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1.
Head Face Med ; 17(1): 4, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33546715

RESUMEN

BACKGROUND: The purpose of this study was to analyze the relationship between body posture and sagittal dental overjet in children before and after early orthodontic treatment with removable functional orthodontic appliances. METHODS: Angle Class II patients (mean age 8.2 ± 1.2 years; 29 males and 25 females) with a distinctly enlarged overjet (> 9 mm) were retrospectively examined regarding body posture parameters before and after early orthodontic treatment. In addition, changes in overjet were investigated with the aid of plaster models. Forms of transverse dysgnathism (crossbite, lateral malocclusions) and open bite cases were excluded. Body posture parameters kyphosis, lordosis, surface rotation, pelvic tilt, pelvic torsion and trunk imbalance were analyzed by means of rasterstereographical photogrammetry to determine, if the orthodontic overjet correction is associated with specific changes in posture patterns. RESULTS: In nearly all patients an overjet correction and an improvement regarding all body posture and back parameters could be noted after early orthodontic treatment. Overjet reduction (- 3.9 mm ± 2.1 mm) and pelvic torsion (- 1.28° ± 0,44°) were significantly (p < 0.05) and moderately correlated (R = 0.338) with no significant associations found for the other posture and back parameters (p > 0.05). CONCLUSION: Overjet reduction during early orthodontic treatment may be associated with a detectable effect on pelvic torsion.


Asunto(s)
Maloclusión de Angle Clase II , Maloclusión , Aparatos Ortodóncicos Funcionales , Niño , Femenino , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Maloclusión/terapia , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Postura , Estudios Retrospectivos
3.
Clin Oral Investig ; 25(3): 1525-1534, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33409688

RESUMEN

OBJECTIVES: Angle Class II malocclusions including a retrognathic mandible are the most frequent orthodontic problems. Both removable and fixed functional appliances can be used for mandibular advancement. Mandibular advancement after treatment with any fixed functional appliance has numerous therapeutic effects, such as stretching of masticatory muscles, ligaments, membranes and surrounding soft tissues, thus causing positional changes of the hyoid bone and epiglottis. This retrospective study investigates and compares treatment effects upon epiglottis- and hyoid bone position and posterior airway space in class II patients who received mandibular advancement through two different cast splint fixed functional appliances. MATERIAL AND METHODS: Two groups of 21 patients each ('Functional Mandibular Advancer' (FMA) and Herbst appliance) were investigated. The same experienced orthodontist performed the treatment in all patients, employing a single-step advancement protocol. The mandible always received initial protrusion into an edge-to-edge position. Conventional lateral cephalograms were available pre-treatment (T1) and immediately after appliance removal (T2) for all patients. The measurements comprised (I) hyoid bone, (II) epiglottis or (III) posterior airway space. Treatment-related changes were analysed with one-sample Student's t tests for intragroup comparisons and independent Student's t tests for intergroup comparisons. Statistical significance was set at p < 0.05. RESULTS: Measurements of the hyoid bone showed mostly increases for both appliances after treatment. Intergroup comparisons were not significant for FMA patients but significant for selected measurements in Herbst appliance patients. Intergroup comparisons showed insignificant changes. The posterior airway space was always insignificantly increased after treatment. The greatest increase was found caudally. Intergroup comparisons showed insignificant changes. CONCLUSIONS: Both fixed functional appliances cause an anterior and caudal displacement of epiglottis and hyoid bone and enlarge the posterior airway space. The therapeutic effects of the Herbst appliance are slightly larger, although not significantly. CLINICAL RELEVANCE: Treatment with either Herbst appliance of FMA alters the hyoid bone position and enlarges the posterior airway space. Still, long-term data are as yet unavailable; it remains unknown if the effects upon posterior airway space remain stable, and if a resulting posterior airway space enlargement may have clinical influence upon obstructive sleep apnoea syndrome.


