Evaluation of the relationship between anxiety levels and dental appearance.

OBJECTIVE: The aim of this study was to evaluate the relationship between personal traits, dental anxiety level and dental appearance of the individuals. STUDY DESIGN: The study included 431 individuals who completed State Trait Anxiety Inventory-Trait Form (STAI-T) and Corah's Dental Anxiety Scale (CDAS) questionnaires during their first appointment at the orthodontic clinic. The Index of Complexity, Outcome and Need (ICON) index scoring was performed using intraoral frontal photographs by an orthodontist. According to the STAI-T scores, three anxiety groups were formed: mild, moderate, and severe. The Kruskal-Wallis H test was used for intergroup comparisons. Spearman's correlation analysis was performed to evaluate the relationship between STAI-T, CDAS, and ICON scores. RESULTS: It was found that 38.28% of the participants had mild, 34.1% had severe, and 27.62% had moderate anxiety levels. CDAS score was significantly lower in the mild anxiety group (p ≤ 0.0001) compared to the groups showing moderate and severe anxiety. There was no significant difference between the moderate and severe anxiety groups. ICON score was significantly higher in the severe anxiety group (p ≤ 0.0001) than the other groups. It was also significantly higher in the moderate anxiety group (p ≤ 0.0001) than in the mild anxiety group. There was a significant positive correlation between STAI-T and both CDAS and ICON scores. There was no significant correlation between CDAS and ICON scores. CONCLUSION: Dental appearance had a significant effect on the general anxiety of individuals. Improving the dental appearance with orthodontic treatments can have positive effects on reducing anxiety. The low level of dental anxiety in individuals with a high need for treatment will facilitate the work of the orthodontist in the procedures to be applied.

A new perspective on the relationship between anchorage and palatal morphology: Three-dimensional digital model analysis.

Background: The tooth movements were generally analyzed in two dimensions on cephalometric radiographs. Nowaday, 3D digital model analysis, which does not have any harmful effects on patients, can be used to evaluate the palatal morphology and coronal tooth movements in a very comfortable and easy way. Aims: To investigate the effect of palatal morphology on anchorage reinforcement during intraoral molar distalization with pendulum appliance using 3D model analysis. Materials and Methods: The material consisted of before (T0) and after (T1) dental plaster models of Class II malocclusion patients (17 females, 3 males) treated with pendulum appliance for molar distalization and Nance appliance for anchorage. T0 and T1 digital models were superimposed using the palatal area as a reference via three points and surface-matching software, and the changes in teeth movement were calculated for left and right central incisors, first premolars, and first and second molars. Palatal morphology was evaluated at T0 on digital models as palatal inclination, palatal depth angles, and anterior hard palate area. Wilcoxon test was used to evaluate the treatment results and Spearman's correlation analysis was performed to evaluate the relationship between palatal morphology and dental movement. The upper limit for the level of significance was taken as 0.05. Results: Mesial movement of first premolars and distal movement of first and second molars were found to be statistically significant (P < 0.001). A weak negative correlation was found between the palatal inclination and the movement of first premolars (P < 0.045 and P < 0.003). Palatal depth angles and anterior hard palate area had no correlation with dental movements. Conclusion: Presented results supported that the mesial movement of premolar teeth decreased as the inclination of the palate increased.

Geometric morphometric analysis of the pharyngeal airway during treatment of Class III malocclusion.

