Herbst–multibracket appliance treatment: is there an association between lower incisor position changes and the development of labial gingival recessions?

Abstract Purpose To assess a potential association between lower incisor (LI) position changes during Herbst–multibracket appliance (Herbst–MBA) treatment and the development of labial gingival recessions (LGR). Methods All class II patients (Department of Orthodontics, University of Giessen, Giessen, Germany) who had undergone Herbst–MBA treatment until 2015 with study models and lateral cephalograms available from before (T0) and after treatment plus ≥24 months of retention (T3) were included (n = 259). Lateral cephalograms were evaluated regarding LI position changes: iiL/ML (angle between LI long axis and mandibular plane [MP]), ii-MLPg (distance between LI incisal edge and a line perpendicular to MP through pogonion), apex-MLPg (distance between LI apex and a line perpendicular to MP through pogonion), ii-MLii (distance between LI incisal edge and MP on a line perpendicular to MP through incisal edge). Using study models the distance between the cementoenamel junction and the deepest point of the gingival margin was defined as LGR. Results The following cephalometric mean changes were recorded (T0–T3): iiL/ML +5.9 ± 5.76° (p = 0.929), ii-MLPg −0.2 ± 0.25 mm (p = 0.430), apex-MLPg +0.1 ± 0.32 mm (p = 0.363), ii-MLii +0.1 ± 0.36 mm (p = 0.206). The mean increase of LGR magnitude measured on the study models was 0.1 ± 0.35 mm. However, no association with the cephalometric LI position changes was found (|R| ≤ 0.2). Conclusion There is no association between the amount of LI position changes and the development of LGR during Herbst–MBA treatment plus retention. Nevertheless, individual predisposition or excessive treatment changes and extraordinary treatment approaches, respectively, might still lead to development of LGR.

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Cephalometric evaluation of adult anterior open bite non-extraction treatment with Invisalign

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.22.5.030-038.oar ◽

2017 ◽

Vol 22 (5) ◽

pp. 30-38 ◽

Cited By ~ 6

Author(s):

Shuka Moshiri ◽

Eustáquio A. Araújo ◽

Julie F. McCray ◽

Guilherme Thiesen ◽

Ki Beom Kim

Keyword(s):

Open Bite ◽

Therapeutic Modality ◽

Occlusal Plane ◽

Anterior Open Bite ◽

Lower Incisor ◽

Mandibular Plane ◽

Lateral Cephalograms ◽

Treatment Changes ◽

Extraction Treatment ◽

Lower Molar

ABSTRACT Objective: The purpose of this study was to evaluate, by means of cephalometric appraisal, the vertical effects of non-extraction treatment of adult anterior open bite with clear aligners (Invisalign system, Align Technology, Santa Clara, CA, USA). Methods: Lateral cephalograms of 30 adult patients with anterior open bite treated using Invisalign (22 females, 8 males; mean age at start of treatment: 28 years and 10 months; mean anterior open bite at start of treatment: 1.8 mm) were analyzed. Pre- and post-treatment cephalograms were traced to compare the following vertical measurements: SN to maxillary occlusal plane (SN-MxOP), SN to mandibular occlusal plane (SN-MnOP), mandibular plane to mandibular occlusal plane (MP-MnOP), SN to mandibular plane (SN-MP), SN to palatal plane (SN-PP), SN to gonion-gnathion plane (SN-GoGn), upper 1 tip to palatal plane (U1-PP), lower 1 tip to mandibular plane (L1-MP), mesiobuccal cusp of upper 6 to palatal plane (U6-PP), mesiobuccal cusp of lower 6 to mandibular plane (L6-MP), lower anterior facial height (LAFH), and overbite (OB). Paired t-tests and descriptive statistics were utilized to analyze the data and assess any significant changes resulting from treatment. Results: Statistically significant differences were found in overall treatment changes for SN-MxOP, SN-MnOP, MP-MnOP, SN-MP, SN-GoGn, L1-MP, L6-MP, LAFH, and OB. Conclusions: The Invisalign system is a viable therapeutic modality for non-extraction treatment of adult anterior mild open bites. Bite closure was mainly achieved by a combination of counterclockwise rotation of the mandibular plane, lower molar intrusion and lower incisor extrusion.

