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1.
Shanghai Kou Qiang Yi Xue ; 30(1): 81-84, 2021 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-33907785

RESUMO

PURPOSE: To investigate the effect of early correction with Twin-block appliance on soft and hard tissues of patients with Class Ⅱ skeletal malocclusion. METHODS: Sixty patients with Angle Class Ⅱ skeletal malocclusion were prospectively selected. The patients were divided into 2 groups, 30 cases in each group, by random number table method. Patients in the experimental group were treated with a Twin-block appliance combined with straight wire appliance, while patients in the control group were treated with a straight wire appliance. The soft and hard tissue indexes(SNA, SNB, ANB, U1-NA angle, U1-NA distance, L1-NB distance, L1-NB angle, U1-L1) before, and 12 months after treatment were measured. Soft tissue measurement indicators included UL-U1, LL-L1, over jet, overbite, E-upper-lip from the upper lip to the E-line, and the lower lip to the E-line, changes in the vertical distance (E-lower-lip), the dip angle of the sulcus, and the thickness of the soft tissue. SPSS 25.0 software package was used for statistical analysis of the data. RESULTS: U1-NA, U1-NA, L1-NB, L1-NB, overjet, overbite, E-upper-lip, and E-lower-lip were significantly less than the control group at 12 months and 36 months after treatment in the experimental group(P<0.05). U1-L1, nasolabial angle, sulcus angle, and soft tissue thickness of the experimental group were significantly greater than those of the control group(P<0.05). CONCLUSIONS: Twin-block appliance combined with straight wire appliance can significantly improve the relationship between the jaw and the soft and hard tissues of patients with Class Ⅱ skeletal malocclusion, and the long-term effect is good.


Assuntos
Má Oclusão de Angle Classe II , Má Oclusão , Sobremordida , Cefalometria , Humanos , Má Oclusão de Angle Classe II/terapia , Mandíbula
2.
Orthod Fr ; 92(1): 17-28, 2021 Mar 01.
Artigo em Francês | MEDLINE | ID: mdl-33871368

RESUMO

The aesthetic and functional success of mandibular advancement surgery often depends on the quality of the orthodontic preparation that preceded it. In order to be optimal, this preparation must try to reproduce a class II malocclusion equivalent to the sagittal skeletal discrepancy, to allow a surgical procedure of sufficient amplitude. The aim of this article is to present, thanks to a clinical case, a new mandibular posterior anchorage device, called Abalakov, used in the context of these preparations. The modalities of placement and use of this simple osteosynthesis wire, placed in the anterior part of the ramus, are exposed step by step, until the final result is obtained. The advantages and effectiveness of the technique are then discussed and compared with other treatment alternatives. It can be concluded that this new device is a simple, comfortable, inexpensive and above all reproducible and highly effective means of distalization of the mandibular arch, with clear uprighting of the incisors.


Assuntos
Má Oclusão de Angle Classe II , Procedimentos de Ancoragem Ortodôntica , Cefalometria , Estética Dentária , Humanos , Incisivo , Má Oclusão de Angle Classe II/terapia , Mandíbula
6.
Eur J Paediatr Dent ; 22(1): 26-30, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33719479

RESUMO

AIM: The current study aimed to analyse the dentoskeletal effects of the Invisalign mandibular advancement (MA) device in the treatment of skeletal Class II malocclusions. MATERIALS AND METHODS: Pre-treatment and post-treatment lateral skull radiographs from patients treated with MA versus TB (Twin-Block Appliance) at the Department of Orthodontics of the University of L'Aquila, Italy, were traced. Eligibility criteria included SNB<78; ANB>4; no previous orthodontic treatments; and vertebral maturation stage (CVM) CS3. Radiographs from patients with craniofacial anomalies, or who underwent extraction treatments, were excluded. Totally, 20 patients were examined, 10 of whom treated with MA and 10 treated with TB. All the radiographs were traced by one expert operator, blind to the groups. A preliminary method error study was performed to exclude intra-operator differences. RESULTS: Baseline characteristics of the participants were similar between the groups. Both appliances demonstrated a reduction of SNB and ANB angle, and a decrease in overjet. TB demonstrated a higher efficacy in increasing mandibular dimensions. A significant retroinclination of the upper incisive was observed in the TB group, where a decrease of SNA angles was additionally observed. The resulting differences between the two groups could be attributed to the different design of the appliances. CONCLUSIONS: The present data show the effectiveness of both TB and MA in the management of skeletal Class II malocclusions due to mandibular retrusion. But some differences exist in the dentoalveolar effect of the two appliances. MA seems indicated in Class II cases where a control of the upper frontal teeth position is needed.