Asunto(s)
Maloclusión de Angle Clase II , Aparatos Ortodóncicos Funcionales , Cefalometría , Epiglotis , Humanos , Hueso Hioides , Maloclusión de Angle Clase II/terapia , Mandíbula , Aparatos Ortodóncicos Fijos , Estudios Retrospectivos , Férulas (Fijadores)
4.
Am J Orthod Dentofacial Orthop ; 159(2): 148-157, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33388197

RESUMEN

INTRODUCTION: This study aimed to compare cephalometrically the pharyngeal airway, hyoid bone, and soft palate (SP) changes after Class II malocclusion treatments using Twin-block (TWB) and Forsus Fatigue Resistant Device (FFRD) (3M Unitek Corp, 3M Dental Products, Monrovia, Calif) during the postpeak growth period. METHODS: Forty-two patients with Class II malocclusion treated during the postpeak growth period were randomly and retrospectively included in this study. These patients were divided into 2 treatment groups: TWB and FFRD. The skeletal, dental, pharyngeal airway, hyoid bone position, and SP measurements were obtained from the lateral cephalometric radiographs taken at the beginning and at the end of the treatment. Paired-samples and independent-samples t tests were used for the intragroup and intergroup comparisons, respectively. RESULTS: In the TWB group, the SNB (°), Md1-NB (mm), Md1-NB (°), and McNamara upper and lower pharyngeal airway dimensions significantly increased, whereas the ANB (°), AD1-Ba (mm), AD2-H (mm), adenoidal nasopharyngeal area, and SP angle decreased (P < 0.05). In the FFRD group, the SNB (°), Md1-NB (mm), Md1-NB (°), Ptm-Ba (mm), and McNamara upper airway dimensions significantly increased, whereas the ANB (°), AD2-H (mm), and interincisor angle decreased (P < 0.05). Moreover, there were statistically significant differences in the Md1-NB angles and SP thicknesses between the 2 groups (P < 0.05). CONCLUSIONS: The effects of TWB and FFRD treatment on the airway during the postpeak growth period were similar. However, the FFRD caused a greater mandibular incisor protrusion.


Asunto(s)
Maloclusión de Angle Clase II , Aparatos Ortodóncicos Funcionales , Cefalometría , Humanos , Hueso Hioides/diagnóstico por imagen , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Mandíbula/diagnóstico por imagen , Paladar Blando/diagnóstico por imagen , Faringe/diagnóstico por imagen , Estudios Retrospectivos
5.
Am J Orthod Dentofacial Orthop ; 159(2): 202-209.e2, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33388198

RESUMEN

INTRODUCTION: This study aimed to establish mathematical equations to describe the dental and basal arch forms in skeletal Class II malocclusion and to investigate correlations between these forms to facilitate clinical diagnosis and treatment design. METHODS: Cone-beam computed tomography images of 60 patients (30 each with skeletal Class II malocclusion and normal occlusion) were subjected to 3-dimensional volume rendering, image reconstruction, and measurement. Using a computer program written in Java on the Eclipse platform (Eclipse Foundation, Ottawa, Canada), a beta function was used to establish mathematical models of dental and basal bone arch forms, and model-fitting was performed. RESULTS: A mathematical model was developed to describe the dental and basal arch forms in skeletal Class II malocclusion. The maxillary and mandibular dental arch lengths were significantly longer in skeletal Class II malocclusion than in normal occlusion, whereas the width of the maxillary molar segment was smaller. The maxillary molar and mandibular intercranial segments in the basal arch were significantly longer in skeletal Class II malocclusion than in normal occlusion, whereas the mandibular intercranial segment width was smaller. CONCLUSIONS: The dental arch and basal bone arch forms in the maxilla and mandible follow individual curves, described by a beta function. In skeletal Class II malocclusion, the dental and basal arches are discrepant in horizontal and anteroposterior dimensions, which should be considered during orthodontic treatment planning to improve arch matching.


Asunto(s)
Arco Dental , Maloclusión de Angle Clase II , Canadá , Cefalometría , Arco Dental/diagnóstico por imagen , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen
6.
Angle Orthod ; 91(1): 22-29, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33339047

