Growth rotations /certified fixed orthodontic courses by Indian dental academy

1,735 views

Published on


The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078

0 Comments
7 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,735
On SlideShare
0
From Embeds
0
Number of Embeds
5
Actions
Shares
0
Downloads
199
Comments
0
Likes
7
Embeds 0
No embeds

No notes for slide

Growth rotations /certified fixed orthodontic courses by Indian dental academy

  1. 1. GROWTH ROTATIONS www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3. Contents • • • • • • Introduction Terminologies Concepts of Mandibular growth Rotations Concepts of Maxillary growth Rotations Prediction of Mand growth Rotation Interaction b/n jaw Rotation &Tooth eruption • Clinical implications • conclusion www.indiandentalacademy.com
  4. 4. Introduction Since Cephalometrics introduced in 1930, originally used to reveal The Anatomy of head Longitudinal study is possible, soon employed to test various Concepts of mechanisms of postnatal growth of head www.indiandentalacademy.com
  5. 5. Introduction Longitudinal Cephalometrics analysis of profile radiographs shows that facial shape is remarkably constant during growth www.indiandentalacademy.com
  6. 6. • Until the use of metallic implants the extent to which the mand & maxilla rotate during growth was not appreciated • The Rotation tends to be masked by surface remodeling www.indiandentalacademy.com
  7. 7. • Lande in 1952 observed that the lower border of the mand becomes less steeply inclined • The phrase “GROWTH ROTATION” was introduced in 1955 by Bjork • With the use of metallic implants, He could infer the sites & amt of growth & resorption • Superimposing 2 consecutive tracings showed that the older Mand rotated www.indiandentalacademy.com
  8. 8. www.indiandentalacademy.com
  9. 9. Forward Rotation (Bjork) Counterclockwise Rotation (shudy) Posterior growth is greater than Anterior Backward ward Rotation (Bjork) Clockwise Rotation (shudy) Anterior growth is greater than posterior www.indiandentalacademy.com
  10. 10. www.indiandentalacademy.com
  11. 11. TERMINOLOGIES • 1965-Schudy introduced clockwise and counterclockwise rotation. • 1969-Bjork discussed different directions of rotation of the mandibular implant line and the relation of these to mandibular form. www.indiandentalacademy.com
  12. 12. • 1970-Odegard described rotation as the change in the orientation that can occur between implant line and lower border of the mandible. • 1977-Lavergne and Gasson described the terms Positional and Morphogenetic rotations. • 1983-Bjork and Skieller gave the termsTotal rotation. Matrix rotation. Intramatrix rotation www.indiandentalacademy.com
  13. 13. • 1985-Dibbets introduced the term Counterbalancing rotation. • 1988-Solow,Houston True rotation. Apparent rotation. Angular remodeling of the lower border. • Proffit- used the terms Internal rotation. Total rotation . External rotation. www.indiandentalacademy.com
  14. 14. www.indiandentalacademy.com
  15. 15. www.indiandentalacademy.com
  16. 16. TOTAL ROTATION / TRUE ROTATION / INTERNAL ROTATION • Is the rotation of the mandibular corpus and is measured as a change in inclination of the implant line, in the mandibular corpus relative to the anterior cranial base. www.indiandentalacademy.com
  17. 17. If the implant line rotates forwards, the total rotation is designated as Negative The Total Forward Rotation is indicated by converging sella – nasion lines www.indiandentalacademy.com
  18. 18. www.indiandentalacademy.com
  19. 19. MATRIX ROTATION / APPARENT ROTATION / TOTAL ROTATION • Rotation of the soft tissue matrix of the mandible relative to the Anterior cranial base • The soft tissue matrix is defined by the Tangential mandibular line(ML1) • Is designated as Negative,when Tangential mandibular line rotates forwards www.indiandentalacademy.com
  20. 20. The matrix rotates forwards & backwards in same individual during the growth period – PENDULUM MOVEMENT Center of Rotation – Condyles www.indiandentalacademy.com
  21. 21. www.indiandentalacademy.com
  22. 22. INTRAMATRIX ROTATION/ ANGULAR REMODELING/ EXTERNAL ROTATION Defined as the change in inclination of an implant line in the mandibular corpus relative to the tangential mandibular line Intramatrix Rotation is an expression of remodeling at the lower border of the mandible www.indiandentalacademy.com
  23. 23. www.indiandentalacademy.com
  24. 24. • Forward Rotation of the corpus relative to the tangential mand line is recorded as Negative • Center of rotation is somewhere in the corpus • Depends on rotation of corpus of mand & rotation of maxilla & occlusion of teeth www.indiandentalacademy.com