INTRODUCTION: The pharyngeal airway is important during diagnosis and treatment planning in orthodontics. This study aimed to compare the changes in the shape of the pharyngeal airway in patients with Class III malocclusion treated with a facemask (FM) with a removable maxillary appliance and modified tandem traction bow appliance (MTTBA). METHODS: This study consisted of pretreatment and posttreatment lateral cephalograms of 35 subjects with skeletal and dental Class III malocclusion. In the first group, 20 patients (12 males, 8 females; mean age, 10.2 years) were treated with MTTBA. The mean treatment time was 12 months. In the second group, 15 patients (10 males, 5 females; mean age, 10.3 years) were treated with FM. The mean treatment time was 11.7 months. Nineteen pharyngeal landmarks were considered from the image corresponding to the midsagittal plane and marked using tpsDig software (version 2.04; Stony Brook, NY). Pharyngeal airway shape difference between the groups was assessed by performing a Generalized Procrustes analysis. The shape deformation of the pharyngeal airway from the pre- to posttreatment periods was evaluated using the thin-plate spline method. RESULTS: There were no differences between MTTBA and FM groups according to airway shape for pretreatment and posttreatment periods. However, there were some deformities using the enlargement of the nasopharyngeal area in the FM group and oropharyngeal area in the MTTBA group according to pretreatment periods. CONCLUSIONS: There were no differences between the groups according to the mean pharyngeal airway shapes when the posttreatment periods of the FM and MTTBA groups were examined.

Perception of dental students towards case-based orthodontic education.

PURPOSE: To evaluate perceptions of fifth-year dental students' towards case-based orthodontic education. METHODS: The sample population consisted of 108 final year dental students (39 men, 69 women) who volunteered to participate in the project during their orthodontic clinical internship. Patient files including extraoral, intraoral photographs, hand-wrist, panoramic and cephalometric radiographs were randomly distributed. Each group presented their evaluations after 1 week. At the end of case discussions, students were given a questionnaire regarding their perceptions of case-based education. Differences in mean scores between groups were compared by independent samples t­test. RESULTS: The response rate was 100%. The majority of students strongly agreed that their interest and ability to interpret and diagnose the orthodontic data were increased. More than 60% strongly agreed that this education had a positive effect on their attention and effective learning. More than 45% strongly agreed that their communication with colleagues was increased, and women were significantly more inclined to group work than men (p < 0.05). More than 45% declared no additional burden. CONCLUSIONS: Orthodontic case-based education was well received by final year dental students. The most noted improvement was observed in motivation, ability to comment on the diagnosis and treatment planning of orthodontic cases, without feeling an extra workload.

The Influence of Abnormalities in the Profile and Overjet on Psychological Well-Being.

OBJECTIVE: This study aimed to comparatively evaluate the psychological well-being and health-related quality of life of subjects having either a convex or concave profile and abnormal overjet, with subjects having a straight profile and normal overjet. METHODS: In this study, 163 children and their parents who applied to the Faculty of Dentistry were classified into 3 groups: Group 1: convex profile, Class II molar relationship, and increased overjet (n=62; 28 boys and 34 girls; mean age: 11.6 years); Group 2: concave profile, Class III molar relationship, and negative overjet (n=55; 32 boys and 23 girls; mean age: 11.2 years); and Group 3: straight profile, Class I molar relationship without crowding, and normal overjet (n=46; 24 boys and 22 girls; mean age: 11.0 years). The severity of malocclusion was evaluated using the Index of Orthodontic Treatment Need (IOTN). Self-concept, depression, and state-trait anxiety were evaluated to determine the psychological well-being of the children. RESULTS: No differences were found among the groups with respect to self-concept, depression levels, state-trait anxiety levels, and quality of life scores. No correlation was found between the IOTN scores and psychological well-being. CONCLUSION: Abnormalities in the facial profile and negative or increased overjet have no influence on children's psychological well-being.

Effects of Combined Rapid Maxillary Expansion and Facemask Therapy on the Mandibular Dental Arch in Mixed Dentition.

