Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion (original) (raw)
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American Journal of Orthodontics and Dentofacial Orthopedics, 2006
The purpose of this study was to evaluate the skeletal and dentoalveolar effects of the Twin-block and bionator appliances in the treatment of Class II Division 1 malocclusions. Methods: Fifty-five girls from North India with Class II Division 1 malocclusion and the same physical growth maturation status were selected for the study. The subjects were divided among a Twin-block group (n ϭ 25), a bionator group (n ϭ 20), and a control group (n ϭ 10). Pretreatment and posttreatment lateral cephalometric radiographs of the treatment group subjects, and prefollow-up and postfollow-up radiographs of the control group subjects, were traced manually and subjected to the pitchfork analysis. Results: Statistical software was used for 1-way analysis of variance and multiple comparisons (post-hoc test, Bonferroni). A P value of .05 was considered statistically significant. Neither the Twin-block nor the bionator appliance significantly restricted forward growth of the maxilla (P ϭ .476). Mandibular growth in the Twin-block subjects was significantly greater than in controls (P ϭ .005). Mandibular growth was comparable in the control and the bionator subjects. Molar correction, overjet reduction, and proclination of the mandibular incisors were significantly greater (P ϭ .000) in the treated subjects compared with the controls.
International Journal of Applied Dental Sciences, 2020
Objective: The objective of this study was to compare effects on soft tissue profile and dentoalveolar changes in class II patients after treatment with either Herbst appliance or Korn mandibular advancer as fixed functional appliances. Materials and methods of study: The sample of study consisted of (30) patients divided into two groups (G1):group one included (15) patients was treated by Korn mandibular advancer appliance, and (G2): group two included (15) patients was treated by Herbst appliance. In both groups fixed functional appliances were applied concurrently with fixed orthodontic appliance. Lateral cephalograms were taken and analyzed before treatment and after treatment. Statistical analyses were used to analyze data by (Kolmogorov smirnov, K-S) and student's t tests. Statistical significance was set at P
The European Journal of Orthodontics, 2015
Objective: To assess the treatment effects of fixed functional appliances (FFAs) in treated versus untreated Class II patients by means of lateral cephalometric radiographs. Search methods: Unrestricted electronic search of 18 databases and additional manual searches up to October 2014. Selection criteria: Prospective randomized and non-randomized controlled trials reporting on cephalometric angular measurements of Class II patients treated with FFAs and their matched untreated controls. Data collection and analysis: Skeletal, dental, and soft tissue cephalometric data were annualized and stratified according to the time of evaluation in effects. Following risk of bias evaluation, the mean differences (MDs) and 95 % confidence intervals (CIs) were calculated with random-effects models. Patient-and appliance-related subgroup analyses and sensitivity analyses were performed with mixed-effects models. Results: Nine studies were included (244 patients; mean age: 13.5 years and 174 untreated controls; mean age: 12.8 years) reporting on cephalometric effects directly after the removal of FFAs. FFAs were found to induce a small reduction of SNA angle (MD = −0.83 degree/year, 95 % CI: −1.17 to −0.48), a small increase of SNB angle (MD = 0.87 degree/year, 95 % CI: 0.30-1.43), and moderate decrease of ANB angle (MD = −1.74 degree/year, 95 % CI: −2.50 to −0.98) compared to untreated Class II patients. FFA treatment resulted in significant dentoalveolar and soft tissue changes. Several patient-or appliance-related factors seem to affect the treatment outcome. Long-term effectiveness of FFAs could not be assessed due to limited evidence. Conclusions: According to existing evidence, FFAs seem to be effective in improving Class II malocclusion in the short term, although their effects seem to be mainly dentoalveolar rather than skeletal.
Srpski arhiv za celokupno lekarstvo
Introduction/Objective. Class II malocclusions are sagittal malocclusions characterized by a distal relationship of posterior teeth. Depending on the underlying problem, class II can be skeletal or dentoalveolar. Class II treatment modality will depend on the cause, severity and age. Growth modification is the best treatment option in skeletal Class II growing patients. The aim of this study was to establish and compare sagittal and vertical skeletal and dental changes in patients treated with the ?M block? appliance, the Fr?nkel functional regulator and the Balters? Bionator. Methods. The sample consisted of 70 patients diagnosed with skeletal class II (ANB > 4?) and mandibular retrognathism (SNB < 80?). Patients were divided into 3 groups according to the type of appliance. All patients went through the standard diagnostic procedure (anamnesis, clinical and functional analysis, study model, panoramic radiograph and cephalometric analysis) and dental and skeletal age was dete...