  25. 25. ----- + +++ ++ www.indiandentalacademy.com
  26. 26. + ----- +++ ++ - www.indiandentalacademy.com
  27. 27. www.indiandentalacademy.com
  28. 28. • The diff b/n Total Rotation & Matrix Rotation is intramatrix Rotation www.indiandentalacademy.com
  29. 29. • According to Bjork & Skieller’ “Intramatrix” concept First,the mandible “wiggles” with in the matrix Second,this “wiggling” is associated predominantly with the corpus, but is caused by the growing condyle Third, Rotation results from or compensates for, a genetically determined program www.indiandentalacademy.com
  30. 30. BJORK SOLOW, HOUSTON PROFFIT Rotation of Mandibular core relative to cranial base implants Total Rotation True Rotation Internal Rotation Rotation of Mandibular plane relative to cranial base Matrix Rotation Apparent Rotation Total Rotation External Rotation of Mandibular Intramatrix Angular Remodeling Rotation plane relative to core of Rotation of lower Mandible border www.indiandentalacademy.com
  31. 31. • The Total Rotation = Matrix Rotation + IntraMatrix Rotation www.indiandentalacademy.com
  32. 32. • The center of Total Rotation depends on other two centers of Rotation • The pattern of vertical facial development is strongly related to the Rotation of both the jaws • For an average individual with normal vertical facial height • Total Rotation = – 15 Matrix Rotation = –4 IntraMatrix Rotation = –11 www.indiandentalacademy.com
  33. 33. “Positional” & “Morphogenetic” Rotation Given by Lavergne & Gasson Positional Rotation deals with the position of the mandible with in the head www.indiandentalacademy.com
  34. 34. Morphogenetic Rotation • concerns the shape of the mandible itself • super imposing the two tracings on a line through condylion & pogonion •The angle b/n two implant lines is determined & this corresponds to the degree of morphogenetic Rotation • similer to Bjork’s Intramatrix Rotation but not identical www.indiandentalacademy.com
  35. 35. Bjork & Skieller consider the key factor of Intramatrix rotation to be found in a rotation of the mandibular corpus inside its matrix Lavergne & GassonFound the effective mechanism in Ramus, its forward or backward growth,therby shortening or elongating the effective length of the mandible www.indiandentalacademy.com
  36. 36. • Maxillary – Mandibular sagittal discrepancy is minimized by opening or closing the gonial angle www.indiandentalacademy.com
  37. 37. “It is a compensating mechanism which is capable of enlarging or reducing mandibular length as measured along the condylion-pogonion diagonal” www.indiandentalacademy.com
  38. 38. J.M.H.Dibbets • Re-examination of the concept of “Intramatrix Rotation" as defined by Bjork & Skieller & also explored by Lavergne & Gasson • Three diff interpretations of Intramatrix concept are www.indiandentalacademy.com
  39. 39. • First option - Bjork & Skieller define the “Intramatrix Rotation” as The Rotation of the mandibular corpus relative to the lower border is a result of genetically determined condylar growth both in magnitude & in direction www.indiandentalacademy.com
  40. 40. Bjork approach Superimposing two tracings of the same mandible registered upon natural reference structures shows Rotation www.indiandentalacademy.com
  41. 41. Divergence of implant lines indicates Intramatrix rotation Superimposed on implant markers Indicates extensive remodeling www.indiandentalacademy.com
  42. 42. • The condyle grows on a circular arc with radius from center at chin to the condyle. • When two tracings are superimposed on their contours, they are identical in size & shape. • The external configuration of mandible need not change in order to allow ‘Intramatrix rotation’ • Any Depositional or Resorptive activity maintains original contours www.indiandentalacademy.com
  43. 43. Painting rotated with in frame but external configuration & dimensions do not change www.indiandentalacademy.com
  44. 44. • The bony element can rotate with in its periosteal frame • Every deflection of condylar growth creates the possibility of compensatory remodeling, mostly resorption of the lower border resulting in Intramatrix rotation • Intramatrix Rotation neutralizes the condylar growth. www.indiandentalacademy.com
  45. 45. Second option-Hunterian concept or Morphogenetic rotation Posterior ramal deposition & Ant resorption The direction of condylar growth follows pattern that enlarges the Mandible maximally www.indiandentalacademy.com
