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Outdated/anthropologically-uninformed diagnostic tools (Angle Malocclusion ClassificationSystem and mostly Steiner-based cephalometric norms) are leading to r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
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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