458 Reviews and abstracts
April 1997
mechanics require m a x i m a l l y reduced frictional
forces that are governed by factors such as dimen-
sional geometry, basic chemistry, and mechanical
behavior of the appliance. In addition to reviewing
frictional mechanics, Kusy et al. discuss how it likely
can be improved by chemistry, structural modification
by means of ion implantation, p l a s m a - e n h a n c e d
parylene, and diamond-line carbon work. The current
use and application of rare-earth magnets in
orthodontics is discussed by Tom Graber. Shown are
some of the innovative appliances used. The potentials
for clinical use of magnets appear to be numerous.
Class II malocclusions are the most common type
orthodontists are called on to treat. It is not surprising
therefore to find no less than seven chapters written
by 14 contributors, devoted to the biomechanical man-
agement of Class II type malocclusions. Strategies to
correct deep bites are emphasized in two of the chap-
ters. Lloyd Pearson o n the other hand described vari-
ous methods of correcting backward rotating man-
dibles. The design and effects of headgear and that of
the Herbst appliance are clearly described in chapters
by Siatkowski and Pancherz, respectively. A short
chapter by Gianelli et al. describes a nonextraction
approach to the treatment of Class II, with the
bidimensional technique. Sliding mechanics and
Sentalloy coils are used to move teeth. Burstone in an
erudite summing of his observations states that growth
considerations are perhaps the most important factor
in planning treatment in Class II patients. The most
dramatic changes in correction he contends are prob-
ably attributable to growth and not tooth movement.
A short chapter by Schroff is devoted to the diagnosis,
treatment planning, and biomechanics of impacted
canines that occurs in about 2% of orthodontic pa-
tients. By recognizing and understanding forces and
moments as they pertain to the mechanics of tooth
movement, Mulligan shows how extraction cases are
able to be treated with relatively inexpensive loop-free
arch wires. Bantleon explains the biomechanical prin-
ciples involved when a modified lingual lever arm
technique is applied. The lingual lever arm in effect
comprises a 0.032 stainless steel spring wire, soldered
to a pad that is bonded to the lingual surface of the
tooth. The tip of the lever arm, where the hook is
placed, is located approximately at the apex of the
tooth. Superelastic closed-coil springs or elastic chains
are used as a power source for moving the tooth. The
photographs showing its application are explicit.
Orthodontic space closure is achieved with sec-
tional arches and closing loops or by sliding brackets
attached to teeth along an arch wire: The biomechani-
cal considerations of the latter procedure are de-
scribed by Ram Nanda and Ghosh. The effect of
American Journal of Orthodontics and Dentofacial Orthopedic
bracket material and design, orthodontic arch wires,
ligation, and saliva on kinetic friction are among the
factors discussed. The management of severely com-
promised orthodontic patients is described in the fi-
nal chapter by Birte Melson. Example of four such
treated cases are shown. The book is well printed and
comprehensively illustrated with 707 drawings and
photographs, 135 of which are in full color and 27 in
two-color. Regardless of the technique currently be-
ing used by the reader, there is a wealth of informa-
tion and ideas that can be usefully incorporated in
any clinical situation. A good investment.
Alex Jacobson
Orthodontic Cephalometry
Athanasios E, Athanasiou
St Louis." Mosby; 224 illustrations; 256 pages; $132
This book is a major contribution to the roster of
orthodontic text books. Many previously published
texts on radiographic cephalometry have gone out of
print, leaving a deficiency that this book fills admi-
rably. The author has prepared a comprehensive text
that is sure to please a wide audience.
Nineteen authors have contributed to this text's
13 chapters. The first chapter is a concise review of
the history of cephalometrics and cephalometric ra-
diographic technique. Chapter 2 is a fine summary of
radiographic anatomy where each landmark is labeled
on dry skull photographs and correlated with their
radiographic image. The exercise neatly illustrates
the limitations associated with a two-dimensional
depiction of a three-dimensional object.
Chapter 3 represents a very reasonable approach
to selection of a cephalometric analysis with recog-
nition of the possibilities and limitations of cephalo-
metric analysis. Chapter 4 is a thorough presentation
of cephalometric superimposition methods for assess-
ing dentofacial changes. A step-by-step synopsis is
provided for each method as well as a critique for
each method. Chapter 5 is a brief compendium of the
sources of error in lateral cephalometry that must be
considered when using diagnostic cephalography.
Posteroanterior (Frontal) Cephalometry, an often
underappreciated subject is the topic of Chapter 6.
This thorough chapter includes radiographic anatomy
and various methods of analysis. Chapter 7 is devoted
to the use of cephalometry in diagnosis and treat-
ment and Chapter 8 is a summary of pathological
conditions that may be diagnosed by use of cephalo-
metric radiographs. While not all possible pathologi-
cal conditions are included, the photographs are ex-
cellent and the chapter increases the practitioner's
awareness of this important use of radiography.
