DEPARTMENT OF REVIEWS AND ABSTRACTS

Edited by
J. A. Salrmann, D.D.S.
New Pork City

A11 inquiries regarding information on reviews and abstraots should be aCrectea to

the respective authors. Articles or boolcs for review in this departlnent should be
addressed to Dr. J. A. Salzmann, 85 Sutton Place South, New Porlc, New Pork 10068.

Growth in Width of the Maxilla Studied by the Implant Method

A. Bjiirk and V. Skieller

SWba. J. Plast. Reomtr. Surg. 8: 86-33, 1974

The transverse growth of the maxilla was studied radiographically by means

of metallic implants. The sample consisted of nine boys without malocclusion who
had never received orthodontic treatment and were followed annually from the
age of 4 years. Sutural growth in width of the maxilla was determined from
frontal radiograms as the increase in the distance between metallic implants in-
serted at the lower aspect of the maxillary zygomatic process on each side. The
development in width of the maxillary dental arch! measured between the first
molars, showed a small puberal growth spurt, but the total increase in width was
only about one fourth of the sutural growth in width of the maxilla in this area.
The increase in distance between the laterally placed implants was three times
greater than between the anterior implants for a corresponding period of time.
This demonstrates that the sutural separation of the two maxillae was greater
posteriorly than anteriorly, and consequently they rotate in the transverse plane
in relation to each other. The influence of the transverse rotation of the two maxil-
lae on the development of the maxillary dental arch is discussed.
The displacement of the maxillae in all three planes during growth may be
explained by the complicated shape of the palatine bone which seems to aet as a
growth wedge. A lowering and rotation of the maxillopaIatine complex obviously
take place against the pterygoid processes. A further lowering of the maxilla in
connection with vertical and transverse rotation is possible in the transverse
suture of the hard palate as well as in the t,wo lateral squamous sutures between
the vertical plates of the palatine bone and the maxillae.
An accurate account of changes in the shape of the upper dental arch during
development is outside the scope of the present study but will be mentioned
briefly. The continuous shortening of the maxilla in the midline due to the mutual
transverse rotation of the two parts may, to some extent, be responsible for a
shortening of the upper dental arch in the median plane seen in most cases. Fur-
thermore, it seems reasonable to relate the difference in development in width of
the dental arch, measured between the canines and between the first molars, to
the greater activity in growth in the posterior part of the median suture. An un-
99
100 Reviews asd abstracts Am. J. Orthoa,
July 1971

derstanding of the general compression of the dental arch in relation to the su-
tural growth in width of the maxilla calls for analysis of other factors, such as
tooth migrations caused by the sagittal development of the face and the vertical
rotation of the jaws.

Hepatitis B-Traffic in the Dentist’s Office

Samuel Vairrub
J.A.M.A.232: Junek?$,1975

Levin and associates investigated an outbreak of hepatitis B surface antigen

(HB,Ag) -positive hepatitis in thirteen patients who contracted their disease from
a dentist convalescing from an acute attack. None of these patients had blood
transfusions or contact with jaundiced persons, and none was addicted to nar-
cotics. The transmission of the disease presumably occurred through needles, sy-
ringes, and possibly aerosolized saliva or blood.
Rimland and Parkin traced an outbreak of hepatitis B involving fifty-three
cases over a 4-year period to one oral surgeon, who was found to be an asympto-
matic HB,Ag carrier. Eighty per cent of these patients were HB,Ag-positive. In
six of seven patients in whom subtyping was done, the antigen subtype was iden-
tical to that of the oral surgeon.
The dentists who transmitted the disease were carriers with positive HB,Ag
test responses. On the other hand, the dentists who did not infect their patients
were incubating the virus. The degree of antigenemia may be a factor in infec-
tiousness. Another factor may be inadequate prophylaxis. Poor sterilization of
instruments and failure to use disposable needles and gloves may play a part
in disseminating infection from dentists to patients. Negligence in prophylaxis
may also promote the spread of infection from patients to dentists.

Hepatitis in Dental Professionals

Ronald E. Feldman and Eugene R. Schiff

J. A. Y. A. 232: lM8-1%?0,1975

To characterize some epidemiologic features of viral hepatitis among

dentists, information was obtained with a mailed questionnaire from 434 dentists
and 787 attorneys in Dade County, Florida. Dentists had a significantly higher
incidence of hepatitis than did lawyers (6.7 per cent versus 2.4 per cent), with
the highest rate among oral surgeons (21 per cent). The incidence of hepatitis
B antigenemia among asymptomatic dentists was not significantly higher than
that of volunteer blood donors.
Twenty-two per cent of dentists with hepatitis reported treating more than
ten drug addicts per year, as compared with 10 per cent of those dentists without
hepatitis. No differences were noted between dentists with and without hepatitis
in methods of sterilization, the wearing of gloves during procedures, or the use
of disposable needles. The increased risk of hepatitis among dentists, however,
may be related to the omission of adequate prophylactice measures, particularly
when treating high-risk patients such as drug abusers.