Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.535
Filtrar
1.
Am J Orthod Dentofacial Orthop ; 159(1): e41-e48, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33223374

RESUMEN

INTRODUCTION: This research aimed to determine whether Class II malocclusion can be treated with clear aligners after completing treatment with the initial set of aligners. METHODS: A sample of 80 adult patients were divided into Group 1 with Class I molar malocclusions (n = 40 [11 men and 29 women]; 38.70 ± 15.90 years) and Group 2 with Class II molar malocclusions (n = 40 [11 men and 29 women]; 35.25 ± 15.21 years). All patients had finished treatment with the initial set of Invisalign aligners (Align Technology, Santa Jose, Calif) without known centric occlusion-centric relation discrepancies, issues of compliance, or overcorrection. The 7 measurements using the American Board of Orthodontics (ABO) Model Grading System and millimetric measurements for anteroposterior (AP) and vertical dimensions were assessed and compared between the 2 groups at pretreatment, posttreatment ClinCheck (Align Technology) prediction, and posttreatment. RESULTS: No improvements were observed in the AP correction. The amount of AP correction in patients with Class II malocclusion was 6.8% of the predicted amount. The amount of overbite correction achieved was 28.8% and 38.9% of the predicted amounts in patients with Class I and Class II malocclusion, respectively. Significant improvements in alignment and interproximal contact scores were observed, with only slight improvements in total ABO scores. An increase in mean occlusal contacts score was observed after treatment. No patient with Class II malocclusions would meet the ABO standards after Invisalign treatment. CONCLUSIONS: The Invisalign system successfully achieves certain tooth movements but fails to achieve other movements predictably. No significant Class II correction or overjet reduction was observed with elastics for an average of 7-month duration in the adult population. Additional refinements may be necessary to address problems created during treatment, as evidenced by a posterior open bite incidence.


Asunto(s)
Maloclusión de Angle Clase II , Maloclusión de Angle Clase I , Maloclusión , Aparatos Ortodóncicos Removibles , Adulto , Cefalometría , Femenino , Humanos , Masculino , Maloclusión/terapia , Maloclusión de Angle Clase II/terapia , Técnicas de Movimiento Dental
2.
Am J Orthod Dentofacial Orthop ; 159(1): e7-e16, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33234459

RESUMEN

INTRODUCTION: To evaluate the influence of compensatory tipping of maxillary and mandibular incisors on the anterior arch length ratio and canine relationship in skeletal Class II malocclusion. METHODS: The study was based on posttreatment lateral head films and dental casts of 88 patients. The sample was divided into a Class II malocclusion group (32 patients; ANB ≥5° and mean [± standard deviation] age, 20.82 ± 7.67 years) and a Class I malocclusion group (56 patients; 1° ≤ ANB ≤ 2.5° and mean [± standard deviation] age, 19.20 ± 5.04 years). Measurements obtained for anterior arch length and width, Bolton discrepancy, canine relationship, growth pattern, and incisor position were compared between the groups. The canine relationship was correlated with dental and skeletal variables (P <0.05). RESULTS: The mean ANB angles were 6.21° and 1.78° for the Class II and Class I malocclusion groups, respectively. The skeletal Class II group presented significantly larger mandibular anterior arch length, producing an unbalanced anterior arch length ratio. The canine relationship was more displaced toward Class II in this group. Anterior arch length ratio was the most influential variable in the canine relationship. The mandibular incisors had a higher compensation degree than the maxillary incisors. The groups were similar regarding overjet, overbite, and growth pattern. CONCLUSIONS: Class II malocclusion camouflage treatment with excessive proclination of the mandibular incisors was associated with an increase in mandibular arch length, negatively influencing the anterior arch length ratio and the final canine relationship. Mandibular anterior arch length reduction by interproximal stripping may be necessary in moderate to severe skeletal Class II malocclusion orthodontic treatment.


