifies this book as an original contribution. The author is not primarily concerned with the fact that functional appliances can induce favorable treatment results but, rather, with how these results have been obtained. The author confronts the reader essentially with an application of the functional matrix concept of Moss to explain disharmonious relations of the two jaws, alveolar processes, and dental arches. This thesis is developed even further, and the references cited indicate considerable familiarity wit,h publications in the British and American literature. Frlnkel attempts to modify the functional matrix of a patient by means of a skeletal appliance, not attached to the teeth, consisting of labial and buccal screens that are joined together by stainless steel wires. In Class II malocclusions the cheeks are kept away from the maxillary posterior teeth and alveolar process, and a lip plumper likewise affects the posture and behavior of the lower lip. This “function regulator” leaves the oral cavity proper free for unihibited tongue movement. It influences physiologic activity and rest, posture of the lips. and cheeks and, in fact, the entire facial and chewing musculature. A fairly continuous stimulus is thereby provided to modify existing muscular patterns which, in turn, elicit changes in form (alveolar processes and dental arches). A basically similar approach is used for treatment of Class III malocclusions, except that a labial screen or lip plumper is provided for the upper lip. Labial bows are added to retrude incisors, and lingual bows are used to procline them. They may be activa,ted whenever desirable, for shorter or longer time periods as needed. Three basic types of function regulator are described, together with adaptations for specific objectives dictated by the malocclusion of the individual patient. Case presentations deal in general wit,h problems of no more than medium severity but establish beyond question that excellent results can be obtained. As stated, these results are to be interpreted as experimental evidence of the correctness of the etiologic concept. This reviewer is tempted to argue with many interpretations and applications of the functional matrix concept as used by the author to explain the genesis of different malocclusions. Yet, in raising questions, one is immediately confronted with a general lack of understanding about the exact mechanisms of growth. Thus, the author’s views can remain for the time being as a working
hypothesis. Wis results support the g~nc~r’al thesis hut MI nc~wss;lriIy 111(, sp+ cific detail in which he indulges. The method itself is limited because crowding and rotations of tcacth cannot be efficiently corrected ; nor are t>he function regulators indicatchd to achicvo controlled tooth movements required in c>xtraction therapy. ~E’r~nkcl recognizes t,he need to institute certain corrective measures by means of conventional procedures eiLher before or after the USC ol’ his appliances. Yet t,heir use, as prcscribed at approximately 8 years of age, may well be advantageous for treatment of sagittal, transversal (narrow arch), and vertical (deep bitt ) aspects of Class II malocclusions, and final correction of tooth position at a later stage is thereby facilitated. Special mention should be made of the chapter on psycholou and orthodontics because it. adds a dimension to diagnosis that is too often lacking in clinical practice. This reviewer can well understand that many colleagues ha~r returnrd from a visit to the orthodontic department o-c’the county hospital “Heinrich Braun“ in Zwickau, like pilgrims returning from Mecca, with a spiritual enlightenment t,hat broadens their outlook, although it may not immediately change their established clinical routine. The book is recommended as a ne\v and fresh approach to orthodontics, further development of which will be interesting to observe. C’. F. il. ~~IoorrPPs In Vivo Implantation of the Mandibular Condyle investigation of the growth of the lower jaw
of the
Rat; an experimental
By H. S. Duterloo, School of Dentistry, i?aiversity of Nijmegen, lands, Translated from the Dutch by Louis Groaten, 1967.
Nethe]*-
This investigation was intended to determine mhtxther the in viva transplanted mandibular condyle is capable of perceptible growth and how such growth differs from normal condylar growth. The author reports that the implants all showed endochondral ossification. This indicates that chondrogenesis and endochondral ossification can occur independently of their normal sites. The author of this significant contribut.ion to our knowledge of mandibular growth concludes that it is chondrogenesis in the mandibular condyle which is largely responsible for the increase in length of the ramus. However, the extent of longitudinal growth and the change in shape of the mandibular condyle are largely dependent on extrinsic functional factors.