IU Indianapolis ScholarWorks :: Browsing by Author "Hathaway, Ronald R."

Browsing by Author "Hathaway, Ronald R."

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A Bolton Analysis Comparison of Hispanic vs. Caucasian Samples in Indianapolis, Indiana
(2004) Kutsch, Devon R.; Roberts, W. Eugene; Baldwin, James J.; Hohlt, William F.; Hathaway, Ronald R.; Shanks, James C.
Although many studies examining tooth size discrepancy have been conducted, many were originally done on unknown populations and genders. They were also conducted on Class I ideal occlusions. Since that time, there have been many studies of the Caucasian population, but little has been done to compare the differences between Caucasian and Hispanic patients. The objective of this study was to establish whether there is a greater incidence of Bolton tooth mass discrepancies in the Hispanic population than in the Caucasian population of Indianapolis, Indiana. Secondly, the objective was to examine possible differences in the incidence of tooth mass discrepancy according to gender and dental malocclusion in the same sample. A sample of 292 pretreatment casts was measured to determine the incidence in both populations. The sample was composed of 146 Caucasian patients and 146 Hispanic patients. The patient sample was composed of 86 Caucasian females, 60 Caucasian males, 87 Hispanic females, and 59 Hispanic males. Patient's ethnicity was defined by photos and patient history. Individuals with a known mixed ethnicity were excluded. The sample was taken from patients in both the pre- and postdoctoral clinics at Indiana University School of Dentistry Section of Orthodontics, and the offices of selected private practitioners. Mesio-distal width of all teeth from first molar to first molar was measured with the mesio-buccal and disto-buccal contact areas normally being the widest area. The inter-incisal angle was evaluated utilizing lateral cephalometric radiographs. The molar and cuspid classification, overjet, overbite, and maxillary central incisor anterior-posterior dimension was measured from the dental casts. Results demonstrated that overjet, overbite, interincisal angle, molar class, and cuspid class did not have a significant effect on the Bolton discrepancy with each gender or between the two ethnic groups. Ethnicity did have a significant effect on the overall and anterior Bolton discrepancy with the ratio the Hispanics showing a significantly higher proportion of cases outside normal. Exploratory analysis also demonstrated which teeth were most discrepant. Clinicians are faced daily with the challenge of trying to produce ideal occlusions with optimal esthetics. Tooth mass discrepancies present an impediment to the clinician in trying to achieve this goal. By studying malocclusions common to a population, the clinician can more effectively treat his/her patients by being aware of potential problems that might compromise the final outcome. With the burgeoning Hispanic population in the US, this study was indicated using the Hispanic population as a patient base to ascertain how commonly used norms relate to the Hispanic population. This study demonstrated Hispanics have a significantly greater proportion of patients with a significant Bolton discrepancy. Being aware of this will allow the clinician to treat his/her patients more effectively and obtain an optimum esthetic and functional result.
A Cephalometric Study of Non-Cleft Parents of Children with Cleft Lip, Cleft Lip and Palate, and Cleft Palate : Evidence to Support a Different Etiology for Isolated Cleft Palate Versus Cleft Lip?
(1993) Sadler, Charles A., Jr.; Ward, Richard E.; Bixler, David; Hathaway, Ronald R.; Shanks, James C.; Roberts, W. Eugene
Cleft lip with or without cleft palate (CLI P) and isolated cleft palate (CP) have been shown to be separate epidemiologic and embryologic entities. Furthermore, it has been proposed that noncleft biologic parents of children with facial clefts may demonstrate craniofacial differences genetically predisposing them to pass on the cleft phenotype to their offspring. With these two hypotheses in mind, the objective of the present study was to determine if differences exist in the craniofacial morphology between parents of CL/P children and parents of CP children. Twenty-seven measurements were obtained from anterior-posterior (AP) cephalograms on 127 biologic parents of sporadic CL/P and CP children. Each measurement was compared with sex and age-matched normals, and Z-scores were determined. The mean Z-scores for each group were tested for significant differences from normal and from each other. In agreement with past literature, the craniofacial morphology of parents of cleft children was generally found to have greater facial widths and shorter facial heights. Differences between the findings of the present study and the past literature are discussed. Although CL/P and CP are thought to be separate entities, differences between the parents of CL/P and CP children were not statistically evident.