RESUMEN

OBJECTIVES: To compare the dental and skeletal treatment effects after total arch distalization using modified C-palatal plates (MCPPs) on adolescent patients with hypo- and hyperdivergent Class II malocclusion. MATERIALS AND METHODS: The study group included 40 patients with Class II malocclusion (18 boys and 22 girls, mean age = 12.2 ± 1.4 years) treated with MCPPs. Fixed orthodontic treatment started with the distalizing process in both groups. Participants were divided into hypo- or hyperdivergent groups based on their pretreatment Frankfort mandibular plane angle (FMA) ≤22° or ≥28°, respectively. Pre- and posttreatment lateral cephalograms were digitized, and 23 variables were measured and compared for both groups using paired and independent t-tests. RESULTS: The hyper- and hypodivergent groups showed 2.7 mm and 4.3 mm of first molar crown distalizing movement, respectively (P < .001). The hypodivergent group had a slight 2.2° crown distal tipping of first molars compared with 0.3° in the hyperdivergent group. After distalization, the FMA increased 3.1° and 0.3°, in the hypodivergent and hyperdivergent groups, respectively (P < .001). SNA decreased in the hypodivergent group, while other skeletal variables presented no statistically significant differences in the changes between the groups. CONCLUSIONS: The hypodivergent group showed more distal and tipping movement of the maxillary first molar and increased FMA than the hyperdivergent group. Therefore, clinicians must consider vertical facial types when distalizing molars using MCPPs in Class II nonextraction treatment.


Asunto(s)
Maloclusión de Angle Clase II , Diseño de Aparato Ortodóncico , Adolescente , Cefalometría , Femenino , Humanos , Masculino , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Maxilar , Técnicas de Movimiento Dental
7.
Angle Orthod ; 90(3): 362-368, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378427

RESUMEN

OBJECTIVE: To investigate treatment stability of miniscrew-anchored maxillary distalization in Class II malocclusion. MATERIALS AND METHODS: This retrospective study included a distalization (n = 19) and a control (n = 19) group; a patient group with minor corrections served the control. Lateral cephalograms of 38 adult patients were taken before (T0), immediately after (T1), and 3-4 years after (T2) treatment. Horizontal and vertical movement and tipping of the maxillary first molars (U6) and central incisors (U1) were measured along with skeletal craniofacial parameters at three time points to compare the two groups regarding the achieved treatment effects and their stability. RESULTS: Total arch distalization therapy led to 4.2 mm of distal movement of U6 without distal crown tipping (0.6° of axis change) and 3.3° of occlusal plane steepening. Over an average retention period of 42 months, maxillary total arch distalization provided high stability of treatment results, showing the same amount of mesial movement (0.7 mm) as the control group. CONCLUSIONS: In Class II treatment, miniscrew-anchored maxillary total arch distalization can provide stable distal movement of the maxillary first molars and central incisors.


Asunto(s)
Maloclusión de Angle Clase II , Métodos de Anclaje en Ortodoncia , Adulto , Cefalometría , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Maxilar , Diente Molar/diagnóstico por imagen , Diseño de Aparato Ortodóncico , Estudios Retrospectivos , Técnicas de Movimiento Dental
8.
Angle Orthod ; 90(5): 627-633, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378481

RESUMEN

OBJECTIVES: To evaluate the stability of maxillary interincisor diastema closure and the relationship between space relapse and interincisor diastema width, overjet, overbite, angulations between adjacent maxillary anterior teeth and presence of intermaxillary osseous cleft after orthodontic treatment with extractions. MATERIALS AND METHODS: Twenty-four individuals with a maxillary interincisor diastema pretreatment, treated with maxillary first premolar extractions were evaluated. Dental casts and panoramic radiographs taken at pretreatment (T1), posttreatment (T2), and posttreatment follow-up (T3) were assessed. Periapical radiographs at T1 and T2 were also evaluated. Diastema relapse was assumed when T3-T2 interincisor space change was greater than zero. Diastema relapse was considered clinically significant when it was at least 0.50 mm. Data were analyzed using repeated-measures analysis of variance followed by post hoc Tukey tests or Friedman followed by Wilcoxon tests. T-test or Mann-Whitney U-test, Pearson correlation coefficient, and multiple linear regression analyses were also performed. RESULTS: No statistically significant relapse of maxillary interincisor diastemas was found. The percentage of clinically significant relapse of the maxillary interincisor diastemas was 27.78%. Specifically, for the interincisor midline diastema, it was 8.33%. CONCLUSIONS: Maxillary interincisor diastema closure showed no statistically significant relapse after orthodontic treatment with premolar extractions. Clinically significant stability for maxillary interincisor diastema closure was 72.22% and, specifically, for interincisor midline diastema closure, it was 91.67%.