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Factors associated with long-term vertical skeletal changes induced by facemask therapy in patients with Class III malocclusion

The Angle Orthodontist ◽

10.2319/042717-282.1 ◽

2017 ◽

Vol 88 (2) ◽

pp. 157-162 ◽

Cited By ~ 2

Author(s):

Hee-Jong Kwak ◽

Hae-Jin Park ◽

Yoon-Ji Kim ◽

Dong-Yul Lee

Keyword(s):

Multivariate Linear Regression Analysis ◽

Class Iii ◽

Class Iii Malocclusion ◽

Short Term ◽

Gonial Angle ◽

Skeletal Changes ◽

Mandibular Plane ◽

Lateral Cephalograms ◽

The Mean

ABSTRACT Objectives: This study investigated the long-term vertical skeletal changes induced by facemask therapy in patients with Class III malocclusion and different vertical skeletal patterns. Materials and Methods: A total of 54 patients (20 boys and 34 girls; mean age, 7.7 ± 2.0 years) with Class III malocclusion who were successfully treated with facemask therapy were included in this study. Vertical skeletal changes (overbite depth indicator, angle between the Sella-Nasion (SN) plane and Gonion-Gnathion (GoGn) line, angle between the Frankfort horizontal (FH) plane and mandibular plane, gonial angle, and angle between the SN plane and palatal plane) were measured on lateral cephalograms from before treatment (T0) to after facemask therapy (T1) and from T0 to after retention (T2). Multivariate linear regression analysis was used to study the associations of the patients' skeletal patterns with the short-term (T0–T1) and long-term (T0–T2) vertical skeletal changes as a result of facemask therapy. Results: The mean treatment period of facemask therapy (T0–T1) was 1.4 ± 0.6 years, and the mean retention period (T1–T2) was 6.9 ± 2.6 years. Age at T0 was significantly correlated with vertical skeletal changes from T0 to T1. Differences in the treatment results between sexes were not significant. The angle between point A-point B line and mandibular plane to mandibular plane angle at T0 and the angle between the FH plane and mandibular plane at T0 were significant predictors for short-term and long-term changes. Changes in the Sella-Nasion-point A from T0 to T1 and from T1 to T2 significantly affected vertical changes in the short term and long term, respectively. Conclusions: Vertical skeletal changes as a result of facemask therapy are significantly associated with severity of the skeletal Class III malocclusion and mandibular plane angulation before treatment and the amount of forward maxillary growth during the treatment and retention periods.

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Cephalometric Profile of Bangladeshis: Tweed’s Analysis

APOS Trends in Orthodontics ◽

10.4103/apos.apos_22_17 ◽

2017 ◽

Vol 7 ◽

pp. 130-134

Author(s):

Hasan Md Rizvi ◽

Md Zakir Hossain

Keyword(s):

Young Adults ◽

Plane Angle ◽

Linear Regression Equation ◽

Morphometric Analyses ◽

Mandibular Plane ◽

Lateral Cephalograms ◽

Facial Pattern ◽

The Mean ◽

Ethnic Variations ◽

Mandibular Plane Angle

Introduction Tweed’s diagnostic triangle is simple yet provides a definite guideline in treatment planning. The aim of the present study was to establish the Tweed’s norms for Bangladeshi people. Methods The study was conducted for 89 Bangladeshi young adults (45 males and 44 females), aged 19–27 years, having balanced and harmonious facial profiles. Lateral cephalograms taken of these subjects were used for a series of morphometric analyses. Results All three angular parameters Frankfort-mandibular plane angle (FMA), Frankfort-mandibular incisal angle (FMIA), incise mandibular plane angle (IMPA)were measured and found to be 24.52°, 54.60°, and 100.88°, respectively. The mean FMA has been found to be 24.52° (with a range of 14°–36°) which is quite close to Tweed’s norm and found to be statistically insignificant. However, IMPA and FMIA values of Bangladeshis found to be statistically significantly different from that of the Caucasians. The linear regression equation of IMPA on FMA was fitted, and the estimated value of IMPA was computed for a given FMA. Conclusion The results support the idea that treatment objectives of IMPA should be considered according to the facial pattern, i.e., FMA. Ethnic variations of norms cannot be overlooked while outlining goals and planning the treatment.