  46. 46. Third option - Dibbets • Two divergent patterns of mandibular growth • 1)Circular growth pattern of condyle, resulting in Intramatrix Rotation without any enlargement of mandible • 2)linear growth pattern of the condyle, characterized by the absence of intramatrix rotation but evidencing mandibular enlargement. suggested mechanism www.indiandentalacademy.com Counterbalancing Rotation
  47. 47. Counterbalancing Rotation “Counterbalancing Rotation pertains to circular condylar growth, accompanied by selective coordinated remodeling, which does not contribute to the incremental growth of the mandible” *The actual path of the mand condyle is accompanied by selective remodeling & thus neutralizes the growth * Results in selective enlargement of the mandible, apart & distinct from mechanisms that have been described in the literature www.indiandentalacademy.com
  48. 48. Counterbalancing proportion Defined as the percentage of condylar incremental growth, detected by implants that has contributed to the enlargement of the condylion- pogonion dimension • The quantification & comparison of condylar growth & mandibular enlargement www.indiandentalacademy.com
  49. 49. Mandibular growth =pg-Ar2 – Pg-Ar1 Condylar growth – Ar1 – Ar2 Growth of articulare to pogonion Counterbalancing = Condylar incremental growth proportion www.indiandentalacademy.com ×100
  50. 50. • According to the concept of congruous mandibular growth, the proportion expected is 100%. • But the proportion ranges from 50% to 97%. • Average counterbalancing proportion for Angle classes Class III – 85% Class I – 76% Class II Div 2 – 59% Class II Div 1– 65.5% Effective contribution vary among individuals because of varying condylar directions & mand remodeling www.indiandentalacademy.com
  51. 51. Concepts of mandibular Rotations www.indiandentalacademy.com
  52. 52. Enlow’s concept Two categories of Rotations - Remodeling Rotations - Displacement Rotations www.indiandentalacademy.com
  53. 53. Remodeling www.indiandentalacademy.com
  54. 54. Ramus • Ramus undergoes remodeling to carryout following functions • Place the corpus in constant functional relationship with maxillary arch • To bridge the pharyngeal compartment • To accommodate the vertical dimension of nasomaxillary complex • Give attachment to the growing masticatory musculature. www.indiandentalacademy.com
  55. 55. www.indiandentalacademy.com
  56. 56. Vertical lengthening ramus continues after horizontal growth ceases www.indiandentalacademy.com
  57. 57. Opening and closing of the gonial angle compensates for extreme forward or backward rotation www.indiandentalacademy.com
  58. 58. • Vertical growth changes of the mandibular dento-alveolar arch, the ramus & middle cranialfossae must match nasomaxillary growth to achieve facial balance • Any diff will lead to Displacement mand Rotations www.indiandentalacademy.com
  59. 59. Displacement rotations • Changes in the junctional contact with the cranial floor and maxilla. • Cranial base angleOpen-downward and backward rotation of mandible. Closed-forward rotation. www.indiandentalacademy.com
  60. 60. www.indiandentalacademy.com
  61. 61. Closed Angle Open Angle www.indiandentalacademy.com
  62. 62. Vertically short midface causes forward rotation & upward inclination of mandible www.indiandentalacademy.com
  63. 63. Long nasomaxillary region causes downward & backward alignment of mandible www.indiandentalacademy.com
  64. 64. Schudy’s concept • The Rotation of the mandible resulting from an inhormony b/n vertical growth & horizontal growth • Counter clockwise Rotation deficiency of vertical growth compared to horizontal growth & tends to cause closed bite • Clockwise Rotation – excessive vertical growth compared to horizontal growth & tends to cause open bite www.indiandentalacademy.com
  65. 65. www.indiandentalacademy.com
  66. 66. www.indiandentalacademy.com
  67. 67. Vertical elements of growth • Growth at nasion • Growth of maxillary corpus • Growth of max post alveolar processes • Growth of mand post alveolar processes www.indiandentalacademy.com
  68. 68. Posterior growth analysis The ratio b/n horizontal growth & Vertical growth A= I+ II + III www.indiandentalacademy.com
  69. 69. Bjork concept www.indiandentalacademy.com
  70. 70. Forward Rotation – 3 Types Type – I Center- TMJ Deep bite ↓ Ant facial height Lower dental arch compressed in to upper Cause-occlusal imbalance due to loss of teeth/powerful www.indiandentalacademy.com musculature