Asunto(s)
Diastema , Maloclusión de Angle Clase II , Sobremordida , Diastema/terapia , Humanos , Incisivo , Maxilar/diagnóstico por imagen
9.
Angle Orthod ; 90(4): 571-577, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378491

RESUMEN

OBJECTIVE: To evaluate the esthetic perceptions of orthodontists and laypersons for facial profile changes after orthodontic treatment using Herbst or Forsus appliances. MATERIALS AND METHODS: Pre- and posttreatment facial profile contour images of 20 Class II patients treated with Herbst (group H; n = 10) and Forsus (group F; n = 10) appliances were analyzed by 30 orthodontists and 30 laypersons, who graded them from 1 (unattractive) to 10 (very attractive) using a visual analog scale. Two assessments were carried out with a 15 day-interval. In the first evaluation, 40 images were presented in a random sequence. In the second evaluation, initial and final facial profile images of each patient were randomly presented side by side. To compare groups in relation to treatment method, Mann-Whitney tests were used. To evaluate differences between time points, Wilcoxon tests were used. RESULTS: In the first evaluation, there was a significant difference between initial and final images only for group H, for both laypersons (P = .017) and orthodontists (P = .037). There was also a significant difference between laypersons and orthodontists in their ratings of posttreatment Herbst appliance profiles (P = .028). There was no significant difference between initial and final facial profile images for group F and no significant differences between or within evaluator groups in their ratings of initial or final Forsus appliance profiles. In the second evaluation, there was a significant difference between appliance groups only for laypersons, who considered cases treated with the Herbst appliance more attractive than those treated with the Forsus (P = .031). Laypersons also considered Herbst profiles more attractive than did orthodontists (P = .047). CONCLUSIONS: Class II malocclusion treatment using the Herbst appliance may produce a more esthetically improved facial profile silhouette compared with Forsus appliances. The magnitude of perceived changes may not be considered clinically relevant.


Asunto(s)
Maloclusión de Angle Clase II , Aparatos Ortodóncicos Funcionales , Cefalometría , Estética , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Percepción , Resultado del Tratamiento
10.
Angle Orthod ; 90(4): 491-499, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378493

RESUMEN

OBJECTIVES: To determine three-dimensional treatment changes produced by the Class II Carriere Motion appliance (CMA) in Class II adolescent patients with Class I and Class II skeletal relationships. MATERIALS AND METHODS: The sample included 59 adolescents (16 boys and 43 girls) with unilateral or bilateral Class II molar and bilateral Class II canine relationship. They were divided into group 1 with skeletal Class I (N = 27; ANB 2.90° ± 1.40°; 13.30 ± 1.53 years) and group 2 with skeletal Class II (N = 32; ANB 6.06° ± 1.64°; 13.26 ± 1.76 years). Cone beam computed tomography images were traced with Invivo software pretreatment (T1) and post-CMA usage (T2). The treatment changes in 36 measurements were calculated in each group, and the changes in 16 measurements were compared between them. RESULTS: In group 1 and 2, maxillary first molars underwent significant distal movement (1.92 mm ± 0.80 mm and 1.67 mm ± 1.56 mm, respectively) with distal tipping and rotation, maxillary canines underwent significant distal movement (2.34 mm ± 1.07 mm and 2.24 mm ± 1.91 mm, respectively) with distal tipping and rotation, and mandibular molars underwent significant mesial movement (-1.37 mm ± 1.23 mm and -2.51 mm ± 1.51 mm, respectively) with mesial tipping. Between the groups, there were significant differences in mandibular molar mesial movement and the U1-SN changes (P < .05). CONCLUSIONS: The CMA corrected Class II malocclusion through distal tipping and rotational movement of maxillary canines and molars and corrected mesial tipping of mandibular molars. Significantly more mandibular molar mesial movement and maxillary incisor flaring were observed in patients with skeletal Class II.