Asunto(s)
Maloclusión de Angle Clase II , Sobremordida , Adolescente , Adulto , Cefalometría , Arco Dental , Humanos , Maloclusión de Angle Clase II/terapia , Mandíbula , Maxilar , Diente Molar , Adulto Joven
3.
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
4.
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
5.
Niger J Clin Pract ; 23(11): 1624-1627, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33221792

RESUMEN

This report describes the successful use of two multifunctional mini-implants that were inserted into the palate in the treatment of an 18-year-old woman in whom the maxilla was skeletally narrowed and the molars have migrated mesially on both sides. Three different appliances were used in sequence in the course of treatment: first, an appliance supported by bone and teeth (hybrid hyrax) for surgically-assisted rapid maxillary expansion (SARME); second, a distalization device supported by mini-implants to achieve molar distalization; and third, a transpalatal arch (TPA) stabilized by mini-implants to allow indirect anchorage during retraction of the incisors. The mini-implants in the palate led to a reduction in the adverse effects of the SARME procedure and made treatment with cervical headgear unnecessary. TPA stabilized by the mini-implant was also used to retract the anterior teeth en masse, with no need for alterations in the treatment mechanism and using routine orthodontic methods.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Maxilar/cirugía , Métodos de Anclaje en Ortodoncia/instrumentación , Técnicas de Movimiento Dental/métodos , Adolescente , Cefalometría/métodos , Constricción , Femenino , Humanos , Incisivo , Diente Molar/patología , Técnica de Expansión Palatina , Paladar (Hueso) , Radiografía Dental , Técnicas de Movimiento Dental/instrumentación , Resultado del Tratamiento
6.
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
7.
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
8.
Shanghai Kou Qiang Yi Xue ; 29(3): 281-286, 2020 Jun.
Artículo en Chino | MEDLINE | ID: mdl-33043345

RESUMEN

PURPOSE: To investigate the effect of extraction on condylar process position and upper airway in 12-14 years old females with skeletal ClassⅡhigh angle. METHODS: Twenty seven 12-14 years old females with skeletal ClassⅡhigh angle (experimental group) and 30 physical examinees without malocclusion (control group) in Stomatology Hospital Affiliated to Southwest Medical University from January 2016 and June 2017 were enrolled. All patients received cone-beam CT (CBCT) examinations. Mimics 20.0 was used to process the data. The changes of the condylar process position and upper airway were recorded. The data were analyzed using SPSS 20.0 software package. RESULTS: Before treatment, patients in the experimental group had higher Sa as well as lower Sp than those of the control group (P<0.05), but with no difference in Su between 2 groups before treatment (P>0.05). After treatment, Sa was decreased in the experimental group (P<0.05), but no change was observed in Sp and Su(P>0.05). After treatment, the joint space indexes were increased in the experimental group (P<0.05). Before treatment, the V total, V tongue, V mouth, and SMIN in the experimental group were significantly lower than those of the control group (P<0.05). Before treatment, V nose, V palate, V larynx, APTE, APHP and APSP in the experimental group showed no difference with those of the control group (P>0.05). V nose, V larynx, APHP and APTE showed no difference before and after treatment within the experimental group (P>0.05). After treatment, the V total, V tongue, V palate, V mouth, SMIN and APSP in the experimental group were significantly increased (P<0.05). CONCLUSIONS: Extraction treatment can widen the airway, suggesting that there may be a certain correlation between the changes of condyle position and upper airway volume.


Asunto(s)
Laringe , Maloclusión de Angle Clase II , Maloclusión , Adolescente , Niño , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Boca
9.
J Contemp Dent Pract ; 21(6): 666-672, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33025936