Cephalometric Similarity Among Parents of Individuals with Sporadic Isolated Cleft Palate : Is There Evidence for an Inherited Predisposition?
(1999) Sammons, Edward M.; Ward, Richard E.; Hartsfield, James K., Jr.; Avery, David R.; Hathaway, Ronald R.; Garetto, Lawrence P.
Isolated cleft palate is one of the most frequent congenital conditions that affect the oral and facial structures, yet its etiology remains obscure. Previous studies of both cleft palate (CP) and cleft lip and/ or palate [CL(P)] have shown that there may be unusual facial characteristics among the parents of such sporadic cases. Such findings have been used to support the possibility that there are predisposing familial (genetic) factors for both conditions. However, previous studies have generally not controlled for the possibility of genetic heterogeneity or for different contributions from each of the parents. The objective of this study is to examine parents of individuals with CP in order to test the hypothesis that these "non cleft" individuals have abnormal facial structures. Lateral (LA) and Posterior-Anterior (PA) cephalograms were examined from thirty parents of fifteen individuals with sporadic CP. Seventeen LA and twenty-five PA variables were obtained on each subject and converted to standardized "z-scores" through comparison to published age and sex matched reference data. Multivariate cluster analysis was used to define groupings of individuals who shared similar patterns of facial features. Results demonstrate that as a group, relatives of CP individuals show significantly different patterns of facial measurements compared to reference norms. Values significantly larger (p < 0.05) from parental data included: ANS-Me, PNS-ANS, S-N-Pg, Ar-Go-Me, MoL-MoR, NSR-NCR. Values significantly smaller (p < 0.05) from parents included: N-ANS, S-Ba, PNS-ANS / N-ANS, PNS-ANS/ N-Pg, N-S-Ba, ZyLZyR, GoL-GoR, GoNL-GoNR, CRO-CNS, CNS-SD, CNS-Me, ID-Me, MxR-ZyR, MeGoR. These findings were not entirely consistent with those few previously reported findings. Additional analysis of the present data demonstrated that such inconsistencies may be due in part to the presence of distinct phenotypic subgroupings within the parental sample. Cluster analysis identified two such subgroups. Significant findings (p < 0.05) that were smaller for Cluster 1 relative to Cluster 2 included: N-Me, ANS-Me, S-Go, PNS-ANS, Ar-Go, CNS-SD, MxR-ZyR. Significant variables that were larger for Cluster 1 included: S-N-Pg. In addition, gender was significantly different across clusters with Cluster 1 containing 75 percent female individuals and Cluster 2 containing 67 percent male individuals. These results extend those reported in other studies by demonstrating that unusual facial patterns, when present are not uniformly distributed in parents of sporadic cases of CP. Phenotypic assessment in conjunction with multivariate analysis may help to identify families in which there is a significant heritable component for CP.
Cephalometric similarity among parents of individuals with sporadic isolated cleft palate: is there evidence for an inherited predisposition?
(1999) Sammons, Edward M.; Ward, Richard E.; Avery, David R.; Hathaway, Ronald R.; Garetto, Lawrence P.; Hartsfield, James K., Jr.