Assuntos
Má Oclusão de Angle Classe II , Avanço Mandibular , Aparelhos Ortodônticos Funcionais , Aparelhos Ortodônticos Removíveis , Cefalometria , Humanos , Itália , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula , Estudos Retrospectivos , Resultado do Tratamento
7.
Orthod Fr ; 92(1): 129-140, 2021 Mar 01.
Artigo em Francês | MEDLINE | ID: mdl-33787498

RESUMO

The objective of this case series was to show how only one miniscrew can be used to treat simultaneously or successively canine impaction and different malocclusions. Three patients aged of 13 years old who had malocclusions, such as Class II, overbite and canine impaction, were each one treated with the same miniscrew throughout the treatment period. Palatal miniscrews were placed mesially to the first molar and used as a direct or indirect anchorage depending on the moment of the treatment. In each case, satisfactory treatment was obtained with correction of overbite, class II malocclusion and canine impaction. The first steps of treatment were aesthetic for the patient and did not require patient cooperation.


Assuntos
Má Oclusão de Angle Classe II , Procedimentos de Ancoragem Ortodôntica , Adolescente , Idoso , Parafusos Ósseos , Cefalometria , Estética Dentária , Humanos , Má Oclusão de Angle Classe II/terapia , Técnicas de Movimentação Dentária
8.
Head Face Med ; 17(1): 4, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546715

RESUMO

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.


Assuntos
Má Oclusão de Angle Classe II , Má Oclusão , Aparelhos Ortodônticos Funcionais , Criança , Feminino , Humanos , Masculino , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Postura , Estudos Retrospectivos
10.
Am J Orthod Dentofacial Orthop ; 159(5): 594-603, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33563504

RESUMO

INTRODUCTION: This study aimed to test whether control in maxillary and mandibular incisor position, during treatment with an acrylic splint Herbst appliance, could influence the mandibular response in growing patients with skeletal Class II malocclusion. METHODS: The lateral cephalograms of 61 patients (mean age, 12.3 years; standard deviation, 1.6) with skeletal and dental Class II malocclusion were retrospectively analyzed both at baseline and after Herbst appliance removal, using a modified Pancherz cephalomeric analysis. Forty-five patients had received miniscrew in the mandibular arch to control mandibular incisor anchorage. In 21 patients, the maxillary incisors had been proclinated before starting the treatment for deepbite and maxillary incisor lingual inclination. All the patients were categorized a posteriori into 2 homogeneous groups, according to dental overjet reduction: 30 patients with dental overjet reduction (DR) and 31 patients without dental overjet reduction (NDR). RESULTS: Both groups presented a significant skeletal correction. However, the change was significantly greater in the NDR group than in the DR group (P <0.01). The mandibular bone base reached a median value of 4.0 mm (interquartile range, 2.5) in the NDR group vs 1.1 mm (interquartile range, 2.8) in the DR group (P <0.001). The 2 groups were also significantly different in terms of the positional change of maxillary incisor, which was proclinated in group NDR and lingualized in group DR (P <0.001). CONCLUSIONS: The results showed that dental control of overjet was beneficial to improve the effectiveness of Herbst treatment in increasing mandibular length in growing patients with skeletal Class II malocclusion.


Assuntos
Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Cefalometria , Criança , Humanos , Incisivo , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula/diagnóstico por imagem , Maxila , Estudos Retrospectivos
11.
Am J Orthod Dentofacial Orthop ; 159(4): 470-479, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33558030

RESUMO

INTRODUCTION: The aims of this study were to evaluate the long-term skeletodental effects, the volume of maxillary tuberosity, and airway space changes after maxillary molar distalization using modified C-palatal plate (MCPP) in adolescents with Class II malocclusion. METHODS: The sample consisted of 20 adolescent patients (MCPP group; mean age, 12.9 ± 1.0 year) who underwent bilateral distalization of their maxillary dentition and 20 subjects as a control group. In the MCPP group, cone-beam computed tomography images were taken before distalization, at the end of the treatment, and during retention with a minimum of a 3-year posttreatment follow up period. Repeated measures ANOVA followed by post-hoc analysis with the Bonferroni test were used to identify significant differences between time points. RESULTS: After the long-term observation period, sagittal skeletal and dental relationships were maintained (there were no significant changes in ANB, occlusal plane angle, and overjet postretention). The vertical skeletal dimension did not change during treatment and was stable at the long-term follow-up (the mandibular plane angle and ANS-Me were relatively well maintained). The volume of the maxillary tuberosity showed no significant change during long-term retention. However, the volume was significantly smaller in the treatment group than in the control group (P <0.0001). There were no significant airway space changes after distalization and the postretention period. In addition, there was no significant difference between the MCPP and control groups. CONCLUSIONS: Improved sagittal skeletal and dental relationships because of treatment were maintained in the long-term evaluation. There was no negative long-term effect on airway space associated with the maxillary arch distalization. Therefore, these findings might be beneficial for clinicians in diagnosis and treatment planning for Class II malocclusion in adolescents.