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Effects of Invisalign (G5) with virtual bite ramps for skeletal deep overbite malocclusion correction in adults

The Angle Orthodontist ◽

10.2319/072220-646.1 ◽

2021 ◽

Author(s):

Douglas Henick ◽

Willy Dayan ◽

Robert Dunford ◽

Stephen Warunek ◽

Thikriat Al-Jewair

Keyword(s):

Comprehensive Treatment ◽

Deep Bite ◽

Fixed Appliance ◽

Skeletal Changes ◽

Mandibular Plane ◽

Lateral Cephalograms ◽

Sex Type ◽

The Mean ◽

Overbite Depth Indicator ◽

Extraction Treatment

ABSTRACT Objectives To investigate the skeletal and dentoalveolar effects of Invisalign's G5 protocol with virtual bite ramps in the treatment of adults with skeletal deep bites. Materials and Methods This retrospective study was conducted on consecutively treated adults presenting with skeletal deep bites as defined by the Overbite Depth Indicator (ODI). Subjects were divided into 2 groups: Invisalign group (n = 24) treated with the Invisalign G5 protocol and a full fixed appliance (FFA) group (n = 24) treated with edgewise FFAs and matched to the Invisalign group by ODI, sex, type of malocclusion, and non-extraction treatment. Pretreatment (T1) and post–comprehensive treatment (T2) lateral cephalograms were obtained and analyzed. Results Both the Invisalign and FFA groups showed significant changes from T1 to T2 in ODI and other skeletal and dentoalveolar measurements. The mean change in ODI was −1.5° (P < .001) for the Invisalign group and −2.0° (P < .001) for the FFA group. The mean decrease in overbite was 1.3 mm (P < .001) and 2.0 mm (P < .001) for the Invisalign and FFA groups, respectively. The mean increase in mandibular plane angle (Sn-GoGn) was 0.65° (P = .003) for the Invisalign group and 1.15° (P < .001) for the FFA group. When the groups were compared with each other, both ODI (P = .03) and overbite (P = .003) were significantly different in addition to other measurements. Conclusions Although FFA treatment had more apparent skeletal changes for deep bite adult patients when compared with Invisalign, both systems were effective in opening deep bites at dentoalveolar and skeletal levels.

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Determination of Tweed's cephalometric norms in Bengali population

European Journal of Dentistry ◽

10.4103/ejd.ejd_274_16 ◽

2017 ◽

Vol 11 (03) ◽

pp. 305-310

Author(s):

Lalima Kumari ◽

Anuranjan Das

Keyword(s):

Treatment Planning ◽

Mean Value ◽

Diagnosis And Treatment ◽

Mandibular Angle ◽

Mandibular Plane ◽

Normal Occlusion ◽

Lateral Cephalograms ◽

Males And Females ◽

The Mean

ABSTRACT Objective: The purpose of this study was to establish Tweed's cephalometric norms for Indian Bengali population and to compare it with Caucasian norms. Materials and Methods: The participants were of 50 adults with normal occlusion and pleasant profile. Lateral cephalograms were taken in natural head position, and cephalometric norms were established using Tweeds diagnostic triangle. Results: The study showed more proclined lower incisors in comparison with Caucasians. The result of the study also indicated that separate norms should be considered for Bengali males and females during diagnosis and treatment planning as mean Frankfort mandibular angle value for females was found to be significantly higher than that of males (t 48= 2.97; P < 0.01) and the mean value of incisor mandibular plane angle for males was significantly higher than that of females. Conclusion: The findings emphasize the need for group-specific norms for orthodontic diagnosis and treatment planning and provide cephalometric standards for normal Bengali adults.

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Comparison between direct vs indirect anchorage in two miniscrew-supported distalizing devices

The Angle Orthodontist ◽

10.2319/040715-231.1 ◽

2016 ◽

Vol 86 (3) ◽

pp. 399-406 ◽

Cited By ~ 6

Author(s):

Mauro Cozzani ◽

Mattia Fontana ◽

Giuliano Maino ◽

Giovanna Maino ◽

Lucia Palpacelli ◽

...