Isolated cleft palate is one of the most frequent congenital conditions that affect the oral and facial structures, yet its etiology remains obscure. Previous studies of both cleft palate (CP) and cleft lip and/ or palate [CL(P)] have shown that there may be unusual facial characteristics among the parents of such sporadic cases. Such findings have been used to support the possibility that there are predisposing familial (genetic) factors for both conditions. However, previous studies have generally not controlled for the possibility of genetic heterogeneity or for different contributions from each of the parents. The objective of this study is to examine parents of individuals with CP in order to test the hypothesis that these "non cleft" individuals have abnormal facial structures. Lateral (LA) and Posterior-Anterior (PA) cephalograms were examined from thirty parents of fifteen individuals with sporadic CP. Seventeen LA and twenty-five PA variables were obtained on each subject and converted to standardized "z-scores" through comparison to published age and sex matched reference data. Multivariate cluster analysis was used to define groupings of individuals who shared similar patterns of facial features. Results demonstrate that as a group, relatives of CP individuals show significantly different patterns of facial measurements compared to reference norms. Values significantly larger (p < 0.05) fro1n parental data included: ANS-Me, PNS-ANS, S-N-Pg, Ar-Go-Me, MoL-MoR, NSR-NCR. Values significantly smaller (p < 0.05) from parents included: N-ANS, S-Ba, PNS-ANS/ N-ANS, PNS-ANS/ N-Pg, N-S-Ba, ZyL-ZyR, GoL-GoR, GoNL-GoNR, CRO-CNS, CNS-SD, CNS-Me, ID-Me, MxR-ZyR, Me-GoR. These findings were not entirely consistent with those few previously reported findings. Additional analysis of the present data demonstrated that such inconsistencies may be due in part to the presence of distinct phenotypic sub groupings within the parental sample. Cluster analysis identified two such subgroups. Significant findings (p < 0.05) that were smaller for Cluster 1 relative to Cluster 2 included: N-Me, ANS-Me, S-Go, PNS-ANS, Ar-Go, CNS-SD, MxR-ZyR. Significant variables that were larger for Cluster 1 included: S-N-Pg. In addition, gender was significantly different across clusters with Cluster 1 containing 75 percent female individuals and Cluster 2 containing 67 percent male individuals. These results extend those reported in other studies by demonstrating that unusual facial patterns, when present are not uniformly distributed in parents of sporadic cases of CP. Phenotypic assessment in conjunction with multivariate analysis may help to identify families in which there is a significant heritable component for CP.
Comparison of the Incidence of Bolton Tooth Mass Discrepancy in African-American and Caucasian Populations
(1998) Adelsperger, M. Jayme; Hartsfield, James K., Jr.; Dean, Jeffrey A.; Garner, LaForrest D.; Hathaway, Ronald R.; Hohlt, William F.; Shanks, James C.
Tooth mass discrepancies have been studied extensively in Caucasian populations, but little has been done to compare differences between Caucasian and African-American populations. The objective of this study was to determine whether the incidence of tooth mass discrepancies between the maxillary and mandibular arches was greater in African-American populations than Caucasian populations. Pretreatment plaster orthodontic models of 100 African-American and 100 Caucasian patients from the Indiana University Orthodontic Clinic and from one private practitioner were measured with a Mitutoyo Digimatic® caliper accurate to 0.01 mm. Mesiodistal widths of all teeth from first molar to first molar were measured with the mesio-buccal and disto-buccal contact areas normally being the widest area. The investigator was blinded to the gender and ethnicity of the subject by assigning each model a random number which was matched to the patient profile only following statistical analysis. Anterior ratios and total (posterior+ anterior) ratios were calculated according to the methods described by Bolton and were compared to the Bolton means and standard deviations. Incidence of tooth mass discrepancy was also investigated according to gender and dental malocclusion classification of the individuals. Tooth mass discrepancies present a hurdle to the clinician in achieving an ideal occlusion. Reports of the incidence of significant discrepancies in defined populations alerts the practitioner to problems in finishing their patients' occlusions. Results of the study show nearly double the incidence of overall Bolton tooth mass discrepancy in the African-American sample than in the Caucasian. The overall tooth mass discrepancy was more severe in the African-American sample, while anterior tooth mass discrepancies were nearly identical in both populations.
Craniofacial pattern profile analysis of individuals with frontonasal malformation
(1994) Hiester, John David, 1964-; Bixler, David; Hathaway, Ronald R.; Sadove, A. Michael; Shanks, James C.; Avery, David R.