Asunto(s)
Maloclusión de Angle Clase II , Adolescente , Cefalometría , Femenino , Humanos , Incisivo , Masculino , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Diseño de Aparato Ortodóncico , Técnicas de Movimiento Dental
11.
Angle Orthod ; 90(6): 783-793, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378509

RESUMEN

OBJECTIVE: To evaluate the effects of functional appliance treatment on mandibular trabecular structure using fractal dimension (FD) analysis of dental panoramic radiographs. MATERIALS AND METHODS: This study was conducted using digital panoramic radiographs of 45 patients with Class II malocclusion treated with functional appliances (treatment group, mean age: 11.39 ± 0.97 years; 23 girls, 22 boys) acquired before (T0) and after (T1) treatment and the panoramic radiographs of 45 control subjects who had undergone no orthodontic treatment (control group, mean age: 11.31 ± 0.87 years; 23 girls, 22 boys). FD values in the condylar process, mandibular corpus, and mandibular angle were analyzed from the panoramic radiographs of both groups. RESULTS: Analysis of changes in FD between T0 and T1 revealed significant increases in the FD values of the right and left condylar processes and right mandibular corpus in the treatment group (P < .001) and in the right condylar process in the control group (P < .05). Between-group comparisons demonstrated that the treatment group showed greater changes in the condylar process (right, P < .001; left, P < .05) and right mandibular corpus (P < .05) compared to controls. Correlation analysis between the cephalometric and FD changes in the treatment group showed the right condylar process changes were negatively correlated with GoGn/SN angle (P < .05) and positively correlated with Co-Go (P < .05), although these correlations were weak. CONCLUSIONS: FD analysis demonstrated significant changes in trabeculation of the condyle and mandibular corpus in the treatment group compared to the control group. Functional appliance treatment may lead to skeletal correction by altering skeletal form and trabeculation of the mandibular bone.


Asunto(s)
Fractales , Maloclusión de Angle Clase II , Cefalometría , Niño , Femenino , Humanos , Masculino , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Mandíbula/diagnóstico por imagen , Radiografía Panorámica
12.
Angle Orthod ; 90(6): 851-856, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378513

RESUMEN

OBJECTIVE: To compare second molar angulation to the occlusal plane with cephalometric measurements corresponding to AP skeletal discrepancy. MATERIALS AND METHODS: 72 patients' pre-orthodontic records were analyzed. A plane was constructed along the cusps of the upper second molar and measured to a proxy for the occlusal plane. The angle between the planes was measured. ANB, Wits appraisal, U1-SN, IMPA, A-B perpendicular to Frankfort, and overjet were measured on the patients' cephalograms. Generalized additive mixed model analysis was performed to analyze the relationship between the second molar angulation and the cephalometric measurements. RESULTS: All six cephalometric measurements showed a significant relationship with the second molar angulation, with Class III patients having a larger angle than Class II and I patients. CONCLUSIONS: Class III patients have upper second molars that are significantly tipped from the occlusal plane. The second molars require special attention for correction prior to orthognathic surgery for Class III patients in order to avoid deleterious effects from the malpositioned teeth.


Asunto(s)
Maloclusión de Angle Clase III , Maloclusión de Angle Clase II , Cefalometría , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase III/diagnóstico por imagen , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen
13.
Angle Orthod ; 90(6): 794-800, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378521

RESUMEN

OBJECTIVES: To determine whether there was a correlation between patients' bone thickness and time spent in orthodontic treatment. The secondary aim was to study the influence of Angle classification, extraction treatment, and age on overall treatment duration. MATERIALS AND METHODS: In this retrospective study, records of 971 orthodontic patients from two centers were reviewed and 500 subjects were included after imposing inclusion/exclusion criteria. The Mental Index was used to determine patients' bone density. For the Mental Index, a line perpendicular to the inferior border of the mandible was drawn on a panoramic radiograph so that it intersected the inferior border of the mental foramen. The mandibular cortical thickness was measured along this line. Two-sample t-test or a chi-square test, followed by multiple linear regression, were used to identify the factors affecting treatment duration. RESULTS: Mandibular cortical thickness was negatively associated with treatment time for all subjects (P < .05). After adjusting for covariables, it remained significant for center-1, but non-significant for center-2 subjects. Angle Class II and Class III malocclusion, extraction therapy, and age had significant positive correlations with treatment duration (P < .05). CONCLUSIONS: There is a negative correlation between the mandibular cortical thickness and orthodontic treatment duration. An extraction treatment plan and treatment of Angle Class II and Class III malocclusions significantly increase the duration of orthodontic treatment. Additionally, patients over 12 years of age have shorter treatment times compared to patients under 12 years of age.


