class iv malocclusion a new angle

Kevin L. Boyd, DDS, MS

Anthropologist in training

HYPOTHESIS:

Outdated/anthropologically-uninformed diagnostic tools (Angle Malocclusion ClassificationSystem and mostly Steiner-based cephalometric norms) are leading to r inaccurate diagnoses, inappropriate Tx recommendations and consequential increased susceptibility to airway disease.

Although dentists and orthodontia recognize the importance of evaluating and treating OSA, they have yet to realize howwell-positioned they are for the prevention of sleep-

disordered breathing (SDB).

Another possible explanation for our findings is that oral cavity features such as high palates, narrow dental arches, and retruded chin all are additional risk factors for SDB in

children338. Kushida CA, Efron B, Guilleminault C. A predictive morphometric model for the obstructive

sleep apnea syndrome. Ann Intern Med. 1997;127:581–587

Sleep Breath. 2012 Jun;16(2):271-3.

Is the basis for McNamara’s “Ideal” anthropologically informed?

CEPHALOMETRICS

STEINERCEPHALOMETRIC ANALYSIS

STEINERCEPHALOMETRICANALYSIS

The Angle Orthodontist: 54 (1): 5-17 1984

Angle Orthod. 54(1): 5-17 1984

“… jaw anomalies (malocclusions wherein the teeth cannot fit properly in the jaw) are relatively new to European populations. Well-preserved skeletons from the 15th and 16th centuries show almost no malocclusion in the population….”

“ …(malocclusion) is a relatively new phenomenon in the human population and we do not find it in skeletons until after the seventeenth century. ” -Peter Gluckman

I

Dear John:You have ruined me for other men. I yearn for you. I feel nothing but heartache when we are apart. I

am so happy.

Yoko

Dear John:You have ruined me. For other men, I yearn. For you, I feel nothing but heartache. When we are

apart, I am so happy.

Yoko

EPI-GENETICS vs. GENETICS

75% of children, ages 6 to 11 and 89% of youths, ages 12 to 17, have some

degree of malocclusion

-

malocclusion in modern populations is higher than in ancient times.

malocclusion a “Disease of Westernization” - R Corruccini

Revolutions in Human Evolution: Have Advancements

in Agriculture and Industry Impacted Modern Facial

Form? Kevin L. Boyd, M.Sc. (Nutrition), D.D.S. (Peds.)

LARGER=wider and more prognathic

A-point

Porion(P) Frankfort Horizontal Plane (FH)

Orbitale

Nasion (N)

Nasion-perpendic. (to FH)

Abingdon Cemetery

“….there is much circumstantial evidence that jaws and faces do not grow to the same size that they used to precisely because of our softer, more processed diets.” Daniel E. Lieberman

prolonged OET tube can deform palate

ILLINOIS SLEEP SOCIETY CONFERENCE 2012

Advancing Mandibles and Maxillas with

Biobloc-Orthotropics: A Non-Surgical

Approach to Increasing Posterior

Pharyngeal Airway Space in Pediatric

OSA PatientsKevin Boyd, DDS

Kevin L. Boyd, M Sc,

DDS

Jeffrey Hindin, DDS and

John Kelly, DDS NYU-DSMC

Stephen Sheldon, MD CMH

Pierre-Robin pt. –retrusive mandible…retrusive maxilla!

2/15/2010 BIOBLOC STAGE-1 Tx 2/21/2012 BIOBLOC STAGE- 3 Tx

Example: Assign an arbitrary control value for airway radius of 1.0. A 50% reduction in airway radius would mean that the new airway radius would be 0.5. Now, according to Poiseuille, that gives us...R = 1/(0.5)4R = 1/0.0625 = 16Therefore, resistance to airflow is increased 16-fold with a decrease in airway diameter (and radius) of 50%.

Stephen Sheldon,DO LurieCorrelating PSG data with Biobloc TX

response

Are malocclusion/SDB risk factors detectable in utero?

Mother Nature’sPALATE EXPANDER

BREAST-FEEDINGa.k.a