Assuntos
Má Oclusão de Angle Classe II , Técnicas de Movimentação Dentária , Adolescente , Cefalometria , Criança , Tomografia Computadorizada de Feixe Cônico , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Maxila/diagnóstico por imagem , Desenho de Aparelho Ortodôntico
12.
Am J Orthod Dentofacial Orthop ; 159(3): 333-342, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33541786

RESUMO

INTRODUCTION: The purpose of this study was to evaluate the effects of 2 extraction patterns on incisor and molar movements in patients with growing Class II Division 1. METHODS: The sample included 54 patients 10-17 years of age treated by 2 private practice orthodontists using Tweed directional force mechanics, 4 premolar extractions, J-hook headgears, and Class II elastics or Saif springs. The sample was divided on the basis of having maxillary and mandibular first premolars (4/4) or maxillary first and mandibular second premolars (4/5) extracted. Each group included 27 patients. Treatment lasted 2.8 ± 0.60 years and 2.6 ± 0.54 years for the 4/4 and 4/5 groups, respectively. Pretreatment (T1) and posttreatment lateral cephalograms and dental casts were evaluated. Cranial base, mandibular, and maxillary superimpositions were performed to quantify tooth movements and displacements. RESULTS: There were no statistically significant T1 between-group differences in crowding or in the SNA, SNB, ANB, and MPA angles. Analyses of covariance, controlling for statistically significant (P <0.05) differences in T1 mandibular incisor position, showed that mandibular first premolars extractions produced greater (1.6 mm) mandibular incisor retraction than second premolar extractions. The mandibular first molars were protracted significantly more (0.7 mm) after the second premolar than the first premolar extractions. Within-group changes of the MPA, between-group differences in the changes in MPA, and the amount of vertical eruption of the maxillary and mandibular molars were not significantly different between the 2 extraction patterns. CONCLUSIONS: Extraction of mandibular second premolars enhances Class II molar correction, with greater mesial first molar movement and less distal incisor movement. Neither extraction pattern has an effect on the MPA or the vertical dimension (ie, there was no "wedge effect").


Assuntos
Má Oclusão de Angle Classe II , Mandíbula , Dente Pré-Molar/cirurgia , Cefalometria , Humanos , Má Oclusão de Angle Classe II/terapia , Maxila , Dente Molar , Extração Dentária , Técnicas de Movimentação Dentária
13.
Am J Orthod Dentofacial Orthop ; 159(2): 202-209.e2, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33388198

RESUMO

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.


Assuntos
Arco Dental , Má Oclusão de Angle Classe II , Canadá , Cefalometria , Arco Dental/diagnóstico por imagem , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem
14.
Angle Orthod ; 91(2): 149-156, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33434285

RESUMO

OBJECTIVES: To determine dentoalveolar and skeletal effects produced in mature patients by the Carriere Motion Class III (CM3) appliance followed by fixed appliances. MATERIALS AND METHODS: This retrospective study evaluated 32 patients at three time points: T1 (initial), T2 (removal of CM3), and T3 (posttreatment). Serial cephalograms were traced and digitized, and best-fit regional superimpositions were constructed. Eleven linear and 7 angular variables were measured. The starting forms of the CM3 patients were compared with a sample of untreated subjects with normal occlusions and well-balanced faces. RESULTS: The CM3 phase lasted 6.3 months, followed by a phase of fixed appliances lasting 12.9 months; the total duration of treatment was 19.2 months. Minimal skeletal changes were measured sagittally, with only a slight increase in lower anterior facial height observed during treatment. Most treatment changes were dentoalveolar in nature. Wits appraisal increased 4.0 mm during treatment. The molar relationship improved by 6.0 mm during phase I, a value that rebounded slightly during phase II, resulting in an improvement toward Class I of 4.8 mm. Best-fit regional superimpositions revealed anterior movement of upper molars relative to the maxilla and posterior movement of lower molars relative to the mandible. CONCLUSIONS: The Carriere Motion Class III appliance is an effective and efficient method of resolving occlusal problems in minimally growing Class III patients. Primary treatment effects are dentoalveolar in nature with minimal skeletal alterations.