RESUMEN

AIM: The development of a class II malocclusion is usually related to a reduced oropharyngeal airway space. In order to prevent airway obstruction, functional appliances are commonly used for orthodontic therapy. The aim of the article is to verify if these appliances could positively influence oropharyngeal diameters preventing the onset of future respiratory disorders. MATERIALS AND METHODS: A group of 10 patients treated at the Dental Clinic of San Gerardo Hospital in Monza with mandibular activator was selected. Ten similar untreated class II subjects with retrognathic mandible were used as control group. The cephalometric tracings were made on lateral teleradiographs of the skull before and after the active therapy with functional devices for the treated group and before and after growth peak for the control one. Descriptive statistical analysis was calculated for all the cephalometric values in both study cases and control group using Excel worksheet. The data distribution was evaluated with Shapiro-Wilk test and the in-between group discrepancies were evaluated with Mann-Whitney U test. RESULTS: At T1 period, both case and control groups showed a class II pattern. At T2 period, the study group shows an improvement in bones relationship with reduced ANB angles and OVJ measurements. The control group otherwise did not show any important changes in maxillo-mandibular discrepancies. The airway size increased in either group in most cases. No significant differences between the treated and control groups were detected for airway size neither in the upper, middle, nor lower level at the T1-T2 interval. CONCLUSION: The upper airway values did not show any significant discrepancies between the two groups during the observation period. CLINICAL SIGNIFICANCE: Functional devices were effective in solving class II relationships, but there is no evidence of successful breathing disorders prevention by using mandibular activators, probably due to the stability of airway tissues reached in pubertal age in both groups.


Asunto(s)
Maloclusión de Angle Clase II , Faringe , Cefalometría , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Mandíbula/diagnóstico por imagen , Estudios Retrospectivos
10.
Am J Orthod Dentofacial Orthop ; 158(5): 684-693, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33010980

RESUMEN

INTRODUCTION: This retrospective pilot study assessed the pre- and posttreatment lip profile changes among adult patients with Class II Division 1 malocclusion of varied growth patterns and compared these changes with patients with a skeletal Class I relationship, to identify the dental, skeletal, and soft tissue cephalometric variables that altered the posttreatment lip profile. METHODS: A total of 33 digital cephalograms were divided into 4 study groups based on the mandibular plane (Mp-SN) angle: group 1 (control, skeletal Class I; mean angle = 21.5°) (n = 8), group 2 (Class II Division 1 malocclusion; low angle = <26°) (n = 8), group 3 (Class II Division 1 malocclusion; intermediate angle = 26°-38°) (n = 9), and group 4 (Class II Division 1 malocclusion; high angle = >38°) (n = 8). RESULTS: We observed a significant decrease in SNA, ANB, maxillary incisor to NA (degrees and millimeters), and soft tissue parameters, especially lip strain and lower lip to E line and upper lip to E line. Posttreatment intergroup comparison showed a significant increase of Mp-SN, and this increase was greater in group 3, followed by group 4 as compared with group 1. In addition, statistically significant differences in SNA, ANB, mandibular incisor to NB (degrees) and IMPA, and H angle in groups 2-4 were observed. CONCLUSIONS: Patients with Class II Division 1 malocclusion showed a significant decrease in SNA, ANB, maxillary incisor to NA, and all soft tissue parameters in posttreatment compared with group 1. Thus, the soft tissue changes resulted in a similar profile to patients in group 1, who are considered to have an aesthetically pleasing posttreatment profile.


Asunto(s)
Labio , Maloclusión de Angle Clase II , Adulto , Diente Premolar/cirugía , Cefalometría , Humanos , Labio/anatomía & histología , Labio/diagnóstico por imagen , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Proyectos Piloto , Estudios Retrospectivos
11.
Am J Orthod Dentofacial Orthop ; 158(4): 518-526, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32988567

RESUMEN

INTRODUCTION: This study aimed to evaluate the effects of 3 different fixed or removable functional appliances on the soft tissue changes in patients with Class II Division 1 malocclusion using 3-dimensional images. METHODS: A total of 60 patients with Class II Division 1 malocclusion (38 girls and 22 boys; mean age, 12.35 ± 1.01 years) were treated with 3 different functional appliances, namely, Twin-block (TB) (group TB, n = 20), mono-block (MB) (group MB, n = 20), or Herbst (H) (group H, n = 20) for 9.55 ± 1.46 months. Three-dimensional photographs of each patient were taken at the baseline and the end of the therapy with a 3dMD Face system (3dMD, Atlanta, Ga). Statistical analyses were performed using the dependent samples t test, 1-way analysis of variance, Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed rank tests. RESULTS: No statistically significant differences were detected for soft tissue changes except for the lower facial width found, at least in group H (P <0.05). Volumetric differences in the mandible were similar between the groups (P >0.05). A statistically significant decrease in total facial height and an increase in convexity angle and facial depth were detected in all groups after treatment compared with the baseline (P <0.05). The upper and lower facial height, lower lip height, and nasal width were statistically significantly increased in the TB and MB groups after treatment compared with the baseline (P <0.05) and similar to those in group H (P >0.05). CONCLUSIONS: TB, MB, and H appliances may promote the facial soft tissue profile, including volumetric improvement, in the mandibular region.