American Journal of Orthodontics and Dentofacial Orthopedic
Volume 111, No. 4
Chapter 9 is devoted to research applications of
cephalometry and Chapter 10 concerns the cephalo-
metric assessment of cervical angulation, pharyngeal
relationships, soft palate dimensions, hyoid bone, and
tongue positions. While this information is not often
used in the clinical practice of orthodontics, the in-
formation is often the topic of orthodontic research
and may find future clinical usefulness.
Chapter 11 reviews digital computed radiology
with cephalometric applications. Although digital ra-
diology has not spread to orthodontic applications,
the advantages of reduced radiation exposure, lack of
chemical processing , and image enhancement por-
tend increased popularity in the future.
Chapter 12 introduces the reader to computerized
cephalometrics and reviews the computerized cepha-
lometric systems currently available. For the practi-
tioner contemplating the purchase of such a system,
this chapter alone may be worth the purchase price
of the book. Chapter 13 concludes with a compila-
tion of 23 different cephalometric analyses. For each
analysis, there is a review, graphic depiction, and an
explanation of the derivation of the norms.
This book is extensively referenced, and beautifully
presented with superb photography and graphics, it
could easily establish a has of knowledge for both the
beginner and experienced practitioner. For any one
interested in diagnosing pathology, posteroanterior
cephalometry, digital radiology, or computerized
cephalometrics, the text will be especially useful.
T. Michael Speidel
Clinical Diagnosis Compared with Findings
of Magnetic Resonance Imaging in 242
Patients with Internal Derngement of the
TMJ
Richard E. Marguelles-Bonnet, DDS, P.
Carpentier, DDS, J. P. Yung, DDS, D.
Defrennes, MD, C. Pharaboz, MD
J Orofacial Pain 1995;9:244-53
The aim of this study was to compare the provisional
diagnosis based on an initial clinical examination with
subsequent findings of magnetic resonance imaging in
patients with internal derangement of the temporoman-
dibular joint. Clinical examinations were conducted on
242 patients (198 women and 44 men) who had unilat-
eral (51%) or bilateral (49%) temporomandibular joint
internal derangement. They were divided into the fol-
lowing catergories: (1) disk displacement with reduc-
tion; (2) disk displacement without reduction; (3)
"stuck" disk; (4) degenerative arthrosis with or without
one of the above; and (5) normal temporomandibular
Reviews and abstracts 459
joint of the contralateral side. There was no statistically
signficant difference in te distribution of disorders on a
unilateral or bilateral basis or in the prevalence of dis-
orders in fight versus left joints. Based on the high
ocurrence of matching true-negative data, this study
showed a highly statistically significant correlation be-
tween the magnetic resonance findings and the clinical
data for all categories of derangement. Despite this high
correlation, the magnetic resonance imaging and clini-
cal diagnoses matched exactly in only 287 of the 484
joints studies. There was only partial agreement in the
remaining 197 joints. The best clinical diagnosis in re-
lation to the magnetic resonance findings was observed
in teh arthrosis category followed by the categories of
normal joint, disk displacement with reduction, stuck
disk, and disk displacement without reduction, in de-
scending order. This study strongly suggests that de-
generative arthrosis is a result of a long-term displaced
disk. The clinical examination alone did not correctly
indicate all teh structural defects: therefore it is insuffi-
cient for determining the status of the joint.
Alex Jacobson
The Evaluation of the Orthopedic
Appliances by Using Standard Growth
Curves of Maxilla and Mandible
Keio Kusumoto, Koshi Sato, and Hideo Mitani
J Jpn Orthod Soc 1996;55(4):311-21
The purpose of this study was to evaluate growth
behavior with treatment of orthopedic appliances us-
ing the standard growth curves of maxilla and man-
dible. Materials consisted of longitudial lateral cepha-
lometric roentgenograms of 21 Class I females with-
out any orthopedic treatment, 10 females with head-
gear treatment, and 13 females with chincap treatment.
The average growth curve and growth velocity of the
patients treated by occipital pull headgear and chincap
appliances were drawn on standard growth curve.
Results were as follows: (1) The standard growth
and velocity curves of maxillary length ('-Ptm'),
mandibular total length (Cd-Gn), rams height (Cd-
Go), and mandibular body length (Go-Pog') were
made from 9 to 17 years of age. (2) The growth ve-
locity of the maxillary length tended to decrease un-
der the application of headgear, and increase after
removal. There were no significant differences be-
tween the initial and last stage SD scores. (3) The
growth velocity of each part of the mandible signifi-
cantly decreased under the application of chincap, but
increased after removal. There were no significant
differences between the initial and last stage SD
scores.