Asunto(s)
Maloclusión de Angle Clase II , Mandíbula , Cefalometría , Niño , Hueso Cortical/diagnóstico por imagen , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Mandíbula/diagnóstico por imagen , Radiografía Panorámica , Estudios Retrospectivos
14.
Ned Tijdschr Tandheelkd ; 127(12): 671-676, 2020 Dec.
Artículo en Holandés | MEDLINE | ID: mdl-33367293

RESUMEN

In this article, the short- and long-term results of two types of functional appliances are discussed regarding their ability to stimulate the mandibular growth at mandibular retrognathia and reduce an increased overjet. Removable functional appliances, or activators, are compared to a fixed functional appliance, the Herbst appliance. The activator, often consisting of an acrylic base, is advised to be worn for 12 to 20 hours a day. The Herbst appliance consists of interconnected bands around the molar- and premolar bands, keeping the mandibula continuously positioned forward by means of hinges or telescopes. In the short-term, both appliances are effective in reducing the overjet, improving the molar-occlusion and reducing the mandibular retrognathia. The comparative literature is inconclusive as to which appliance is more effective on which level, skeletal or dentoalveolar. The removable appliances are more likely to be accepted at a younger age, whilst the fixed appliances are more suitable for the adolescents. The stability of the long-term treatment effects is minimally described in the existing literature. However, the highest stability rate seems to apply to the Herbst appliance. The impact of a widely applied second phase of treatment with fixed appliances, with possible use of intermaxillary class II elastics and retention using functional appliances is barely taken into account.


Asunto(s)
Maloclusión de Angle Clase II , Aparatos Ortodóncicos Funcionales , Adolescente , Diente Premolar , Cefalometría , Humanos , Mandíbula
15.
Medicine (Baltimore) ; 99(50): e23221, 2020 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-33327241

RESUMEN

BACKGROUND: Angle class II malocclusion is clinically complex and common malocclusion type, which affects beauty. Conventional treatment has the disadvantages of long course of treatment, high cost, easy recurrence and limited curative effect. Clinical practice shows that micro-implant anchorage has certain advantages in the treatment of Angle II malocclusion, but lacks the evidence of evidence-based medicine. This study systematically evaluates the efficacy and safety of micro-implant anchorage in the treatment of Angle class II malocclusion. METHODS: A systematic search was performed by retrieving on English databases (PubMed, Embase, Web of Science, and the Cochrane Library) and Chinese databases (CNKI, Wanfang, Weipu [VIP], CBM). Besides, manually search for Google and Baidu academic of micro-implant anchorage in the treatment of Angle class II malocclusion in randomized controlled clinical research. The retrieval time limit was from the establishment of the database to September 2020. Two researchers independently extracted and evaluated the quality of the data in the included study. A meta-analysis was performed using RevMan5.3 software. RESULTS: In this study, the efficacy and safety of micro-implant anchorage against Angle class II malocclusion were evaluated by SNA, BNA, ANB, NLA°, Adverse reaction. CONCLUSIONS: This study will provide reliable evidence-based evidence for the clinical application of micro-implant anchorage in the treatment of Angle class II malocclusion. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.OSF Registration number: DOI 10.17605/OSF.IO/UPBR8.


Asunto(s)
Implantes Dentales , Maloclusión de Angle Clase II/terapia , Métodos de Anclaje en Ortodoncia/métodos , Ortodoncia Correctiva/métodos , Implantes Dentales/efectos adversos , Humanos , Métodos de Anclaje en Ortodoncia/efectos adversos , Ortodoncia Correctiva/efectos adversos
16.
Eur J Paediatr Dent ; 21(4): 271-276, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33337901