  71. 71. • Type II • Center- incisal edges of lower ant teeth • Marked development of post facial height & normal ↑ ant facial height • ↑ Post facial height Lowering of middle cranial fossae increase in height of ramus www.indiandentalacademy.com
  72. 72. Vertical direction of the condylar growth lowered the mandible more than it is carried forward Muscular & ligamentus attachments Carries the lowered mandible forward Lower border undergoes characteristic remodeling www.indiandentalacademy.com
  73. 73. Type III Center of rotation - premolars The dental arches compressed in to each other & basal deep bite develops Cause – Anomalous occlusion of ant teeth www.indiandentalacademy.com
  74. 74. • The inclination of teeth is greatly influenced by rotation of jaws • Displaces the path of eruption of teeth in mesial direction • Ant crowding referred as packing www.indiandentalacademy.com
  75. 75. Backward Rotation –two Types Type I Center - TMJ underdevelopment of post facial height leads to Backward Rotation Causes- the middle Cranial fossae is rised -Incomplete development in height of middle cranial www.indiandentalacademy.com fossae as in oxycephaly
  76. 76. Type II • Center – Most distal occluding molars • Cause - Sagittal growth direction of condyle • The symphysis is swung backwards & chin drawn back • Double chin www.indiandentalacademy.com
  77. 77. Basal open bite develops Lower ant teeth retroclined & alveolar prognathism is reduced Rotation did not lie in the over eruption of lower teeth This type of rotation is characteristic in condylar hypoplasia & In condylar aplasia www.indiandentalacademy.com
  78. 78. Mandibular growth Rotation is closely associated with both the direction & the amount of growth at the condyles www.indiandentalacademy.com
  79. 79. www.indiandentalacademy.com
  80. 80. Maxillary Rotations www.indiandentalacademy.com
  81. 81. Bjork & Skieller Implant studies of Bjork & Skieller have shown that, The downward & forward displacement of maxillae are associated with varying degrees of vertical Rotation Internal Rotation produced with in the core of maxilla tends to be masked by surface changes & alterations in the rate of teeth eruption www.indiandentalacademy.com
  82. 82. • The maxilla is less easy to delude in to core of bone & functional processes • Alveolar process is functional process but no areas of muscle attachment www.indiandentalacademy.com
  83. 83. • Lateral implants – 4yrs of age, inserted in the zygomatic process two on each side, antly on the lower margin away from the crest •Indicates increase in width of median suture at the level of first molars www.indiandentalacademy.com
  84. 84. • Anterior implants – 10yrs of age, inserted below the anterior nasal spine on each side of median suture at the level of apices of central incisors www.indiandentalacademy.com
  85. 85. • Maxillary Rotations studied in 2 planes Transverse plane Vertical plane www.indiandentalacademy.com
  86. 86. Transverse / Mutual Rotation of two Maxillae Triangle is constructed with the sides of constant length by joining ant & lateral implants www.indiandentalacademy.com
  87. 87. • Lateral implants separate more than ant implants • Two maxillae rotate in relation to each other in transverse plane • Length of the maxilla is reduced in mid sagittal plane • Length of dental arch becomes reduced www.indiandentalacademy.com
  88. 88. www.indiandentalacademy.com
  89. 89. Vertical Rotation A line from tip of ant implant to Lateral implant is drawn on profile radiograph Tracings shows change in inclination of implant line to the SN plane at diff ages www.indiandentalacademy.com
  90. 90. The inclination of nasal floor to ant cranial base is maintained by differential remodeling In forward rotation – the resorption at nasal floor is greater antly than postly Facial growth is greater postly www.indiandentalacademy.com
  91. 91. In backward Rotation Rotates downwards & backwards Resorption at nasal floor is greater postly Facial growth is greater antly than postly www.indiandentalacademy.com
  92. 92. www.indiandentalacademy.com
  93. 93. Enlow’s Maxillary Rotations Displacement Remodeling www.indiandentalacademy.com
  94. 94. Displacement Rotations Primary displacement The whole nasomaxillary complex is displaced in conjunction with its own growth www.indiandentalacademy.com
  95. 95. Secondary Displacement - Results from growth of other bones & their soft tissues www.indiandentalacademy.com
  96. 96. • Displacement in clockwise/counterclockwise direction would result in canting & misfit of the palate & maxillary arch in to either open / closed bite positions • Remodeling fields along nasal & oral sides of the palate offset & compensate www.indiandentalacademy.com