Asunto(s)
Cara/anatomía & histología , Cara/diagnóstico por imagen , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Adolescente , Cefalometría , Niño , Femenino , Humanos , Labio/diagnóstico por imagen , Masculino , Mandíbula
12.
Am J Orthod Dentofacial Orthop ; 158(4): 599-611, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32988568

RESUMEN

Growth modification is a feasible approach for the treatment of skeletal Class II malocclusion. A positive association was found between the lateral functional shift of the mandible due to occlusal prematurities and skeletal changes. This finding is reminiscent of an equivalent anteroposterior skeletal effect of the anterior functional shift of the mandible. Inclined planes can be considered as a form of premature contact. In this case, bonded occlusal maxillary and mandibular bite raisers were used to create occlusal prematurities artificially. These bonded inclined bite raisers are used in conjunction with full-time light short Class II elastics. The results showed an improvement in profile convexity and achievement of Class I canines and molars. The bonded inclined bite raisers combined with light and short intermaxillary elastics can correct Class II malocclusion and improve the soft tissue profile.


Asunto(s)
Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Cefalometría , Oclusión Dental , Humanos , Mandíbula , Maxilar
13.
Am J Orthod Dentofacial Orthop ; 158(4): e17-e27, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32863088

RESUMEN

INTRODUCTION: The objective of this research was to evaluate the treatment outcomes, long-term occlusal changes, and patient satisfaction after 37 years of nonextraction and extraction treatments. METHODS: Fifty-seven patients with Class I and Class II malocclusion were divided into 2 groups. Group 1 included 16 patients treated with nonextraction therapy, with mean initial (T1), final (T2), and long-term posttreatment (T3) ages of 13.2, 15.0, and 50.3 years, respectively. Mean treatment time (T2 - T1) and long-term follow-up time (T3 - T2) were 1.8 and 35.2 years, respectively. Group 2 included 41 patients treated with extraction of 4 first premolars, with mean ages at T1, T2, and T3 of 13.3, 15.6, and 53.6 years, respectively. Mean treatment (T2 - T1) and long-term follow-up (T3 - T2) times were 2.3 and 37.9 years, respectively. The Peer Assessment Rating (PAR) index and Objective Grading System (OGS) indexes were evaluated at T1, T2, and T3 stages. The subjects also answered an online questionnaire regarding esthetic and occlusal self-perception at T3. Intergroup comparison was performed with t tests. RESULTS: The PAR index improved with treatment and similarly worsened at T3 for both groups. OGS scores were close to the passing score at T2 for both groups. The nonextraction group presented worse OGS scores at T3 than the extraction group. Nonextraction patients perceived more changes in alignment over time, but overall satisfaction was similar. CONCLUSIONS: The PAR index improved with treatment, and the PAR and OGS scores showed a significant increase, indicating great occlusal changes in the long-term stage. The nonextraction group showed more occlusal changes and perceived more changes in their alignment over time, but overall patient satisfaction was similar in both groups.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Satisfacción del Paciente , Diente Premolar , Estética Dental , Humanos , Persona de Mediana Edad , Ortodoncia Correctiva , Extracción Dental , Resultado del Tratamiento
14.
Am J Orthod Dentofacial Orthop ; 158(4): 477-494.e7, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32888735