OBJECTIVE: The aim of this study was to evaluate changes in the mandibular dental arch and incisor alignment induced by combined bonded Rapid Maxillary Expansion (RME) and Face Mask (FM) therapy in the mixed dentition stage in which leeway space was used throughout the treatment. STUDY DESIGN: This retrospective study evaluates pretreatment (T0) and posttreatment (T1) cephalometric radiographs and orthodontic models of 25 patients (mean age: 10.75±2.64), in mixed dentition, having skeletal Class 3 anomaly (ANB<0) with maxillary retrognatism (SNA=77.2±0.68) and bilateral posterior crossbite treated with bonded Hyrax RME-FM. Mean treatment duration was 10.4 months. Dental model measurements were performed using the 3Shape OrthoAnalyzerTM 2013-1 program. Changes in the mandibular incisor and first molar positions were determined on cephalometric radiographs. Statistical evaluation was done with a paired t-test. RESULTS: A significant increase of 1.2 mm was found in intermolar width (p<0.001) in the mandibular dental arch. There was a significant decrease (1.4 mm) (p<0.001) in arch depth and an increase in arch length discrepancy (1.7mm)(p<0.01). There was a significant increase (0.8mm) (p<0.05) in the incisors' irregularity score (LII). IMPA showed a significant decrease (p<0.05). CONCLUSION: Clinicians should be aware that mandibular crowding tends to increase during this type of combined therapy.

Mandibular posterior space in class II division 1 and 2 malocclusion in various age groups.

PURPOSE: The aim of this study was to compare the mandibular posterior space in subjects with skeletal class II division 1 and division 2 malocclusions in two different age groups. METHODS: Pretreatment cephalometric radiographs of 160 patients from 9 to 13 years of age (n = 80) and 15 to 18 years of age (n = 80) with class II division 1 or division 2 malocclusion were used for the study. Equal numbers of male and female patients (n = 20) were included in the two age groups in each of the malocclusion groups. Eight linear and six angular measurements were taken for mandibular posterior space evaluation. The data obtained from the study were compared using the independent t-test. RESULTS: In the present study, the mandibular posterior space was greater in both malocclusion groups in subjects aged 15-18 years than in those aged 9-13 years (p < 0.05). The available posterior spaces behind the mandibular first molars were 4.4 mm and 6.3 mm in females (class II divisions 1 and 2, respectively) and 5.3 mm and 7 mm in males (class II divisions 1 and 2, respectively) in the 9­ to 13-year-old age group. This space increased significantly by 6.9 mm (p < 0.001) and 3.2 mm (p < 0.01) in females (class II division 1 and 2, respectively) and 3.8 mm (p < 0.01) and 3 mm (p < 0.01) in males (class II division 1 and 2, respectively) in the 15- to 18-year-old age group. CONCLUSION: Class II division 1 and division 2 malocclusions had similar and inadequate posterior space dimensions for the eruption of the third and an unknown portion of the second molars.

Evaluation of the effects of the hybrid Pendulum in comparison with the conventional Pendulum appliance.

OBJECTIVE: To evaluate the anchorage control and distalization of maxillary molars with the hybrid Pendulum appliance and to compare the results with a conventional Pendulum appliance. MATERIALS AND METHODS: This study was carried out on the pre-(T0) and post-(T1) treatment lateral cephalograms and dental casts of 43 patients with Angle Class II molar relationships who were treated with conventional or hybrid Pendulum appliances. The hybrid Pendulum (HP) group consisted of 22 patients (14 females; eight males; mean age 14.3 ± 2.43 years) and treatment results were compared with a conventional Pendulum appliance (CP) group, which consisted of 21 patients (15 females; six males; mean age 14.6 ± 3.39 years). Intragroup comparisons were made with Wilcoxon test and intergroup comparisons were made with Mann-Whitney U-test (P < .05). RESULTS: The mean distalization duration was 0.70 ± 0.25 years in the HP group and 0.83 ± 0.4 years in the CP group. Maxillary first molars showed significant distal movement and tipping of 4.25 mm and 9.09° in the HP group, and 3.21 mm and 9.86° in the CP group. Loss of anchorage at the first premolars was significantly smaller in the HP appliance group compared to CP group. The second premolars distalized spontaneously in the HP group while they mesialized significantly in the CP group. Proclination and protrusion of maxillary incisors were greater with the CP appliance compared to the HP appliance. CONCLUSIONS: Maxillary molar distalization was achieved with both appliances. Mesialization of the anchorage unit was controlled successfully with the hybrid Pendulum; however, the conventional Pendulum appliance caused anchorage loss.