Keyword(s):

Treatment Time ◽

Class Ii ◽

T Test ◽

Class Ii Malocclusion ◽

Lateral Cephalograms ◽

Treatment Changes ◽

The Mean ◽

T1 And T2 ◽

Student’S T ◽

Student’S T Test

ABSTRACT Objective: To compare two distalizing devices supported by palatal miniscrews, the MGBM System (MGBM) and the Distal Screw appliance (DS), in dental Class II patients. Materials and Methods: Pretreatment (T1) and postdistalization (T2) lateral cephalograms of 53 Class II malocclusion subjects were examined. MGBM consisted of 29 patients (16 males, 13 females) with a mean pretreatment age of 12.3 ± 1.5 years; DS consisted of 24 patients (11 males, 13 females) with a mean pretreatment age of 11.3 ± 1.2 years. The mean distalization time was 6 ± 2 months for MGBM and 9 ± 2 months for DS. Initial and final measurements and treatment changes were compared by means of a Student’s t-test. Results: Maxillary superimpositions showed that the maxillary first molar distalized an average of 5.5 mm in the MGBM and 3.2 mm in the DS between T1 and T2; distal molar tipping was greater in the MGBM (10.3°) than in the DS (3.0°). First premolar showed a mean mesial movement of 1.4 mm, with a mesial tipping of 4.4° in the MGBM; on the contrary, first premolar showed a distal movement of 2.2 mm, with a distal tipping of 6.2°, in the DS. Conclusions: The MGBM system resulted in greater distal molar movement and less treatment time, resulting in more efficient movement than was associated with the DS; DS showed less molar tipping during distalization.

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A Comparison of Craniofacial Characteristics between Two Different Adult Populations with Class II Malocclusion—A Cross-Sectional Retrospective Study

Biology ◽

10.3390/biology10050438 ◽

2021 ◽

Vol 10 (5) ◽

pp. 438

Author(s):

Arvind Sivakumar ◽

Prasad Nalabothu ◽

Huyen Nguyen Thanh ◽

Gregory S. Antonarakis

Keyword(s):

Growth Pattern ◽

Class Ii ◽

Class Ii Malocclusion ◽

South Indian Population ◽

The South ◽

Facial Height ◽

South Indian ◽

Mandibular Plane ◽

Lateral Cephalograms ◽

Craniofacial Characteristics

The dental, skeletal, and soft-tissue characteristics of a particular malocclusion can differ based on ethnicity, race, age, sex and geographical location with Class II malocclusion being one of the most prevalent malocclusions encountered in orthodontic clinical practice. The broad understanding of the characteristics of vertical skeletal and dental parameters in patients with Class II malocclusion can help clinicians to identify patterns and variations in the expression of this phenotype for better treatment outcomes. Hence, we compared the craniofacial characteristics of skeletal and dental Class II malocclusion traits from Indian and Vietnamese individuals to analyze the vertical skeletal and dental patterns in both population groups. The sample comprised of lateral cephalograms from 100 young adults with Class II malocclusion, of which fifty (25 males and 25 females) were from South India and the other 50 age- and sex-matched adults from Vietnam. The lateral cephalometric radiographs were digitized into anonymous image files and were traced and assessed for 16 vertical skeletal and dental parameters. The ANB angle was greater in males (+1.4 deg; p < 0.001) and females (+1.9 deg; p < 0.001) in the South Indian population. The Vietnamese males had a larger mandibular plane angle, articular angle, anterior facial height and lower anterior facial height compared to the Indian males. The Vietnamese females had larger mandibular plane and articular angles compared to the Indian females. The skeletal class II malocclusion was more severe in the South Indian compared to the Vietnamese adults. The Vietnamese sample showed a generalized tendency towards a more vertical skeletal growth pattern and in males this pattern seemed to be due to the dentoalveolar component. The Vietnamese females showed a tendency towards a vertical growth pattern, but without apparent contribution by the dentoalveolar component.