RESUMEN

INTRODUCTION: We aimed to explore the prevalence and nature of complications associated with Class II correctors in adolescents and their impact on the quality of life (QOL), completion of treatment, and success rate. METHODS: The review was registered in PROSPERO, and a comprehensive electronic search was performed without language or date restrictions. Randomized and nonrandomized trials, prospective cohort and cross-sectional studies, case series, and qualitative research were included. The Cochrane Collaboration's risk of bias tool and the Newcastle-Ottawa scale were used to assess the quality of included studies. Data were grouped according to appliances design: removable functional, fixed functional, hybrid functional, headgear, and fixed maxillary molar distalization appliances. RESULTS: Data from 27 studies were included, of which 11 were deemed eligible for meta-analysis. Overall, 1676 adolescents were included related to fixed functional (n = 682), removable functional (n = 682), hybrid functional (n = 84), headgear (n = 186), and Carriere (n = 42) appliances. The mean number of emergencies was 0.8 (95% confidence interval [CI], 1.1-2.1) and 2 (95% CI, 0.9-3.0) for removable and fixed designs, respectively. However, the rate of discontinuation was 35% (95% CI, 0.28-0.42) and just 1% (95% CI, 0.01-0.1) for removable and fixed designs, respectively. Other QOL dimensions such as eating, sleep, speech, and emotional domains were significantly impaired during treatment with removable functional appliances. CONCLUSIONS: Removable Class II correctors were associated with a high rate of treatment discontinuation, most likely because of the negative impact on QOL and lack of compliance. More complications were observed with fixed designs, although this did not impact the overall success rates. Further prospective studies are needed to explore patient perceptions and cost-effectiveness to inform treatment decisions better.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Calidad de Vida , Adolescente , Estudios Transversales , Humanos , Diente Molar , Estudios Prospectivos
15.
Am J Orthod Dentofacial Orthop ; 158(4): 505-517.e6, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32828608

RESUMEN

INTRODUCTION: The purpose of this study was to quantify and qualify the 3-dimensional (3D) condylar changes using mandibular 3D regional superimposition techniques in adolescent patients with Class II Division 1 malocclusions treated with either a 2-phase or single-phase approach. METHODS: Twenty patients with Herbst appliances who met the inclusion criteria and had cone-beam computed tomography (CBCT) images taken before, 8 weeks after Herbst removal, and after the completion of multibracket appliance treatment constituted the Herbst group. They were compared with 11 subjects with Class II malocclusion who were treated with elastics and multibracket appliances and who had CBCT images taken before and after treatment. Three-dimensional models generated from the CBCT images were registered on the mandible using 3D voxel-based superimposition techniques and analyzed using semitransparent overlays and point-to-point measurements. RESULTS: The magnitude of lateral condylar growth during the orthodontic phase (T2-T3) was greater than that during the orthopedic phase (T1-T2) for all condylar fiducials with the exception of the superior condyle (P <0.05). Conversely, posterior condylar growth was greater during the orthopedic phase than the subsequent orthodontic phase for all condylar fiducials (P <0.05). The magnitude of vertical condylar development was similar during both the orthopedic (T1-T2) and orthodontic phases (T2-T3) across all condylar fiducials (P <0.05). Posterior condylar growth during the orthodontic phase (T2-T3) of the 2-phase approach decreased for all condylar fiducials with the exception of the posterior condylar fiducial (P <0.05) when compared with the single-phase approach. CONCLUSIONS: Two-phase treatment using a Herbst appliance accelerates condylar growth when compared with a single-phase regime with Class II elastics. Whereas the posterior condylar growth manifested primarily during the orthopedic phase, the vertical condylar gains occurred in equal magnitude throughout both phases of the 2-phase treatment regime.


Asunto(s)
Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Aparatos Ortodóncicos Funcionales , Adolescente , Cefalometría , Tomografía Computarizada de Haz Cónico , Humanos , Mandíbula
16.
Rev. ADM ; 77(4): 216-221, jul.-ago. 2020. ilus, tab
Artículo en Español | LILACS | ID: biblio-1130113

RESUMEN

Los pacientes con problemas esqueléticos clase II que han terminado su crecimiento, generalmente, se tratan con cirugía ortognática o extracciones de piezas dentarias. Un objetivo del tratamiento es obtener estabilidad a largo plazo. El presente caso clínico es de un paciente masculino de 15 años de edad con clase II esquelética sagital que se realizó desprogramación neuromuscular con un plano de acrílico, que permitió determinar la verdadera discrepancia intermaxilar y obtener que la articulación temporomandibular estuviera en una posición estable en relación céntrica del paciente previo a su tratamiento ortodóncico prequirúrgico (AU)