Frontonasal malformation, FNM, was first described by Hoppe in 1859. FNM is an anomaly that is characterized by ocular hypertelorism, broad nasal root, lack of a nasal tip, V-shaped hair, prolongation onto the forehead (widow's peak), anterior cranium bifidum occultum, median facial cleft affecting the nose, upper lip, and/or palate, and uni- or bilateral clefting of the ala nasi. The anomalies noted in FNM may be explained as a single malformation. If the nasal capsule fails to develop properly, the primitive brain vesicle fills the space normally occupied by the capsule, thus producing anterior cranium bifidum occultum, an arrest in the positioning of the eyes, and a lack of formation of the nasal tip. The condition presents clinically with variable expressions as sporadic cases and infrequently in familial cases. The present study is the first attempting to quantify and characterize FNM via anatomic radiographic measurements. The lateral (LA) and posterior-anterior (PA) cephalometric radiographs of twenty-four individuals, both sporadic and familial, with FNM were analyzed for comparison of linear and angular measurements with previously published data of a "normal," i.e. unaffected, population standard. Usual and customary cephalometric points were identified and located, then digitized into the computer. Twenty-nine measurements included the previously diagnosed anomalous features of hypertelorism, medial nasal cavity, and palatal shelves, as well as other facial features. The radiographs of individuals with FNM have anatomic features that are unusual and distinct to the specific malformation. The data from this research suggest that patients with FNM, regardless of a genetic or sporadic predisposition, have a midface deficiency in height and depth, an increased interorbital width with possible increased orbital socket width, and a longer zygomatic buttress. Also, the familial cases tend to have a flatter cranial base than the sporadic cases. Furthermore, the familial patients might be a different type of FNM since this subgroup shows narrower zygomatic widths. The patients with surgical procedures demonstrated improvement different from the growth of those patients who did not have surgery. The hypothesis that the facies of a patient with frontonasal malformation is different from the "normal" control population is supported by this research. The differences between the familial and sporadic patients tend to support the general theory that genetic predisposition is less severe than FNM that occurs randomly.
Craniofacial Pattern Profile, Analysis of Individuals with Frontonasal Malformation
(1994) Hiester, John David; Bixler, David; Avery, David R.; Hathaway, Ronald R.; Sadove, A. Michael; Shanks, James C.
Frontonasal malformation, FNM, was first described by Hoppe in 1859. FNM is an anomaly that is characterized by ocular hypertelorism, broad nasal root, lack of a nasal tip, V-shaped hair prolongation onto the forehead (widow's peak), anterior cranium bifidum occultum, median facial cleft affecting the nose, upper lip, and/or palate, and uni- or bilateral clefting of the ala nasi. The anomalies noted in FNM may be explained as a single malformation. If the nasal capsule fails to develop properly, the primitive brain vesicle fills the space normally occupied by the capsule, thus producing anterior cranium bifidum occultum, an arrest in the positioning of the eyes, and a lack of formation of the nasal tip. The condition presents clinically with variable expressions as sporadic cases and infrequently in familial cases. The present study is the first attempting to quantify and characterize FNM via anatomic radiographic measurements. The lateral (LA) and posterior-anterior (PA) cephalometric radiographs of twenty-four individuals, both sporadic and familial, with FNM were analyzed for comparison of linear and angular measurements with previously published data of a "normal," i.e. unaffected, population standard. Usual and customary cephalometric points were identified and located, then digitized into the computer. Twenty-nine measurements included the previously diagnosed anomalous features of hypertelorism, medial nasal cavity, and palatal shelves, as well as other facial features. The radiographs of individuals with FNM have anatomic features that are unusual and distinct to the specific malformation. The data from this research suggest that patients with FNM, regardless of a genetic or sporadic predisposition, have a midface deficiency in height and depth, an increased interorbital width with possible increased orbital socket width, and a longer zygomatic buttress. Also, the familial cases tend to have a flatter cranial base than the sporadic cases. Furthermore, the familial patients might be a different type of FNM since this subgroup shows narrower zygomatic widths. The patients with surgical procedures demonstrated improvement different from the growth of those patients who did not have surgery. The hypothesis that the facies of a patient with frontonasal malformation is different from the "normal" control population is supported by this research. The differences between the familial and sporadic patients tend to support the general theory that genetic predisposition is less severe than FNM that occurs randomly.