RESUMEN

AIM: The aim of the present prospective study was to evaluate if the treatment performed using high-pull traction on a Stephenson plate had real orthopaedic outcomes in subjects with severe Class II Division 1 malocclusion due to maxillary protrusion. MATERIALS AND METHODS: Twenty-three growing patients showing Class II Division 1 malocclusion (Stephenson plate group, SPG) were treated and compared with an untreated Class II control group (CG - 21 subjects selected from the database of Bolton-Brush Growth Study). Lateral cephalograms at T0 and T1 for both groups were analysed using cephalometric tracing by Jarabak, Pancherz and Ghosh-Nanda. RESULTS: Orthopaedic forces were applied in SPG. SPG group showed significantly greater decrease than CG group of SNA° (-1.4° vs +0.7°), ANB° (-1.3° vs +0°), WITS (-1° vs 0.6°), overjet (-4.1 mm vs +0.3 mm), molar relationships (-6.1° mm vs -0.1 mm) and upper incisors proclination (1/SpP, -10.3° vs -1°). The maxilla substantially maintained its position (A/OLp +0.3 mm, SNA° -1.4°) while the mandible slightly grew (Pg/OLp +1.7 mm; SNB° + 0.7°). Facial pattern and AFA/AFP ratio did not change. CONCLUSION: The high-pull traction on the Stephenson plate produced more dental than skeletal outcomes in growing subjects, despite of the application of orthopaedic forces.


Asunto(s)
Maloclusión de Angle Clase II , Maxilar , Cefalometría , Aparatos de Tracción Extraoral , Humanos , Maloclusión de Angle Clase II/terapia , Mandíbula , Estudios Prospectivos , Tracción
17.
Am J Orthod Dentofacial Orthop ; 158(6): e111-e120, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33158633

RESUMEN

INTRODUCTION: This single-centered, parallel-groups trial aimed to evaluate the efficacy of traditional corticotomy vs flapless corticotomy in accelerating en-masse retraction. In addition, to assess the skeletal, dental, and soft-tissue variables, as well as the external apical root resorption (EARR) of the maxillary anterior teeth. METHODS: Forty patients with Class II Division 1 malocclusion aged >18 years at the beginning of treatment, requiring maxillary first premolar extractions, were randomly distributed into 2 groups (n = 20 each): 1 group was treated using traditional corticotomy, and the other group was treated with flapless corticotomy in en-masse retraction with anchorage based on miniscrews placed between maxillary second premolars and first molars bilaterally. Randomization was implemented with a computer-generated list of random numbers; allocation was concealed in sequentially numbered, opaque, sealed envelopes. The study was single-blinded (outcomes' assessor). The primary outcome was the en-masse retraction duration. Secondary outcomes were the skeletal, dental, and soft-tissue changes on lateral cephalometric and the EARR of maxillary anterior teeth on digital panoramic radiographs. RESULTS: The en-masse retraction duration in the flapless corticotomy group was longer than the traditional corticotomy group. The average retraction duration was 4.04 ± 1.10 months for the flapless corticotomy group and 3.75 ± 2.14 months for the traditional corticotomy group, with no significant difference between the 2 groups (95% confidence interval [CI], -0.81 to 1.39; P = 0.59). No significant differences were observed between the 2 groups regarding changes in several lateral cephalometric variables (eg, SNA angle [95% CI, -2.55° to 1.66°; P = 0.67], SN-U1 angle [95% CI, -1.70° to 1.32°; P = 0.80], and UL-E [95% CI: -1.33 to 1.00 mm; P = 0.78]) or in the amount of EARR in the maxillary anterior teeth (P = 0.31). The proportion of the observed EARR ranged from 1% to 6% of root length in both corticotomy groups. No serious harms were observed in both groups. CONCLUSIONS: No significant differences between the flapless and traditional corticotomies were found in terms of the skeletal, dental, and soft-tissue variables as well as in the amount of EARR. Corticotomy-assisted en-masse retraction led to improvements in skeletal structures and facial profile and resulted in sufficient retraction of maxillary anterior teeth, slight distal movement of maxillary first molars, and an intrusion movement for both anterior and posterior teeth. Both corticotomy techniques did not cause significant EARR. REGISTRATION: ClinicalTrials.gov (Identifier: NCT03279042). PROTOCOL: The protocol was not published before the trial commencement.