In patients with class II skeletal problems who have finished their growth; they are treated with orthognathic surgery or dental extractions usually. One treatment goal is to obtain long-term stability. The present case report is of a 15 years old male patient with skeletal sagittal class II who underwent neuromuscular deprogramming with an acrylic plane, which allowed to determine the true skeletal discrepancy and achieve a stable position of the temporomandibular joint in centric relation before the orthodontic treatment (AU)


Asunto(s)
Humanos , Masculino , Adolescente , Relación Céntrica , Ferulas Oclusales , Cirugía Ortognática , Maloclusión de Angle Clase II/terapia , Planificación de Atención al Paciente , Articulación Temporomandibular/fisiopatología , Cefalometría , Manifestaciones Neuromusculares , México
17.
J Oral Rehabil ; 47(11): 1337-1345, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32813880

RESUMEN

BACKGROUND: Skeletal Class II subjects present often a retruded mandible that might increase the probability of breathing disorders. OBJECTIVE: To evaluate the effects of functional treatment by means of the Sander bite-jumping appliance (BJA) on the upper airways of growing subjects. METHODS: Thirty-four subjects (21 males, 13 females; mean age 11.1 ± 1.2 years) with skeletal Class II malocclusion due to mandibular retrusion were treated with the Sander BJA (BJA group). The control group consisted of thirty-four untreated subjects with skeletal Class II malocclusion (25 males, 9 females; 10.4 ± 1.2 years; CTR group). The effect of the Sander BJA appliance on the airway dimensions was evaluated by comparing lateral cephalograms recorded before (T0) and after (T1) the period of observation/treatment. Within- and between-group comparisons were statistically evaluated according to the distribution of the data (P < .05). RESULTS: The oropharyngeal region (ph_pph) increased in the BJA group (1.8 ± 3.2; P = .001) but the difference respect to the CTR group was not statistically significant (0.73 ± 4.0; P = .314; P = .077). The tongue height (th) increased in the BJA group (2.8 ± 3.7; P < .001), and this increase was statistically significant respect to the CTR group (0.6 ± 4.7; P = .461; P = .038). In the BJA, the Ans_Pns_P angle showed a statistically significant decrease (-3.8 ± 7.8; P = .007) compared to the CTR group (-0.1 ± 5.4; P = .705; P = .026). CONCLUSIONS: The airway dimensions increased for both control subjects and Class II patients treated with Sander BJA due to physiological growth. The Sander BJA induced a statistically significant change in the tongue and soft palate position, but the clinically relevant of these changes is questionable.


Asunto(s)
Mordeduras y Picaduras , Maloclusión de Angle Clase II , Estudios de Casos y Controles , Cefalometría , Niño , Femenino , Humanos , Masculino , Maloclusión de Angle Clase II/terapia , Mandíbula , Estudios Retrospectivos
18.
Am J Orthod Dentofacial Orthop ; 158(4): e5-e15, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32843251

RESUMEN

INTRODUCTION: The objective of this research was to evaluate the anterior tooth alignment and dental arch dimension changes after orthodontic treatments with and without premolar extractions in the long-term. METHODS: Fifty-seven patients with Class I and Class II malocclusion were divided into 2 groups. Group 1 included 16 patients treated with nonextraction therapy, with mean initial (T1), final (T2), and long-term follow-up (T3) ages of 13.20 years, 15.07 years, and 50.32 years, respectively. The mean treatment (T2 - T1) and long-term follow-up (T3 - T2) times were 1.86 years and 35.25 years, respectively. Group 2 included 41 patients treated with extraction of 4 first premolars, with T1, T2, and T3 ages of 13.31 years, 15.63 years, and 53.60 years, respectively. The mean treatment and long-term follow-up times were 2.32 years and 37.96 years, respectively. The mean retention time was 2.26 years for both groups. The dental casts were obtained and digitized at T1, T2, and T3 stages. The following measurements were obtained: Little irregularity index, arch length, perimeter, and intercanine, interpremolar, and intermolar widths. Intragroup and intergroup comparisons were performed with repeated measures analysis of variance and t tests, respectively. RESULTS: Anterior tooth irregularity index increased at T3 in both groups. In addition, all arch dimensions, except the intercanine width, were significantly smaller in the extraction group at T3. Both groups showed similar arch dimension changes at T3, except for the mandibular arch perimeter. The percentage of mandibular anterior tooth alignment change was significantly greater in the nonextraction than in the extraction group. CONCLUSIONS: There was no difference in the changes of anterior alignment and transverse arch dimensions in patients treated with and without premolar extraction at T3, but the percentage of mandibular anterior tooth alignment changes was higher in the nonextraction than in the extraction patients at T3. The mandibular arch perimeter showed more of a decrease at T3 in extraction patients.