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Use of Frenum in Determining the Original Vertical Position of Teeth

Journal of Oral Health and Community Dentistry ◽

10.5005/johcd-7-1-44 ◽

2013 ◽

Vol 7 (1) ◽

pp. 44-46 ◽

Cited By ~ 1

Author(s):

KD Prasad ◽

H Alva

Keyword(s):

Coefficient Of Variation ◽

Vertical Position ◽

Central Incisor ◽

Incisal Edge ◽

The Mean ◽

Natural Dentition ◽

Lingual Frenum ◽

Functional Position

ABSTRACT Purpose To determine the functional position of labial, lingual and buccal frenii with the corresponding central incisor, premolar or molars in natural dentition. Materials and method 20 dentate subjects between 20-40years of age were selected for the study. Maxillary and mandibular impressions were made and the distance from anterior attachment of frenum to the cusp tip of the corresponding tooth was measured. Result The mean distance between the anterior attachment of labial frenum to the incisal edge of incisor was 12.25mm, the mean distance between the anterior attachment of buccal frenum of right side to cusp tip of corresponding teeth was 12.75mm and left side was 12.8mm and the mean distance between the anterior attachment of lingual frenum to incisal edge of incisor was 15.4mm. The coefficient of variation were 14.7%, 16.65%, 15.75% and 6.4% respectively. Conclusion The distance between the anterior attachment of the frenum to the cusp tips/incisal edges can be used as a pre-extraction record for determining the original vertical position of teeth.

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Dental and skeletal effects after total arch distalization using modified C-palatal plate on hypo- and hyperdivergent Class II malocclusions in adolescents

The Angle Orthodontist ◽

10.2319/031720-18.1 ◽

2020 ◽

Author(s):

Chang Yoon Jung ◽

Jae Hyun Park ◽

Ja Hyeong Ku ◽

Nam-Ki Lee ◽

Yoonji Kim ◽

...

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

Study Group ◽

Class Ii Malocclusion ◽

Plane Angle ◽

Mandibular Plane ◽

Lateral Cephalograms ◽

Palatal Plate ◽

Skeletal Effects ◽

Facial Types

ABSTRACT 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.

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Comparison of Treatment Effects with Modified C-Palatal Plates vs Greenfield Molar Distalizer Appliances in Adolescents

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-44.3.12 ◽

2020 ◽

Vol 44 (3) ◽

pp. 202-208

Author(s):

Mohammed Alfaifi ◽

Jae Hyun Park ◽

Kiyoshi Tai ◽

Ja Hyeong Ku ◽

Nikhilesh R Vaid ◽

...

Keyword(s):

Treatment Effects ◽

Group Differences ◽

Class Ii Malocclusion ◽

Molar Distalization ◽

Skeletal Changes ◽

Lateral Cephalograms ◽

Significant Difference ◽

Maxillary Molar ◽

The Mean ◽

Maxillary Incisors

Objectives: The aim of study was to evaluate skeletodental and soft tissue treatment effects and the amount of maxillary molar distalization with modified C-palatal plates vs. Greenfield molar distalizer appliances in adolescents. Study design: The samples consisted of pre- and posttreatment lateral cephalograms collected from 39 patients with Class II malocclusion. The MCPP group was comprised of 21 patients (mean age: 11.7 ± 1.3 years) treated with MCPP appliances while the GMD group included 18 patients (mean age: 11.2 ± 0.9 years) treated with GMD. Fixed orthodontic treatment started with the distalization process in both groups. From each cephalograpm, twenty-nine variables were measured for analysis and then the two groups were compared. Descriptive statistics, a paired t-test, and multivariate analysis of variance were performed to compare the treatment effects within and between the groups. Results: There was significant treatmentrelated change in the sagittal position of the maxilla and the mandible within each group. However, there were no statistically significant inter-group differences. The mean maxillary first molar distalization was 3.96 mm in the MCPP group vs. 2.85 mm in the GMD group. Both groups showed minimal distal tipping, but the maxillary incisors were significantly extruded by 3.04 ± 0.89 mm (P < .001) in GMD group. There was no significant difference in treatment duration between the groups. Conclusions: The maxillary first molars of both the MCPP and GMD groups were effectively distalized and there were significant skeletal changes in the maxilla. However, the maxillary incisors were significantly extruded in the GMD group.

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