N E W T E C H N IQ U E ?

I do not often w rite this type of letter, b u t I felt th a t the inac­ curacies in “New Technique Remedies Distorted Ja w s” (News Section, January) necessitate th a t I respond. We are all quite fam iliar w ith the H apsburg jaw. However, I was am azed to find out th a t this m andibular prognathism is caused by the upper jaw which is too recessed, and thus consequently m akes the lower jaw only appear distorted. First, I think it would be nice if we used the correct term s such as m andibular retrognatha, m andibular prognath­ ism, m axillary retrognathia and m axillary prognathism . Secondly, anybody who has examined the paintings of the Hapsburgs would recognize th a t this is not solely related to a retrognathic maxilla, b u t is

probably a combined deformity involving both m andibular prognathism and m axillary retrognathia. More im portantly, however, Dr. Turley was not the develop­ er of a new treatm en t for m axill­ ary retrognathia. The so-called “baseball catcher’s m ask,” which in reality applies an orthopedic force in the anterior direction on the maxilla, was designed by Dr. Je an Delaire, and in fact has been used for a num ber of years in Europe and in America. S tep h en A. S ch en d el, M.D., D.D.S. Stanford, Calif.

H APSBURG JA W

“New Technique Remedies Distorted Ja w ” (News Section, January) is entirely inappro­ priate for the following reasons. First, Dr. Turley is recommend­

ing the correction of an exces­ sive protruding lower jaw , more commonly known as m andibular prognathia, ra th e r th an “H apsburg jaw ,” by proposing a treatm en t th a t would m ake the midface excessively protrusive to m atch the excessively pro­ trusive lower jaw. Logic would seem to dictate th a t one would correct the existing deformity ra th e r th an further deforming the face simply to m ake the teeth fit together. Secondly, this is not a new technique. This technique has been used routinely for a t least the last 30 years in special cases. I fail to see the advantage of this particular treatm en t modality. Our prim e purpose in the treatm en t of facial deform­ ities should be to correct the underlying deformity in the sim plest, quickest and most

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potentially stable m eans as we possibly can. It is truly a disservice to sacrifice facial esthetics when there is absolutely no reason to do so. Surgery would avoid prolonged orthodontic treatm en t and the social stigm a of the facial deformities. This is of the utm ost importance to the adolescent during this formative period in their life. In short, why prolong the agony of the treatm en t for the p atien t and a t the sam e tim e tu rn a one-jaw deformity into a two-jaw deformity? B ruce H. M cCullar, D.D.S. M em phis, Tenn. LOCAL. A N E S T H E S IA F A IL U R E S

I enjoyed the article “Reasons for local anesthesia failures,” by Drs. Wong and Jacobsen (January). I expected to miss an occasional m andibular block my first few years of practice after dental school. However, I still miss some blocks. As Drs. Wong and Jacobsen pointed out, this can be frustrating for the dentist and painful for the patient. I need to occasionally review my anatom y by looking a t a skull model. The article was an excellent review. I especially liked it because it focuses on why the block failed and not on different techniques. I will need to occasionally review th a t article. Thanks. E dw ard A. L aga Jr., D.D.S. M ission, Kan. O R A L C A N D ID A L IN F E C T IO N

Drs. Iacopino and W athen are to be commended on their fine review of oral candidal infection and denture stom atitis (January). However, their

discussion of benzoic acid as a denture-soak solution failed to m ention the allergic potential of this agent. This is of concern because absorption of benzoin by the resin denture base can result in prolonged mucosal contact w ith a drug th a t has a well-documented history of causing hypersensitivity reactions in hum ans. In particular, benzoin and its derivatives have been im pli­ cated in orofacial hypersensi­ tivity reactions including angioedema, mucositis, burning m outh syndrome, aphthous ulceration, and erythem a multiforme. The high frequency of hypersensitivity to benzoin in aphthous stom atitis patients (55 percent) reported by Nolan and Lamey (1991) suggests th a t the prevalence of this problem may have been overlooked until recently. C raig S. M iller, D.M.D., M.S. D on ald A. F a lace, D.M.D. D ou glas D. Dam m , D.D.S. U n iv e r sity o f K entucky L exington, Ky. C O R R E C T IO N

In the article on oral candidal infection by Drs. Anthony Iacopino and William W athen (January), the legend for Figure 3 should have read: A maxillary removable partial denture in place shows relatively normal tissue. The authors also would like to thank Dr. William H. Dinnie, chairm an of Baylor’s Oral Pathology D epartm ent for the illustrations. The product mentioned for use in overnight soaks is Oral Safe (Great Lakes Orthodontic Laboratories, Tonawanda, N.Y.).

Hapsburg jaw.

N E W T E C H N IQ U E ? I do not often w rite this type of letter, b u t I felt th a t the inac­ curacies in “New Technique Remedies Distorted Ja w...
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