Factors Affecting Treatment Duration - A Dilemma In Orthodontics.

BACKGROUND: One of the first concerns of new orthodontic patients, apart from the outcome, is the duration of treatment. A better understanding of orthodontic treatment duration as well as factors affecting the treatment duration is useful for efficient patient counselling and improved clinical practice. Hence, the objectives of this study are to compare the treatment durations of subjects with Class I and Class II division 1 (II/1) malocclusions, and to identify the factors affecting the treatment duration of these malocclusions. METHODS: This was a chart review conducted in the orthodontic department of the Aga Khan University Hospital, Karachi. The study sample comprised of 120 subjects and data were recorded from their treatment records. ANOVA and Bonferroni post-hoc were performed to determine the difference in treatment durations of Class I and Class II/1 malocclusions, whereas multiple linear regression was applied to identify the factors affecting the treatment duration. A level of significance (p≤0.05) was used for the statistical tests. RESULTS: A statistically significant difference was found between the treatment durations of Class I and Class II/1 non-extraction (p=0.007), Class I non-extraction and Class II/1 extraction (p=0.001), and Class I and II/1 extraction (p=0.004) groups. The factors significantly increasing the treatment duration included missed appointments, breakages, and lower incisor proclination. CONCLUSIONS: Orthodontic treatment of Class II/1 malocclusion lasts longer than that of Class I malocclusion. Prolonged treatment time is associated with missed appointments, band/bracket debonds and increased lower incisor inclination. The variance in treatment time can be explained most significantly by number of missed appointments and breakages.

Mandibular response and directional forces with a new functional orthopedic appliance - A clinical case treated with a "Paolone-Kaitsas (PK) appliance".

Class II/1 malocclusion needs strict vertical control in order to obtain a mandibular response and correction of the sagittal discrepancy. These objectives can be achieved not only in one-stage treatments but also in two stages, when clinicians decide to perform functional therapy for psychological, traumatological or social reasons. This paper reports on expression of mandibular response and directional forces in a two-stage class II/1 malocclusion using a new functional appliance. The Paolone-Kaitsas (PK) appliance provides vertical control and occlusal plane management during the very first phases of treatment. It prepares the anchorage of the denture used in the second phase of treatment.