Development of a Valid Severity Index of Malocclusion for Patients of Various Racial Profiles in the Mixed and Permanent Dentitions
(2004) Olsen, Gregory D.; Roberts, W. Eugene; Baldwin, James J.; Hohlt, William F.; Hathaway, Ronald R.; Shanks, James C.
Indices of malocclusion have been developed to serve a variety of functions. These functions include diagnostic classification, epidemiological data collection, measurement of treatment need, measurement of treatment success, and determination of treatment complexity. Although numerous occlusal indices have been developed, there are still significant inadequacies that are present in the existing methods. Current occlusal indices do not quantitatively consider changes in facial profile or cephalometric variables that reflect the skeletal malocclusion. Furthermore, no index includes objective analysis of facial soft tissue characteristics. Finally, no published occlusal index analyzes all diagnostic records. These factors are often involved in the patient and doctor perception of treatment need. As a result, the current occlusal indices are inadequate and inaccurate in comprehensively assessing treatment need. A complete index of malocclusion with the objective analysis of all pretreatment records is necessary to accurately quantify treatment need. Recently, an index of malocclusion was developed at IUSD that evaluates a complete set of diagnostic records. This index was shown to be a valid measure of malocclusion for patients of non-Hispanic white descent in the permanent dentition. However, the index was not validated for patients of different races, or for patients in the mixed dentition. In the present study, pretreatment records (dental casts, intra-oral and extra-oral photographs, panoramic radiograph, and cephalogram) of 288 patients from the Indiana University Orthodontic Department were evaluated. The patients represented Asian, African-American, Hispanic, and non-Hispanic white patients in the permanent and mixed dentitions. For patients in the permanent dentition, thirty-six characteristics were scored and combined into a total score representing the new index. Thirty-three characteristics were totaled in a similar manner for patients in the mixed dentition. The scores of the new index were compared to subjective rankings of malocclusion severity from two orthodontic experts. Statistical analysis, for the most part, showed moderately strong correlations of the new index with the ratings of the orthodontic experts. It is the conclusion of this study that the new index is a reasonably valid measure of severity of malocclusion which can be considerably improved with additional developmental research.
Long Term Maxillary Growth Following Primary Bone Grafting in Unilateral Cleft Lip and Palate
(1996) Gandelsman, Genrikh; Hathaway, Ronald R.; Arbuckle, Gordon R.; Hennon, David K.; Katona, Thomas R.; Shanks, James C.
The question of growth attenuation of the maxillary complex arises in connection with primary osteoplasty procedure. The deficiencies associated with the development of the jaws in unilateral complete cleft lip and palate (UCLP) children is an ongoing problem in terms of growth inhibition and orthodontic treatment. Retardation of growth can be attributed to intrinsic cleft factors and/or associated with the treatment of the cleft condition. In this study, the extent of such deficiency, if any, was investigated by assessing arch length, arch width, arch symmetry and inter-arch harmony. Seventeen orthodontic casts of UCLP children (mean age 7 years 11 months) were obtained. All were treated with a primary osteoplasty at James Whitcomb Riley Hospital for Children at Indianapolis, Indiana. The sample was compared to an age and sex matched non-cleft control group (n=38). None of the subjects had undergone orthodontic treatment beyond infant maxillary orthopedics. Anatomic landmarks were identified and digitized by means of optical electronics. The data were automatically fed into a computer which executed preprogrammed data manipulation algorithms. Significant (p<0.05) inhibition of growth has taken place in the maxillary arches of the UCLP group in both anteroposterior and transverse directions. lntercanine width (ICW) was reduced on average by 7.6 mm (23.6 percent) while the intermolar width (IMW) was shortened by 3.9 mm (7.8 percent). Sagittal growth was retarded by 5.5 mm (17.4 percent). A gradient of "normalization" originating at a point of surgical insult was observed anteroposteriorly in the transverse maxillary dimension. In the mandible, ICW was retarded by 2.0 mm (7.8 percent) while IMW and A-P growth vectors were not significantly affected. This investigation also revealed significant (p = 0.0001) differences in the size of the maxillary anterior palatal area (cleft mean = 83.5 mm2, non-cleft mean = 133.9 mm2). These findings lead to the conclusion that primary osteoplasty may contribute to maxillary growth attenuation with concomitant mandibular compensatory growth patterns.