Summary Objective: To assess the treatment effects of fixed functional appliances (FFAs) in treated versus untreated Class II patients by means of lateral cephalometric radiographs. Search methods: Unrestricted electronic search of 18 databases and additional manual searches up to October 2014. Selection criteria: Prospective randomized and non-randomized controlled trials reporting on cephalometric angular measurements of Class II patients treated with FFAs and their matched untreated controls. Data collection and analysis: Skeletal, dental, and soft tissue cephalometric data were annualized and stratified according to the time of evaluation in effects. Following risk of bias evaluation, the mean differences (MDs) and 95 % confidence intervals (CIs) were calculated with random-effects models. Patient- and appliance-related subgroup analyses and sensitivity analyses were performed with mixed-effects models. Results: Nine studies were included (244 patients; mean age: 13.5 years and 174 untreated controls; mean age: 12.8 years) reporting on cephalometric effects directly after the removal of FFAs. FFAs were found to induce a small reduction of SNA angle (MD = −0.83 degree/year, 95 % CI: −1.17 to −0.48), a small increase of SNB angle (MD = 0.87 degree/year, 95 % CI: 0.30–1.43), and moderate decrease of ANB angle (MD = −1.74 degree/year, 95 % CI: −2.50 to −0.98) compared to untreated Class II patients. FFA treatment resulted in significant dentoalveolar and soft tissue changes. Several patient- or appliance-related factors seem to affect the treatment outcome. Long-term effectiveness of FFAs could not be assessed due to limited evidence. Conclusions: According to existing evidence, FFAs seem to be effective in improving Class II malocclusion in the short term, although their effects seem to be mainly dentoalveolar rather than skeletal.
Journal of Clinical Pediatric Dentistry, 2007
Objective: This longitudinal retrospective cephalometric study was undertaken in an attempt to evaluate the effect of upper removable appliances on the hard and soft tissue structures in subjects with postural Class III. Methods: The material consisted of cephalometric films of 17 Class III patients (8 females and 9 males, with a mean age of 10.10 ± 1.63). Each treated patient was matched before treatment with Class III subject for sex and age. Differences in treated group at T1 and T2 and between treated and untreated groups were examined using paired t-test and independent t-test respectively. Results: Treated and untreated Class III subjects differed in mandibular prognathism (SNB, P<0.01). Upper incisors proclined and inter-incisal angle reduced during treatment (P<0.001). Soft tissue A point moved anteriorly as maxillary incisors were proclined (P<0.05). Soft tissue profile was improved (NNP, P<0.05; NAP, P<0.01). Conclusion: Skeletal, dental and soft tissue chan...
Cephalometric outcomes of a new orthopaedic appliance for Class III malocclusion treatment
European Journal of Orthodontics, 2019
Summary Objective To evaluate dental and skeletal effects of a new orthopaedic appliance for the treatment of Class III malocclusion in growing patients. Material and methods This retrospective cephalometric study was performed on a sample of 18 patients with a skeletal Class III malocclusion (4 males; 14 females; mean age 8.8 ± 1.5 years) treated with the Pushing Splints 3 (PS3) protocol. The control group consisted of 18 subjects (5 males; 13 females; mean age 9.1 ± 1.8 years) selected from a database of subjects with untreated Class III malocclusion. The cephalometric analysis was performed at the beginning (T0) and the end of the orthopaedic therapy (T1). Significant differences between the treated and control groups were assessed with independent samples t-test (P < 0.05). Results In the PS3 group, the post-treatment cephalometric values showed a forward displacement of the maxilla, resulting in a statistically significant increase of the SNA angle. ANPg and Wits appraisal i...
Dental Press Journal of Orthodontics, 2014
OBJECTIVE: The aim of this study was to cephalometrically assess the skeletal and dentoalveolar effects of Class II malocclusion treatment performed with the Jones Jig appliance followed by fixed appliances. METHODS: The sample comprised 25 patients with Class II malocclusion treated with the Jones Jig appliance followed by fixed appliances, at a mean initial age of 12.90 years old. The mean time of the entire orthodontic treatment was 3.89 years. The distalization phase lasted for 0.85 years, after which the fixed appliance was used for 3.04 years. Cephalograms were used at initial (T1), post-distalization (T2) and final phases of treatment (T3). For intragroup comparison of the three phases evaluated, dependent ANOVA and Tukey tests were used. RESULTS: Jones Jig appliance did not interfere in the maxillary and mandibular component and did not change maxillomandibular relationship. Jones Jig appliance promoted distalization of first molars with anchorage loss, mesialization and sig...
Treatment of Class II Malocclusion With Removable Functional Appliances: A Narrative Review
European Journal of General Dentistry
Around half of all malocclusions that need orthodontic treatment are Class II in nature. Patients with Class II malocclusion primarily seek treatment for aesthetic improvement. Most of the skeletal class II malocclusions are because of mandibular deficiency, and can be best treated during the growing phase of development by removable functional appliances. The objective of this review is to evaluate and compare skeletal and dentoalveolar effects of various removable functional appliances in the treatment of class II malocclusion. Manual and electronic databases were searched, and out of 5,711 articles, 221 abstracts were shortlisted and reviewed. A total of 19 articles that fulfilled the selection criteria was then retrieved and analyzed. A significant increase in mandibular length and dentoalveolar effects with an increase in vertical dimension in a short time was observed with Twin-Block appliance treatment, followed by Bionator appliance treatment. The long-term stability of resu...
Effectiveness of early treatment of Class II malocclusion
American Journal of Orthodontics and Dentofacial Orthopedics, 2002
W e have previously reviewed many important issues concerning the 2 timing strategies for treating Class II malocclusion. 1 Although growth modification for Class II correction can be quite effective in certain persons, much remains unknown regarding the mechanisms involved in the success or the failure of these treatment approaches.