  97. 97. Remodeling www.indiandentalacademy.com
  98. 98. 2-3 – primary displacement 1-2 - Remodeling movement www.indiandentalacademy.com
  99. 99. Prediction of mandibular growth Rotation Bjork method • Longitudinal method • Metric method • Structural method www.indiandentalacademy.com
  100. 100. Longitudinal method • The course of development in annual x-ray Cephalometric films • Superimposed on natural reference strs www.indiandentalacademy.com
  101. 101. Rotation – angle b/n SN lines www.indiandentalacademy.com
  102. 102. Limitations Pattern of growth is not constant • permits observation of changes only in sagittal direction • Changes in vertical direction are masked to larger extent www.indiandentalacademy.com
  103. 103. Metric method • Prediction of facial development on basis of facial morphology ,determined from a single x-ray • Statistical studies – predicting the intensity & direction of development from shape & size at childhood is not feasible • The changes in shape of face during adolescence weakly correlated with shape of face at 12yrs www.indiandentalacademy.com
  104. 104. Structural method • Based on information gained from implant studies of mandibular remodeling process • Recognizes specific structural signs develop as a result of remodeling • Various types of rotations can be recognized with implant method www.indiandentalacademy.com
  105. 105. Structural signs • Seven structural signs of extreme growth rotation • Considered in relation to condylar growth direction • Greater the number, more reliable the prediction will be. • Signs are not clearly developed before puberty www.indiandentalacademy.com
  106. 106. • Inclination of condylar head • Curvature of the mandibular canal • The shape of the lower border of the mandible • Inclination of the symphysis • Interincisal angle • Interpremolar and molar angles www.indiandentalacademy.com • Lower anterior face height
  107. 107. www.indiandentalacademy.com
  108. 108. www.indiandentalacademy.com
  109. 109. Condylar Inclination www.indiandentalacademy.com
  110. 110. Mandibular Canal www.indiandentalacademy.com
  111. 111. Lower Border & Inclination of Symphysis www.indiandentalacademy.com
  112. 112. Inter Incisal Inclination www.indiandentalacademy.com
  113. 113. Inter Molar Relation www.indiandentalacademy.com
  114. 114. Condylar Inclination www.indiandentalacademy.com
  115. 115. Mandibular Canal www.indiandentalacademy.com
  116. 116. Lower Border & Inclination of Symphysis www.indiandentalacademy.com
  117. 117. Inter Incisal Inclination www.indiandentalacademy.com
  118. 118. Inter Molar Relation www.indiandentalacademy.com
  119. 119. • But Baumrind & Rodney lee contradicted findings of Bjork et al very strongly www.indiandentalacademy.com
  120. 120. • The study conducted in our Department by violet barbosa, • Lower gonial angle • Inclination of condylar head • Inclination of symphysis are reliable signs to predict the type of rotation • Limited extent www.indiandentalacademy.com
  121. 121. Interaction b/n Rotation & Tooth eruption • Rotational pattern greatly influences the magnitude & direction of eruption • Superimposition on mand lower borderno change in incisor eruption www.indiandentalacademy.com
  122. 122. Forward Rotation • Superimposition on implants – forward directed path of eruption • Forward migration of whole dentition • Anterior crowding • Lower post teeth- more upright • Increase in interpremolar & intermolar angles www.indiandentalacademy.com
  123. 123. Average values: Mandibular arch Mean forward migration of mandibular molars 5.2mm. Lower central incisors-3.2mm. Shortening of the dental arch-2.0mm. www.indiandentalacademy.com
  124. 124. Average values: • Maxillary arch -Mesial migration I molars-5mm -central incisors-2.5mm Shortening of arch-1mm+1.5mm www.indiandentalacademy.com
  125. 125. Backward Rotation • Incisors become retroclined • Alv prognathism is reduced • Eruption of lower molars – hindered • Interpremolar& intermolar angles are small www.indiandentalacademy.com
  126. 126. • Proffit -The lower mandibular teeth erupt in upward and forward direction. -Forward rotation –alters the path of eruptiondirected posteriorly. www.indiandentalacademy.com
  127. 127. Clinical implications Forward Rotation • • • • • • • Short face type “Square jaw” type Low mandibular plane angle Skeletal anterior deep bite Crowding of anterior teeth Palatal plane is nearly horizontal. smile - lower incisors are visible with the upper incisors hidden behind the www.indiandentalacademy.com upper lip.