Effects of facemask therapy on the mandibular retromolar space. A follow-up study.

OBJECTIVES: To evaluate the mandibular retromolar space after facemask therapy and a follow-up period.  Methods: This retrospective study was conducted between May and September in 2014. The sample consisted of pre-treatment (T1), post-treatment (T2), and follow-up(T3) panoramic radiographs of 19 skeletal and dental Class III patients (7 female, 12 male; mean age: 10.5 years) treated with facemask and a removable intraoral upper appliance in the Faculty of Dentistry Gazi University, Ankara, Turkey. Each patient's lower arches were evaluated as right and left segments. As third molars were congenitally absent in 3 segments, a total of 35 segments were evaluated. The average treatment time was one year. The average follow-up period was 2.4 years. The positions, angulations, dental maturations of lower third molars, and mandibular retromolar spaces (DJ) were assessed. Friedman's 2-way Analysis of Variance, multiple-comparison, Pearson's correlation, and Chi-square tests were used for statistical evaluation. A p less than 0.05 was considered as significant. RESULTS: The angulation of the first molar (ϒ) increased significantly only in the follow-up period (T3). Mandibular retromolar spaces were increased significantly during all periods. The most commonly determined position of the third molar, by Winter's classification, was vertical angulation in all periods. Moderate and significant correlations were found between third molar angulation(ß) and DJ at T2 and T3. Significant correlations were also found between DJ and Demirjian classification stages during all periods. CONCLUSION: Facemask therapy did not have an adverse effect on the mandibular retromolar space during treatment and follow up periods.

Treatment with facemask and removable upper appliance versus modified tandem traction bow appliance: the effects on mandibular space.

Objective: The aim of this study was to evaluate and compare the mandibular arch posterior space changes in Class III patients treated with facemask (FM) with removable upper appliance or modified tandem traction bow appliance (MTTBA). Methods: Pre- and post-treatment and pre- and post-observation lateral cephalograms of 76 subjects with skeletal and dental Class III malocclusion from the period 2000-10 years formed the materials of this study. In the first group, 25 patients (10 girls, 15 boys; mean age: 10 years, 1 month) were treated with MTTBA. The average treatment time was 12 months. In the second group, 26 patients were treated (13 girls, 13 boys; mean age: 10 years, 4 months) with a Delaire-type FM. The average treatment time was 13 months. The remaining 25 children (9 girls, 16 boys; mean age: 9 years, 8 months) were observed without treatment for 10 months. ANOVA, Duncan, and paired t-tests were used for statistical evaluation. Results: Although ramus width and mandibular posterior space increased significantly in all groups, no significant differences were found among the groups. Significant increase in tipping of lower molar (L6/GoMe) in the MTTBA group showed a significant difference compared with the FM and control groups. Significant retroclination of the lower incisors (L1/NB) in the MTTBA and FM treatment groups was significantly different compared with the control group. Retroclination of lower incisors in the MTTBA group was significantly greater than that in the FM group. Conclusions: FM and MTTBA treatment approaches did not affect the dimensions of posterior space. Limitations: To generalize the results of this study, long term evaluation by considering the third molar position should be done.

Assessment of agreement between molar landmarks: Repeatability, reproducibility, and comparability.

INTRODUCTION: The aims of this research were to test the repeatability and reproducibility of measurements obtained by different molar landmarks and to determine whether the treatment changes measured by them are comparable. MATERIALS: Pretreatment (T0) and postdistalization (T1) lateral cephalograms of 40 patients with a Class II molar relationship were used. Using the mesial cusp tip, distal crown contour, and centroid, 6 linear and 3 angular measurements were evaluated. The intraexaminer and interexaminer reliabilities were assessed with the Bland-Altman method. The T0 to T1 differences were compared by analysis of variance, followed by multiple comparisons with the Bonferroni adjustment. RESULTS: The greatest intraexaminer agreement intervals were correlated with centroid for tipping and vertical movement, and with distal crown contour for anteroposterior movement at T0 and T1. The narrowest interexaminer agreement intervals were observed with mesial cusp tip for all measurements and comparisons at both time points, except for the anteroposterior measurements at T1. Statistical significance was observed between the measurements made with mesial cusp tip and distal crown contour for tipping and with mesial cusp tip and centroid for distalization. For vertical movement, the treatment changes were statistically significantly greater with distal crown contour. CONCLUSIONS: Mesial cusp tip was the most repeatable and reproducible landmark. Clinically unimportant differences were found in some comparisons of treatment changes obtained by different landmarks.

