Evaluation of the skeletal and dental effects of a hybrid aesthetic functional appliance (HAF) in skeletal class II division 1 malocclusion: A prospective uncontrolled clinical trial.

Background: The present study investigated the skeletal and dental effect in class II division I growing patients due to mandibular deficiency treated with the hybrid aesthetic functional (HAF) appliance. Methods: A sample of 16 growing patients (5 boys and 11 girls; mean age: 9.50 years, standard deviation: 1.15) with class II division I malocclusion were treated using the HAF appliance for an average period of 10±3 months. For each patient, a cephalometric radiograph was taken before and after treatment, and digital analysis was applied using the WebCeph program. The statistical analysis was performed to evaluate dental and skeletal changes associated with the HAF appliance and determine if there were any statistically significant variations in anatomical measurements between the start and completion of the treatment. Results: The data showed a significant increase in SNB angle (P=0.002), leading to a significant decrease in ANB angle (P=0.001). The mandibular length significantly increased (P=0.008), the lower incisors were flared significantly (P=0.028), and the lower molars were extruded significantly (P≤0.001). Also, this study revealed a significant decrease in Wits appraisal (P≤0.001), overjet (P≤0.001), and overbite (P=0.041). Additionally, a significant increase in lower anterior facial height (P≤0.001), total facial height (P=0.001), and posterior facial height (P=0.037) were observed. Conclusion: The HAF appliance showed that it could be used to correct class II division 1 skeletal discrepancy by mandibular advancement. The HAF appliance increased all facial heights significantly.

Dentofacial effects of miniscrew-anchored maxillary protraction on prepubertal children with maxillary deficiency: a randomized controlled trial.

BACKGROUND: The introduction of bone-anchored maxillary protraction eliminated the side effects of facemask in the early treatment of patients with maxillary retrusion. This study aimed to evaluate the effects of miniscrew-anchored maxillary protraction (MAMP) and compare them with the growth changes in an untreated control group in growing patients with Class III malocclusion. METHODS: Forty growing patients with Class III malocclusion and retrognathic maxilla were randomly allocated into two groups: treated and control groups. In the treated group, patients were treated with full-time intermaxillary Class III elastics (C3E) anchored by a hybrid hyrax (HH) in the maxilla and a bone-supported bar in the mandible. Protraction was stopped after obtaining a positive overjet. Cephalometric radiographs were acquired before and after the treatment. Data were statistically analyzed on an intention-to-treat basis. Intergroup comparisons were also made using analysis of covariance with the readings at T0 as a covariate. RESULTS: Forty patients agreed to participate, and 30 of them completed the study (treated group, n = 17; control group, n = 13). The average treatment duration was 11.9 months. MAMP resulted in a significant maxillary advancement (A-VR, 4.34 mm) with significant control over the mandibular growth. No significant increase in the mandibular plane angle was found in the treated group compared with the control group. The upper and lower incisors showed significant protrusion in the treated group. CONCLUSIONS: Within the limitations of this study and high attrition rate, the MAMP protocol can effectively increase maxillary forward growth with good control over the growth of the mandible antero-posteriorly and vertically.

The effect of submucosal injection of platelet-rich fibrin vs. platelet-rich plasma on orthodontic tooth movement in rabbits; 28 days follow-up.

OBJECTIVE: This study aimed to compare between the effects of submucosal injection of platelet rich fibrin (i-PRF) versus platelet rich plasma (PRP) on orthodontic tooth movement (OTM) in a rabbit model over a 28-day follow-up period. MATERIALS AND METHODS: Sixty-three rabbits were assigned into 3 equal groups. Group I animals were subjected to the OTM without any treatments and considered as the control. Whereas groups II and III were handled as group I and instead i-PRF and PRP were injected submucosally in the buccal vestibular mucosa next to the mandibular 1st premolar, respectively. The distance of OTM was consecutively measured clinically after 7, 14 and 28 days. Seven rabbits from each group were euthanized after 7, 14 and 28 days for histological evaluation. Two-way ANOVA followed by LSD post-hoc statistical tests were used for comparison. RESULTS: After 28 days, the mean tooth movements were 4.36±0.04mm in the control group, 6.30±0.06mm in the group receiving PRP and, 6.85±0.09mm in the group receiving i-PRF. Statistical analysis for the values of teeth movements revealed highly significant differences between different groups (P=0.001) and between different time periods (P=0.001). Histological analysis showed that submucosal injection of PRP and i-PRF yielded significant differences in periodontal ligament width in compression and tension sides between different groups (P=0.001) and between different time periods (P=0.001). CONCLUSION: Submucosal injection of either PRP or i-PRF is a minimally invasive and safe approach for accelerating OTM. In this rabbit model, the effect of i-PRF is significantly more pronounced than the effect of PRP.

Influence of low-level laser (LLL) on interleukin 6 (IL-6) levels in gingival crevicular fluid (GCF) during orthodontic tooth movement of periodontally affected rabbits.

AIM: To evaluate the effects of LLL on IL-6 levels in the GCF and the Probing Pocket Depth measurements (PPD) during orthodontic tooth movement in periodontally affected rabbits. METHODS: Twenty-four rabbits were divided into 3 groups: Group 1(G1), healthy rabbits with orthodontic movement, Group 2(G2) periodontally affected rabbits and orthodontic movement, Group 3(G3) periodontally affected rabbits with orthodontic movement and LLL therapy. A 0.014 stainless steel spring was inserted in the upper central incisors to produce 60gm force. Laser CAT 500 was applied for 3min/day for 2 weeks. PPD measurements were obtained at base line and after 14 days with electronic periodontal probe. RESULTS: IL-6 levels increased gradually after application of orthodontic force, afterwards the 8th day, a significant difference in the Il-6 levels between G1 vs. G2 and G2 vs. G3 was observed. PPD measurements showed significant difference between the three groups at base line and after 14 days. CLINICAL SIGNIFICANCE: LLL application can enhance periodontal ligament regeneration and decrease the periodontal tissue destruction through suppression of IL-6 levels.