White Paper on the Efficacy of the Osseo-Restore™ Appliance to Effect Skeletal Patency and Growth in The Anterior Maxilla
Moulton D. Abernathy, Jr., DDS, DFBI
Timothy G. Bromage, BA, MA, PhD
Stephen Deal, DDS, BS
Steve Galella, DDS, IBO
W.C. Simmmons, DDS, BS
Introduction. Bone growth remodeling by bone deposition and resorption has a deep scientific research history, which in the present day requires to be put to purpose for understanding remodeling phenomena occurring over the subnasal region during orthodontic treatment;
Methods. A conebeam CT superimposition technique rendering an assessment of bone growth remodeling with an appreciation for its principles, combined with an understanding of the role of mechanical forces aids our understanding of craniofacial growth and development;
Results. Mechanical forces elicited by an orthopedic appliance in the biological range will stimulate normal growth remodeling in the growing child and compensatory remodeling in the adult non-grower.
Conclusions. Anterior alveolar remodeling may be specifically targeted to treat maxillary deficiencies provided that treatment forces do not exceed the biological range.
The functional matrix hypothesis revisited. Orofacial capsular matrices defined
Timothy G. Bromage, BA, MA, PhD
Department of Molecular Pathobiology
New York University College of Dentistry
345 East 24th Street
New York, NY 10010 USA
The functional matrix hypothesis was introduced by Melvin L. Moss in the 1960’s, and has been an enduring concept for explaining the compensatory growth and development of the craniofacial complex in general, and the facial skeleton in particular. It remains true in concept, but we maintain it is incomplete. Functional matrices are of two types: periosteal matrices comprise muscle/tendon attachments to skeletal units, and capsular matrices enclose a tissue mass or volume within a functional space. Regarding the latter, pressure arising from growing contents of the neurocranial capsular matrix explain the expansion of the braincase. However, expansion of orofacial capsular matrices are said to be intrinsically-derived spaces that satisfy the metabolic demands of the body. We offer support for the idea that these capsular matrices have contents that furnish the pressures required to form these spaces. The oropharyngeal capsule is mechanically challenged by chewing a hard and tough diet, and in so being challenged grows sufficiently to render a normal occlusion. The functional matrix of the oral cavity is hard and tough food. The nasopharyngeal capsule is mechanically challenged by air pressures elicited by vigorous nasal breathing. While chewing forces likely also play a role in development of the nasopharyngeal passage, nasal breathing is suggested to be primary. The functional matrix of the nasal cavity is air. The orthodontic community must transition from treating only the symptoms of perturbed facial growth, to acknowledging the public health benefit of identifying the causes of maxillary and mandibular insufficiencies and tooth crowding.
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