Efficacy of different methods to reduce pain during debonding of orthodontic brackets.

OBJECTIVE: To determine pain during debonding and the effects of different pain control methods, gender, and personal traits on the pain experience. MATERIALS AND METHODS: Patients who had fixed orthodontic treatment with metal brackets, but no surgical treatment or craniofacial deformity, were included. Sixty-three patients (32 female, aged 17.2 ± 2.9 years; 31 male aged, 17.2 ± 2.5 years) were allocated to three groups (n = 21) according to the pain control method: finger pressure, elastomeric wafer, or stress relief. Pain experience for each tooth was scored on a visual analogue scale (VAS), and general responses of participants to pain were evaluated by Pain Catastrophizing Scale (PCS). Multiple linear regression analysis, the Mann Whitney U-test, and Spearman's rank correlation coefficient analysis were used to analyze the data. RESULTS: When the VAS scores were adjusted, finger pressure caused a 47% reduction overall, 56% in lower elastomer wafer total, 59% in lower right arch, 62% in lower left, and 62% in lower anterior compared with the elastomeric wafer. In the elastomer wafer group, upper and lower anterior scores were higher than posterior scores, respectively. Females had higher VAS (lower left and anterior) and total PCS scores than males. Regardless of the pain control method, total PCS scores were correlated with total (r = .254), upper total (r = .290), right (r = .258), left (r = .244), and posterior (r = .278) VAS scores. CONCLUSIONS: The stress relief method showed no difference when compared with the other groups. Finger pressure was more effective than the elastomeric wafer in the lower jaw. Higher pain levels were recorded for the anterior regions with the elastomeric wafer. Females and pain catastrophizers gave higher VAS scores.

Evaluation of the effects of modified bonded rapid maxillary expansion on occlusal force distribution: A pilot study.

OBJECTIVE: To evaluate the effects of modified bonded rapid maxillary expansion (RME) on occlusal force distribution. MATERIALS AND METHODS: The sample included 12 patients (7 girls and 5 boys; mean age: 13.1 years) at the permanent dentition stage with bilateral posterior cross-bite. The patients were treated with a modified bonded RME appliance, activated twice a day. The study was terminated when the palatal cusps of the maxillary posterior teeth were occluding with the buccal cusps of the mandibular posterior teeth. The postretention period was 3 months. The T-Scan III device was used to analyze the percentages of occlusal force distribution, and records were taken at the pretreatment (T1), the postreatment (T2), and the postretention (T3) periods. Wilcoxon signed rank test was used for statistical analyses. RESULTS: Incisors were most frequently without contact, followed by canines. The highest forces were seen in the second and first molar regions. A significant decrease was seen in total occlusal force during treatment (T1-T2); however, during retention, the force returned to its initial value, and no significant differences were found (T1-T3). No differences were found between right and left sides and in occlusal forces of the teeth in all time periods. CONCLUSION: The use of modified bonded RME decreases the total occlusal forces during the treatment period, but it does returns to its initial value after the postretention period.

Comparison of transverse dental changes induced by the palatally applied Frog appliance and buccally applied Karad's integrated distalizing system.