Assuntos
Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Adolescente , Adulto , Cefalometria , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula , Maxila , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Fixos , Estudos Retrospectivos
15.
Am J Orthod Dentofacial Orthop ; 159(3): 292-304, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33487502

RESUMO

INTRODUCTION: The purpose of this prospective clinical trial is to evaluate the changes of soft tissues and designate the esthetic perceptions of children with Class II malocclusion after Herbst appliance therapy and maxillary molar distalization using stereophotogrammetry. METHODS: Thirty patients were allocated either to Herbst (6 boys and 9 girls; mean age = 11.60 ± 0.82 years) or distalization (4 boys and 11 girls; mean age = 11.46 ± 1.30 years) groups. Dentoskeletal and soft-tissue treatment changes were examined objectively by cephalometric analysis and stereophotogrammetry, respectively. Pre- and posttreatment profile views were evaluated subjectively by orthodontists and laypeople using the 7-point Likert scale. Intra- and intergroup comparisons for the repeated measurements were performed with 2-way variance analysis. Bonferroni test was used for multiple comparisons (P ≤0.05). RESULTS: Greater skeletal changes were observed in the Herbst group than in the distalization group. Maxillary incisor retrusion and mandibular incisor protrusion were observed in the distalization and Herbst groups, respectively. Stereophotogrammetric measurements showed that mandibular body length and lower and anterior facial height increased in both treatment groups. Convexity angle (P = 0.020) and labiomental angle (P = 0.033) were greater in the Herbst group than the distalization group. CONCLUSIONS: The skeletal contribution to correction of maxillomandibular discrepancy was greater in the Herbst group than the distalization group. Significant profile improvements were recorded for both groups with treatment. After both treatments, orthodontists were found to have higher rates of detection in the profiles than laypeople. The esthetic contribution of treatments to the facial profile was found similar in both groups.


Assuntos
Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Cefalometria , Criança , Estética Dentária , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula , Percepção , Estudos Prospectivos , Resultado do Tratamento
16.
Clin Oral Investig ; 25(3): 1525-1534, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33409688

RESUMO

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.


Assuntos
Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Cefalometria , Epiglote , Humanos , Osso Hioide , Má Oclusão de Angle Classe II/terapia , Mandíbula , Aparelhos Ortodônticos Fixos , Estudos Retrospectivos , Contenções
17.
Am J Orthod Dentofacial Orthop ; 159(2): 148-157, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33388197

RESUMO

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.


Assuntos
Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Cefalometria , Humanos , Osso Hioide/diagnóstico por imagem , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula/diagnóstico por imagem , Palato Mole/diagnóstico por imagem , Faringe/diagnóstico por imagem , Estudos Retrospectivos
18.
Angle Orthod ; 91(1): 22-29, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33339047

RESUMO

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.


Assuntos
Má Oclusão de Angle Classe II , Desenho de Aparelho Ortodôntico , Adolescente , Cefalometria , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Maxila , Técnicas de Movimentação Dentária
19.
Angle Orthod ; 91(2): 255-266, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378419

RESUMO

OBJECTIVES: To compare the effects of Forsus appliances with and without temporary anchorage devices (TADs) for patients with skeletal Class II malocclusion. MATERIALS AND METHODS: Through a predefined search strategy, electronic searching was conducted in PubMed, Embase, Web of Science, CENTRAL, ProQuest Dissertations & Theses, and SIGLE with no language restrictions. Eligible study selection, data extraction, and evaluation of risk of bias (Cochrane Collaboration tool) were conducted by two authors independently and in duplicate. Any disagreement was solved by discussion or judged by a third reviewer. Statistical pooling, sensitivity analysis, subgroup analysis, and assessment of small-study effects were conducted by using Comprehensive Meta-Analysis and Stata 12.0. Heterogeneity was analyzed for different types of study designs, TADs, and radiographic examinations. RESULTS: Electronic search yielded a total of 256 studies after removing duplicates. Among them, six studies were finally included. All articles were of high quality. The pooled mean differences were -0.27 (95% confidence interval [CI]: -0.59, 0.05) for SNA, 0.58 (95% CI: -0.07, 1.23) for SNB, -0.86 (95% CI: -1.74, -0.03) for ANB, 1.63 (95% CI: 0.46, 2.80) for Co-Po, 0.75 (95% CI: 0.28, 1.23) for SN-MP, -7.56 (95% CI: -11.37, -3.76) for L1-MP, 0.47 (95% CI: -0.98, 1.91) for overjet, 0.39 (95% CI: -0.57, 1.35) for overbite, -1.84 (95% CI: -5.15, 1.47) for SN-OP, and 4.97 (95% CI: -1.22, 11.17) for nasolabial angle. CONCLUSIONS: TADs (especially miniplates) were able to eliminate dental adverse effects of Forsus appliances for correction of skeletal Class II malocclusion.


