Faculty Bibliography

Orthodontic diagnosis and treatment planning topics have become predictable in that reports seem to be reactive to societal dilemmas rather than addressing fundamental questions of our science. Issues and reports abound on temporomandibular disorders and their relationship to orthodontics. Investigations of airway function and other topics have tended to compound misunderstandings rather than eliminate them. Furthermore, new technologies heralded as having great promise may eventually fall to the side as mere gimmickry. Well-controlled prospective studies are needed to address many fundamental issues underlying orthodontic treatment. The progress and results from these works will take time to bear fruit

Uptake of a bone-seeking radiopharmaceutical is correlated with growth changes in the rat mandible. Uptake was highest in newborn rats, decreasing with increasing age

Normal standards of technetium-99m methylene diphosphonate (99mTc-MDP) uptake in the jaws of adults and growing children have previously been established. This study utilizes the technique of skeletal scintigraphy for diagnosis and treatment planning in 21 patients with mandibular asymmetry. Diagnoses included hemifacial microsomia (n = 6), condylar hyper or hypoplasia (n = 10), and generalized mandibular asymmetry (n = 5). 99mTc-MDP uptake was measured in the right and left condyle, ramus, and body. Uptake was then compared with the known age-adjusted standards. The data were used to determine 1) mandibular growth activity, 2) normal vs. abnormal side, and 3) the effects of operative and functional therapy. The presence of end stage deformity was predicted when mandibular uptake reached the adult norm

Accurate assessment of facial skeletal growth remains a major problem in craniomaxillofacial surgery. Current methods include 1) comparisons of chronologic age with growth histories of the patient and the family, 2) hand-wrist radiographs compared with a standard, and 3) serial cephalometric radiographs. Uptake of technetium-99m methylene diphosphonate into bone is a reflection of current metabolic activity and blood flow. Therefore, scintigraphy with this radiopharmaceutical might serve as a good method of assessing skeletal growth. Thirty-four patients, ranging in age from 15 months to 22 years, who were undergoing skeletal scintigrams for acute pathologic conditions of the extremities, were used to develop standards of uptake based on age and skeletal maturation. The results indicate that skeletal scintigraphy may be useful in evaluation of mandibular growth