OBJECTIVE: To compare the transverse dental changes induced by the palatally applied Frog appliance and buccally applied Karad's integrated distalizing system (KIDS). METHODS: We evaluated the pre- and post distalization orthodontic models of 39 patients, including 19 treated using the Frog appliance, which is palatally positioned (Frog group), and 20 treated using KIDS, which is buccally positioned (KIDS group). Changes in intermolar and interpremolar distances and the amount of maxillary premolar and molar rotation were evaluated on model photocopies. Wilcoxon and Mann-Whitney U tests were used for statistical evaluations. A p-value of < 0.05 was considered statistically significant. RESULTS: Significant distopalatal rotation of premolars and distobuccal rotation of molars were observed in Frog group (p < 0.05), while significant distopalatal rotation of molars (p < 0.05), with no significant changes in premolars, was observed in KIDS group. The amount of second premolar and first molar rotation was significantly different between the two groups (p < 0.05 and p < 0.001, respectively). Furthermore, expansion in the region of the first molars and second premolars was significantly greater in KIDS group than in Frog group (p < 0.001 for both). CONCLUSIONS: Our results suggest that the type and amount of first molar rotation and expansion vary with the design of the distalization appliance used.

Comparison of double-plate appliance/facemask combination and facemask therapy in treating class III malocclusions.

OBJECTIVE: To compare the treatment effects of double-plate appliance/facemask (DPA-FM) combined therapy and facemask (FM) therapy in treating Class III malocclusions. MATERIALS AND METHODS: The material consisted of lateral cephalometric radiographs of 45 children with skeletal and dental Class III malocclusion. The first treatment group comprised 15 patients (mean age  =  11 years) treated with FM. The second treatment group comprised 15 patients (mean age  = 10 years 9 months) treated with DPA-FM. The third group comprised 15 patients (mean age  =  10 years 5 months) used as controls. The paired t-test was used to evaluate the treatment effects and changes during the treatment and observation period in each group. Differences between the groups were determined by variance analysis and the Duncan test. RESULTS: With the DPA-FM and FM appliances, the SNA and ANB angles increased significantly. These changes were statistically different compared with the control group. Lower facial height showed a greater increase in both treatment groups than in the control group. Molar relation showed a greater increase in the DPA-FM group than in the FM group. The increase in U6/ANS-PNS angle in the FM group was significantly different from the DPA-FM and control groups. The L1/NB angle and Pg-T increased significantly only in the FM group, but no significant difference was found between the treatment groups. CONCLUSIONS: In the treatment of Class III malocclusion, both appliances were effective. The significant sagittal changes in the lower incisors and pogonion in the FM group compared with the nonsignificant changes in the DPA-FM group might be due to the restriction effect of acrylic blocks in the DPA-FM group.

Modified tandem traction bow appliance compared with facemask therapy in treating Class III malocclusions.

OBJECTIVE: To compare the effects of the modified tandem traction bow appliance (MTTBA) and the facemask in treating patients with Class III malocclusion. MATERIALS AND METHODS: The material consisted of the pre-post treatment\pre-post observation lateral cephalograms of 65 subjects with skeletal and dental Class III malocclusion. In the first group 21 patients (mean age: 10 years, 6 months) were treated with a Delaire-type facemask (FM). In the second group 22 patients treated (mean age: 10 years) with MTTBA. The remaining 22 children (mean age: 9 years, 7 months) were observed without treatment for 11 months. RESULTS: Increase in SNA, N-FH ⊥ A, and ANB angles were significantly greater in the treatment groups compared to the control group. However, ANB angle showed a significantly greater increase in the FM group (2.8 ± 0.30°) than in the MTTBA group (2.0 ± 0.18°). The overjet and molar relation increased significantly in both treatment groups, but in the FM group (5.2 ± 0.40 mm) increase in overjet was significantly greater than in the MTTBA group (4.0 ± 0.27 mm). Mesial movement of upper molar and incisor were found to be greater in the FM group compared to the modified TTBA group. CONCLUSIONS: Both appliances were found to be effective in the treatment of Class III malocclusion. Their skeletal and dental effects showed differences due to their design.

Dentofacial effects of a modified tandem traction bow appliance.