A retrospective study of circumpubertal cleft lip and palate patients treated in infancy with primary alveolar bone grafting
(1999) Harrison, Robert B.; Dean, Jeffrey A.; Zunt, Susan L., 1951-; Hathaway, Ronald R.; Sanders, Brian J.; Avery, David R.
The Riley Children's Hospital Craniofacial Anomalies Team rigorously follows a treatment protocol developed by Dr. Sheldon Rosenstein for the treatment of cleft lip and palate patients. Rosenstein's protocol incorporates primary bone grafting and alveolar molding appliances for cleft lip and palate patients. While other cleft lip and palate treatment centers utilize alveolar molding appliances, there remains debate concerning the efficacy of primary bone grafting. The principal detraction of primary bone grafting is the concern that such early surgical treatment affects maxillary and craniofacial growth and development. The purpose of this retrospective study was to analyze post-treatment lateral head plates and dental casts of cleft lip and palate circumpubertal patients treated in infancy at Riley Hospital in Indianapolis by the Craniofacial Team following Rosenstein's protocol. The hypothesis was that primary alveolar bone grafting in conjunction with the use of alveolar molding appliances contributes to the early stabilization of the alveolar segments, and produces no statistically significant difference in craniofacial development among primary bone grafted patients and nongrafted patients. The dental arch dimensions of the nongrafted patients (control group) consisted of the same data utilized by Moorrees in his study of the dentition of the growing child. The dental arch dimensions of nongrafted cleft patients consisted of the same data utilized by Athanasiou in his study of the dentition of cleft patients treated surgically without bone grafting. Of the eight measurements made by the three examiners, six demonstrated excellent interexaminer agreement, one demonstrated moderate interexaminer agreement, and one demonstrated poor interexaminer agreement. The arch width and length for the grafted group was significantly smaller (p < .05, Student's t-test) than the normal group in all measures except for the mandibular canine width. The arch width and length for the grafted group was not significantly different (p < .05, Student's t-test) than the nongrafted group, except for the maxillary molar width where the grafted group was smaller than the nongrafted group. The cephalometric values of the Riley group were compared against a nongrafted group, an early primary grafted group, and the Bolton standard values cited in Rosenstein's study. The Bolton standard values were used as the control group. This study found the cephalometric values of the Riley experimental group (treated following Rosenstein's protocol) to be of no statistically significant difference (p < .05, Students t-test) when compared with cephalometric values of the nongrafted and primary alveolar grafted groups cited in Rosenstein's 1982 study. The cephalometric values of the Riley experimental group were less than the cephalometric values of the nonclefted patients (Bolton standard control group) cited in Rosenstein's 1982 study. Interexaminer agreement ranged from poor to good with the poorest agreement among the linear values of ANS/PNS and GO/ME. The intraclass correlation coefficient values for SNA,m ANB, and SNB ranged from fair to moderate. The Riley cephalometric values were equal or slightly better than Rosenstein's grafted and nongrafted groups. Though smaller than the control group, the Riley cephalometric values were of no statistical significance (p < .05, Students t-test) when compared with the same parameters cited in Rosenstein's study. Although these findings infer that the patients treated following Rosenstein's protocol demonstrate some degree of craniofacial growth attenuation when compared with nonclefted patients (Bolton standard control group), the Riley patients showed no worse growth attenuation than similar patients treated without Rosenstein's protocol for primary alveolar grafting. The hypothesis of this thesis was that Rosenstein's protocol was viable and non-detrimental when compared with other treatment regimens. The results of this study support the hypothesis that Rosenstein's surgical protocol is not a contributing factor in craniofacial growth attenuation among cleft lip and palate patients.

Browsing by Author "Hathaway, Ronald R."

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