Assuntos
Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Sobremordida , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula , Ortodontia Corretiva
20.
Av. odontoestomatol ; 36(4): 200-207, sept.-dic. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-198590

RESUMO

INTRODUCCIÓN: En pacientes con crecimiento esqueletal clase II, el tratamiento ideal es etiológico modificando la cantidad y dirección de crecimiento mandibular. Con estos objetivos, se usan activadores funcionales (AF) que estimulan el crecimiento mandibular, redirigiéndolo posterosuperiormente a nivel condilar por medio del avance mandibular. Después del peak de crecimiento puberal, la corrección etiológica es quirúrgica. El objetivo del presente artículo es reportar un tratamiento exitoso de un paciente después de su peak de crecimiento puberal, tratado con un AF removible. MÉTODOS: Paciente de 13 años, 3 meses, braquifacial y con perfil facial convexo, presentaba clase II esqueletal debido a mandíbula retrognática. El paciente tenía dentición permanente completa, clase II de Angle, resalte incisivo y sobremordida aumentados, proinclinación incisiva bimaxilar y mordida en tijera de dientes #2.4 y #2.5. RESULTADOS: Después de ocho meses de tratamiento, se observó posición mandibular estable en clase I esqueletal, verificada mediante exámenes funcionales y radiográficos. Se logró resolución de la mordida en tijera. Mejoraron resalte incisivo y sobremordida, así como la proinclinación incisiva bimaxilar. CONCLUSIONES: El momento ideal para utilizar AF en tratamiento de clases II esqueletales es durante o ligeramente después del peak de crecimiento puberal. Sin embargo, los resultados clínicos del presente caso, permiten recomendar el avance mandibular con AF en pacientes braquifaciales clase II, a pesar de que se haya producido el peak de crecimiento puberal. En estos casos, el uso de AF está dirigido principalmente a beneficios dentarios, pero, al mismo tiempo, puede favorecer el crecimiento mandibular


INTRODUCTION: In growing skeletal class II patients, the ideal treatment is etiological and is obtained by modifying the amount and direction of mandibular growth. With this objective in mind, functional activators (FA) are used as they stimulate growth, redirecting it at the condylar level through forward mandibular advancement. After pubertal growth peak, etiological correction is surgical. OBJECTIVE: The present article aims to report a successful treatment in a patient after pubertal growth peak treated with a removable FA. METHODS: >A 13 years 3 months male patient, skeletal class II due to retrognathic mandible, brachyfacial and with a convex facial profile. The patient had complete permanent dentition, Angle class II, increased overjet and overbite. Maxillary and mandibular incisive proclination. Scissor bite of teeth #2.4 and #2.5. RESULTS: Treatment started using a FA for one year after first evaluation. Following eight months of treatment, stable mandibular position was observed in skeletal class I, verified by functional and radiographic examinations. Resolution of scissor bite was accomplished. Overjet and overbite, and bimaxillary incisive proclination were improved. CONCLUSIONS: The ideal time to use FAs for skeletal management in skeletal class II is during, or slightly after peak pubertal growth. However, the clinical results of present case, allows recommending the forward mandibular advancement in brachyfacial skeletal class II patients, even though pubertal growth peak had occurred. In these cases, the use of FA is primarily aimed at the dental benefits, but, at the same time, favoring mandibular growth


Assuntos
Humanos , Masculino , Adolescente , Má Oclusão de Angle Classe II/terapia , Aparelhos Ortodônticos Removíveis , Aparelhos Ativadores , Mandíbula/crescimento & desenvolvimento , Mandíbula/patologia , Maxila/crescimento & desenvolvimento , Maxila/patologia , Desenvolvimento Musculoesquelético/fisiologia , Cefalometria
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