The aim of this study was to evaluate the dentofacial effects of a modified tandem traction bow appliance (modified TTBA) in skeletal Class III subjects, and the effect of age on treatment response. The material consisted of the pre-treatment/pre-observation and post-treatment/post-observation lateral cephalograms and hand-wrist films of 45 children with skeletal and dental Class III malocclusions. Thirty patients were treated with a modified TTBA. Two treatment groups of 15 patients each were formed: an early (nine girls, six boys; mean skeletal age: 8.18 ± 0.50 years) and a late treatment (5 girls, 10 boys; mean skeletal age: 11.75 ± 1.00 years) group. The remaining 15 children (5 girls, 10 boys; mean skeletal age: 7.90 ± 0.62 years) were observed without treatment for 8 months and served as a control for the early treatment group. Wilcoxon and Mann-Whitney U-tests were used for statistical analysis. Significant forward maxillary movement was determined in both treatment groups (P < 0.01) while the decrease in SNB was significantly greater in the early treatment group compared with the control (P < 0.01). Upper molar tipping and sagittal displacement of point A (point A-T, N(⊥)FH-A) was found to be significantly greater in the late treatment group compared with the early treatment group (P < 0.05). In both treatment groups, dental and skeletal correction of the Class III malocclusion was achieved.

Facemask therapy with and without expansion.

INTRODUCTION: The aim of this study was to compare the effects of facemask treatment with and without expansion in patients with skeletal Class lll malocclusion. METHODS: The material for this study consisted of the pretreatment and posttreatment lateral cephalograms of 28 subjects with skeletal and dental Class lll malocclusions, divided into 2 groups of 14. In the facemask with expansion group (FMEXP; 8 girls, 6 boys; mean age, 11 years 1 month), each subject wore a Delaire-type facemask and a bonded rapid maxillary expansion appliance. In the facemask only group (FM; 8 girls, 6 boys; mean age, 11 years 6 months), each subject wore a Delaire-type facemask with a removable appliance. A third group of untreated children with Class lll malocclusion (7 girls, 7 boys; mean age, 10 years 2 months) was used as the control sample. RESULTS: The forward displacement of the maxilla in both treated groups was significantly greater than in the control group. The forward displacement of pogonion and increase in facial depth in the control group showed significant differences compared with the treatment groups. Extrusion of the maxillary molars was significantly greater in the FM group than in the control group. The increase in the mandibular plane angle and the decrease in the facial axis were significantly different between the FMEXP group and the control group. Molar relationship increased more in the FM group than in the FMEXP group; this was the only significant difference between the treatment groups. In both treatment groups, dental and skeletal treatment of subjects with Class lll malocclusion were achieved. CONCLUSIONS: If the treatment indications are appropriate, facemask therapy can be an effective method for Class III treatment.

Treatment and posttreatment changes with combined headgear therapy.

OBJECTIVE: To determine the effects of combined headgear treatment in high-angle patients and to evaluate the differences 2 years after treatment. MATERIALS AND METHODS: The study material consisted of lateral cephalograms of 21 patients (13 girls and eight boys; mean age 10 years 3 months) with Class II dental relationship. Only extraoral combined traction that was applied to maxillary first molars was used in the treatment of all patients. The patients were instructed to wear the appliance 20 hours per day until the molar relationship was corrected. The treatment time was approximately 5 months. At the beginning (T0), at the end (T1), and approximately 2 years after (T2) combined headgear treatment, lateral cephalometric radiographs were obtained. RESULTS: SNA and ANB angles and convexity decreased significantly during treatment (T0-T1; P<.05 and P<.01, respectively), and the net changes (T0-T2) in ANB angle and convexity were also found to be statistically significant (P<.01). During treatment, significant distal movement was found in the upper first molar, and the second premolar and molar were also distalized significantly (P<.001). At the end of 2 years, there was a significant mesial migration of the upper molars and the second premolar during the posttreatment period, but all of them were positioned more distally compared to the beginning of treatment (P<.001). The decrease in molar relation was statistically significant during the T0-T1 and T0-T2 periods (P<.001).