Asunto(s)
Maloclusión de Angle Clase II , Métodos de Anclaje en Ortodoncia , Adolescente , Diente Premolar/cirugía , Cefalometría , Humanos , Maloclusión de Angle Clase II/cirugía , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Técnicas de Movimiento Dental
18.
J Clin Pediatr Dent ; 44(4): 274-282, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-33167022

RESUMEN

OBJECTIVE: To investigate the cephalometric changes following anterior repositioning of the mandible for predicting the treatment effects in Class II adolescent patients. STUDY DESIGN: Lateral cephalograms of 28 patients (ANB > 4°) were taken in centric occlusion (CO) and edge-to-edge bite (EtoE) before orthodontic treatment. The patients were classified into two groups according to their mandibular plane angle [MPA; low MPA (LMPA) ≤ 28° and high MPA (HMPA) > 28°]. Cephalometric changes of hard and soft tissues were measured and analyzed with an x-y cranial base coordinate system. RESULTS: For CO to EtoE, there were no significant cephalometric changes between HMPA and LMPA, but the horizontal ratio of soft to hard tissue pogonion (H-Pog'/H-Pog) change was significantly greater with LMPA than with HMPA while the vertical ratio (V-Pog'/V-Pog) showed vice versa. For CO to EtoE, MPA showed significant correlations with H-Pog'/H-Pog and V-Pog'/V-Pog. Y-axis angle, V-Pog'/V-Pog and H-Pog'/H-Pog can be used as good tools to discriminate between HMPA and LMPA. CONCLUSION: Cephalometric findings for CO to EtoE may be useful in predicting the vertical and horizontal changes of hard and soft tissues with the treatment of growing adolescents having various vertical skeletal patterns of Class II malocclusion.


Asunto(s)
Reposicionamiento de Medicamentos , Maloclusión de Angle Clase II , Adolescente , Cefalometría , Estudios Transversales , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Mandíbula/diagnóstico por imagen , Pronóstico
19.
Dental Press J Orthod ; 25(5): 66-84, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33206831

RESUMEN

INTRODUCTION: Moderate and severe bimaxillary protrusion impair the passive lip sealing and the facial and smile esthetics. The extraction of premolars can be avoided by the use of skeletal anchorage to retract both dental arches. This approach brings many advantages such as: prevents premolars extraction; simplifies orthodontic mechanics; there is no volume reduction of a premolar when smiling; control of overbite and gingival exposure. The utilization of this therapeutic approach, when associated with self-ligating brackets, can bring the possibility of spacing the appointments without damage to the treatment efficiency, and allows selection of the most appropriate torque prescriptions for each case. The intra-alveolar miniscrews are indicated for mild cases of bimaxillary protrusion, while extra-alveolar miniscrews may also be indicated for more severe cases. OBJECTIVE: To report the treatment of three cases of mild, moderate and severe bimaxillary protrusion, in which intra- and extra-alveolar miniscrews were used, according to the retraction required. CONCLUSION: The retraction of both upper and lower dental arches using orthodontic intra- and extra-alveolar miniscrews, associated with self-ligating brackets, is an excellent tool to correct mild to severe bimaxillary protrusion, thus reducing the need of premolar extraction and simplifying the orthodontic management.


Asunto(s)
Maloclusión de Angle Clase II , Maloclusión , Métodos de Anclaje en Ortodoncia , Sobremordida , Diente Premolar/cirugía , Estética Dental , Humanos , Técnicas de Movimiento Dental
20.
Orthod Fr ; 91(1-2): 101-114, 2020 06 01.
Artículo en Francés | MEDLINE | ID: mdl-33146125

RESUMEN

We could study Cone Beam documents of patients consulting in ORL with standard Angle Class I occlusion (45 ND), patients consulting in orthodontics with an orthodontic Class II (51 APNS) and patients with a surgical Class II (83 APS). The used 3D biometry calculates systematically a 164 set of parameters able to take into account all kinds of disharmonies; among which 38 parameters are specifically devoted to anterior-posterior "off asymmetry" pathologies. Then the specific Artificial Intelligence (AI) programs treat morphological data and give textual diagnoses. Analysis of the global sample aims to control the efficiency, separating different sub-samples one each other: t test appreciates efficiency of each parameter to recognize clinical sub-sample. The correlation coefficient, r, between each parameter and pseudo Angle molars Class II (GMMy-Gmmy) give the importance of its tie with Class II pathology. Presentation of parameters medium values in each sub-group gives the medium profiles. By direct comparison of patient's parameters values with medium profile, it is possible to locate patient's pathology. So we can take in account new parameters like arches upper/lower gap, anterior bases upper/lower gap, compensatingparameters... It is then possible to make more secure the clinical decision.


Asunto(s)
Inteligencia Artificial , Maloclusión de Angle Clase II , Biometría , Cefalometría , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Cráneo
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