  128. 128. Backward Rotation • • • • • • Long face type “Round jaw” type Steep mandibular plane angle Skeletal anterior open bite Dental protrusion Negative inclination of palatal plane www.indiandentalacademy.com
  129. 129. • Various combinations of rotations can cause malocclusions www.indiandentalacademy.com
  130. 130. www.indiandentalacademy.com
  131. 131. Growth Rotation can also affect sagittally • Hypodivergent - can compensate for class II - worsen class III Hyperdivergent - worsen class II - compensate for class III www.indiandentalacademy.com
  132. 132. Treatment in preadolescent children Growth modificationVertical, sagittal, transverse Before adolescent growth spurt ends www.indiandentalacademy.com
  133. 133. • Both forward & Backward rotation greatly influences paths of eruption • Serious risk of extreme migration after extractions • Extractions should be avoided until the beginning of pubertal growth spurt www.indiandentalacademy.com
  134. 134. • Forward Rotation • Major risk of deep bite developing- prevented stabilizing appliance introduced before puberty • After treatment, stabilization is necessary until the growth of the jaws is completed www.indiandentalacademy.com
  135. 135. • Mandibular deficiency • Functional appliances • Removable appliances Activator, Bionator, Frankel 1&2 Bimler’s appliance, Twin block appliance • Fixed Herbst appliance, Jasper jumper, Churro jumper,Forsus www.indiandentalacademy.com
  136. 136. Mandibular excess Functional appliances Frankel 3 Reverse Activator www.indiandentalacademy.com
  137. 137. MANDIBULAR EXCESS • extra oral force • orthopedic chin cup • occipital pull chin cup vertical pull chin cup Steep mandibular plane angle & excessive lower facial height. www.indiandentalacademy.com
  138. 138. ADULTS BILATERAL SAGITTAL SPLIT OSTEOTOMY SET BACK ADVANCEMENT www.indiandentalacademy.com
  139. 139. Maxillary deficiency • Growth modulation in sagittal plane can be done : 1.face mask Delaire facemask 2.reverse functional appliances. www.indiandentalacademy.com Petite facemask
  140. 140. Maxillary excess • To restrict the maxillary growth Headgear www.indiandentalacademy.com
  141. 141. Cervical head gear: used in patients with horizontal growth pattern with reduced lower facial height. www.indiandentalacademy.com
  142. 142. Occipital pull Head gear:Used in long face patients with high mandibular plane angle. www.indiandentalacademy.com
  143. 143. References • Contemporary orthodontics - William.R.Proffit(2nd &3rd ed.) • Essentials of of facial growth - Donald.H.Enlow. • Dentofacial orthopaedics with functional appliances -Thomas M.Graber, Thomas Rakosi, Alexandrer G.Petrovic. www.indiandentalacademy.com
  144. 144. • Facial growth and facial orthopedics. -van der Linden. • Determinants of mandibular form & growth (CFGS) Monograph-4 • Factors effecting growth of the midface (CFGS) Monogrph-6. • The rotation of mandible resulting from growth;Its implications in orthodontic treament -F.F.Schudy-AO 1965.no.1,36-50. www.indiandentalacademy.com
  145. 145. • Prediction of growth rotation - A.Bjork-AJO-DO1969,jun 39-53. • Facial development and tooth eruption :an implant study at the age of pubertyA.Bjork,V.Skieller AJO-DO 1972,62,4;339-383. • Normal and abnormal growth of mandible.a synthesis of longitudinal cephalometric implant studies over a period of 25 www.indiandentalacademy.com years.A.Bjork,V.Skieller.EJO-1983,5;1-46.
  146. 146. • The puzzle of growth rotation. J.M.H.Dibbets –AJODO June 1985 ,87,6;473-480. • Mandibular rotations – concepts & terminology Beni Solow & William Houston J B-EJO1988,10;177-179. • Mandibular rotation and enlargement. J.M.H.Dibbets.AJO-DO July 1990,29-32. • Mandibular morphologic characteristics in relation to various facial types and jaw rotations.- Dr. Violet Barbosa Aug 1996. www.indiandentalacademy.com
  147. 147. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

×