Asunto(s)
Arco Dental/diagnóstico por imagen , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Adolescente , Diente Premolar/cirugía , Cefalometría , Estudios de Seguimiento , Humanos , Extracción Dental
19.
Artículo en Inglés | MEDLINE | ID: mdl-32580312

RESUMEN

(1) Background: The nature of the changes that contribute to Class II correction with functional appliances is still controversial. A broad variation in treatment responses has been reported. The purpose of this study was to find cephalometric predictors for individual patient responsiveness to twin-block treatment in patients with Class II Division 1 malocclusion; (2) Methods: The study was performed on a sample of 39 pubertal patients (21 females, 18 males) treated with the twin block appliance. Lateral cephalograms were available at the start of the treatment (T1) and at the end of functional therapy (T2). The outcome variable was the T2-T1 change in the sagittal position of the soft tissue pogonion with respect to the vertical line perpendicular to the Frankfort plane and passing through point subnasale. The predictive variables were age, gender at T1, and all the cephalometric parameters measured T1. Forward stepwise linear regression with p value to enter 0.05 and p value to leave 0.10 was applied; (3) Results: The only significant predictive variable that was selected was the Co-Go-Me angle (p = 0.000); (4) Conclusions: A greater advancement of the soft tissue chin on the profile is expected with smaller pretreatment values of Co-Go-Me angle.


Asunto(s)
Maloclusión de Angle Clase II , Cefalometría , Femenino , Predicción , Humanos , Masculino , Maloclusión de Angle Clase II/terapia , Modelos Teóricos , Resultado del Tratamiento
20.
Orthod Craniofac Res ; 23(4): 371-384, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32390332

RESUMEN

To systematically review the effects of functional appliances (FA) using incremental vs maximal mandibular advancement regarding cephalometric measurements in class II malocclusion individuals and to assess patient-centred-outcomes. Six electronic databases were searched without restrictions up to April 2020. We included randomized and non-randomized controlled trials using identical FA. Trials involving participants who used adjunct appliances, inter-maxillary elastics, who received surgical treatment or that recruited individuals with cleft lip/palate or craniofacial deformity/syndrome were excluded. Risks of bias assessments were performed using the Cochrane risk of bias tool-2 and ROBINS-I tools. Mean differences (MD) with their 95% confidence intervals were calculated from random-effects meta-analyses. The GRADE tool was used to assess the certainty of the evidence. Six studies were included. Low to very low certainty of evidence indicated that incremental mandibular advancement resulted in greater gains in mandibular length (MD = 0.89 [0.38, 1.34], P = .0005), anterior mandibular displacement (MD = 0.73 [0.40, 1.06], P < .0001) and SNB angle (MD = 0.44 [0.02, 0.85], P = .04). No significant differences were found for maxillary, dento-alveolar and upper airway outcomes between construction bite protocols (P > .05). Study design and appliance-related factors influenced the results of the subgroup analyses. Existing evidence is inadequate to assess patient-related response and long-term outcome could not be assessed. Currently, there are a heterogeneous number of studies with low quality and methodological issues can lead to biases that strongly limit an evidence-based conclusion. Weak evidence suggests gains in mandibular skeletal parameters in the short term using FA with incremental mandibular advancement. Randomized trials evaluating key topics such as patient-centred outcomes need to be conducted to guide clinical management. PROSPERO (CRD42019147436).


Asunto(s)
Maloclusión de Angle Clase II , Avance Mandibular , Aparatos Ortodóncicos Funcionales , Cefalometría , Humanos , Maloclusión de Angle Clase II/terapia , Mandíbula
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA