Correction of a skeletal Class III malocclusion during a pubertal growth spurt by bone-anchored maxillary protraction

2017 ◽  
Vol 6 (2) ◽  
pp. 62-68
Author(s):  
Masahiro Konno ◽  
Masahiro Iijima ◽  
Moe Nagasaka-Konno ◽  
Itaru Mizoguchi
Keyword(s):  
Growth Spurt ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Pubertal Growth Spurt ◽  
Skeletal Class ◽  
Maxillary Protraction ◽  
Pubertal Growth

scholarly journals Time and pattern of the fusion of the spheno-occipital synchondrosis in patients with skeletal Class I and Class III malocclusion

2018 ◽  
Vol 89 (3) ◽  
pp. 470-479
Author(s):  
Jae-Hee Yang ◽  
Bong-Kuen Cha ◽  
Dong-Soon Choi ◽  
Jae Hyun Park ◽  
Insan Jang
Keyword(s):  
Computed Tomography ◽  
Class I ◽  
Cone Beam ◽  
Growth Spurt ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Pubertal Growth Spurt ◽  
Skeletal Class ◽  
Pubertal Growth ◽  
Stage System

ABSTRACT Objectives: To investigate the time and pattern of fusion of the spheno-occipital synchondrosis in patients with skeletal Class I and Class III malocclusion using cone-beam computed tomography (CBCT). Materials and Methods: A total of 262 CBCT images were collected: 140 skeletal Class I (0° < ANB < 4°; 71 males, 69 females) and 122 skeletal Class III (ANB ≤ 0°; 61 males and 61 females). The fusion stages were identified using CBCT images of a six-stage system defined by the appearance of osseous cores and ossifying vestige in the synchondrosis. The age distributions of each stage and the pattern of fusion were evaluated. Results: The stages of fusion progressed with increasing age (P < .05, r = .824), and the age distributions in the female groups were generally 1 to 3 years younger than those in the male groups. However, no significant differences were observed between the skeletal Class I and Class III groups regarding the time of ossification of the synchondrosis. The osseous cores appeared most frequently in the supero-center part, followed by the mid-center part of the synchondrosis. Conclusions: The time and pattern of fusion of the spheno-occipital synchondrosis are not apparently different between patients with Class I malocclusion and those with Class III malocclusion. The osseous cores appear frequently in the supero-center and mid-center of the synchondrosis with various patterns before the end of the pubertal growth spurt period.

scholarly journals Duration of the pubertal growth spurt in patients with increased craniofacial growth component in sagittal and vertical planes—retrospective and cross-sectional study

2021 ◽  
Author(s):  
Agnieszka Szemraj-Folmer ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak ◽  
Małgorzata Kuc-Michalska
Keyword(s):  
Statistical Significance ◽  
Class I ◽  
Growth Spurt ◽  
Class Iii ◽  
High Angle ◽  
Pubertal Growth Spurt ◽  
Skeletal Class ◽  
Pubertal Growth ◽  
Age Related ◽  
Group I

Abstract Objectives The aim of the study is to assess the skeletal age at the onset and end of the pubertal growth spurt and determine its duration in four growth type groups: (1) normodivergent skeletal Class I (I N), (2) normodivergent skeletal Class III (III N), (3) high-angle skeletal Class III (III H) and (4) high-angle skeletal Class I (I H). Materials and methods Two hundred thirteen subjects were selected from 2163 examined files. The cervical vertebral maturation stage was recorded by means of Baccetti’s method. The sagittal and vertical skeletal relations were evaluated according to Steiner analysis with Kaminek’s modification. The duration of the pubertal growth spurt was calculated from the difference between the means of the chronological age related to CS3 and CS4 maturation stages. Results The shortest lasting pubertal growth spurt was observed in group I N (1.1), followed by group III N (1.6). Major differences between arithmetic means CS4-CS3 were seen in groups I H and III H (2.3 and 2.7, respectively). Conclusions The following tendency was observed in the duration of the pubertal growth spurt: I N < III N < I H < III H. This tendency has statistical significance only in high-angle patients in comparison with normodivergent skeletal Class I. Clinical relevance Knowledge on the longer pubertal growth spurt in high-angle patients compared to patients with normal anteroposterior and vertical relationships can be useful in the selection of an appropriate therapeutic method and a treatment time.

Comparison of skeletal anchorage and tooth-borne maxillary protraction followed by fixed appliance in Class III malocclusion

2019 ◽  
Vol 42 (2) ◽  
pp. 193-199 ◽  
Author(s):  
Sang-Hoon Lee ◽  
Sang-Duck Koh ◽  
Dong-Hwa Chung ◽  
Jin-Woo Lee ◽  
Sang-Min Lee
Keyword(s):  
Phase Ii ◽  
Class I ◽  
Skeletal Anchorage ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Fixed Appliance ◽  
Skeletal Class ◽  
Maxillary Protraction ◽  
Lateral Cephalograms ◽  
Residual Growth

Summary Objectives The purpose of this study was to compare the results of skeletal anchorage (SAMP) and tooth- borne (TBMP) maxillary protraction followed by fixed appliance in growing skeletal Class III patients. Materials and methods Patients treated with maxillary protraction were selected and classified into two groups (SAMP: n = 19, mean age = 11.19 years; TBMP: n = 27, mean age = 11.21 years). Lateral cephalograms taken before treatment (T0), after the maxillary protraction (T1), and after the fixed appliance treatment (T2) were analysed and all variables were statistically tested to find difference between the two groups. Results Compared to the TBMP, the SAMP showed significant forward growth of maxilla (Co-A point and SN-Orbitale) and improvement in intermaxillary relationship (ANB, AB to mandible plane, and APDI) after the overall treatment (T0–T2), with no significant sagittal changes in maxilla or mandible throughout the fixed appliance treatment (T1–T2). Limitations In maxillary protraction, effects of skeletal anchorage were retrospectively compared with those of dental anchorage, not with Class I or III control. Conclusions and implications After maxillary protraction, skeletal and tooth-borne anchorage did not cause significant differences in the residual growth of maxilla throughout the phase II treatment. Orthopaedic effects with skeletal anchorage showed appropriate stability in maxilla and intermaxillary relationship even after fixed appliance treatment.

Vertical and Sagittal Growth in Patients with Unilateral and Bilateral Cleft Lip and Palate—A Retrospective Cephalometric Evaluation

2009 ◽  
Vol 46 (5) ◽  
pp. 512-520 ◽  
Author(s):  
Alexandra I. Holst ◽  
Stefan Holst ◽  
Emeka Nkenke ◽  
Matthias Fenner ◽  
Ursula Hirschfelder
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class I ◽  
Growth Spurt ◽  
Pubertal Growth Spurt ◽  
Skeletal Class ◽  
Pubertal Growth ◽  
Facial Height ◽  
Bilateral Cleft Lip ◽  
Male Patients

Objective: To investigate whether the craniofacial vertical and sagittal jaw relationship in patients with cleft lip and palate (CLP) differed from that of age-matched noncleft controls, before and after the pubertal growth spurt. Design: Retrospective observational study. Patients: The study group comprised 126 patients with CLP, subdivided according to gender and cleft type, and the control group comprised 53 age-matched skeletal class I patients. Methods: Angular and linear measurements were taken from prepubertal and postpubertal lateral cephalograms of all patients. Results: In patients with cleft lip and palate, the maxillary retrognathism became more remarkable with increasing age; whereas, the retrognathic position of the mandible became less pronounced as compared with controls. Reduced posterior midfacial height, a common prepubertal finding in patients with cleft lip and palate, was significant in postpubertal girls and young women with unilateral cleft lip and palate (p  =  .002). The total anterior facial height in male patients with bilateral cleft lip and palate was larger than in control patients (p  =  .002) after the pubertal growth spurt due to an increased anterior midfacial height. In male patients with unilateral cleft lip and palate, this finding was due to an increased anterior lower facial height (p < .001). Conclusions: Patients with cleft lip and palate treated according to a standardized treatment concept had adequate craniofacial jaw relationships after puberty. Despite a measured skeletal class I in both male and female patients with cleft lip and palate regardless of cleft type, there was a slight tendency toward a skeletal class III. Findings were similar for all groups of cleft lip and palate patients irrespective of the type of orthodontic treatment performed.

scholarly journals Postpubertal Effects of the Rapid Maxillary Expansion and Facial Mask versus the Removable Mandibular Retractor for the Early Treatment of Class III Malocclusion: A Study on Lateral Cephalograms

2021 ◽  
Vol 11 (18) ◽  
pp. 8393
Author(s):  
Veronica Giuntini ◽  
Matteo Camporesi ◽  
Valeria Barone ◽  
Matilde Marino Merlo ◽  
Cosimo Nardi ◽  
...  
Keyword(s):  
Early Treatment ◽  
Rapid Maxillary Expansion ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Maxillary Expansion ◽  
Facial Mask ◽  
Skeletal Class ◽  
Maxillary Protraction ◽  
Time Points ◽  
Lateral Cephalograms

The aim of this study was to compare the efficacy of early treatment of Class III malocclusions with rapid maxillary expansion (RME) and facial mask (FM) versus the removable mandibular retractor (RMR) re-evaluated at a postpubertal observation on lateral cephalograms. All prepubertal patients with Class III malocclusion treated consecutively from 1986 to 2013 by means of RME/FM or RMR were analyzed. Twenty-nine patients treated with RME/FM therapy and 23 patients treated with RMR were selected. Lateral cephalograms were available at 3 time points, before treatment (T1), at the end of active treatment (T2), and at a postpubertal observation (T3). Statistical comparisons were performed with independent sample t tests or Mann–Whitney tests. During the T1–T3 interval, a significantly greater maxillary protraction (SNA +1.5 mm, p = 0.031) and significantly greater improvements in ANB and Wits appraisal (+1.9 degrees, p = 0.002, and +2.2 mm, p = 0.012, respectively) were recorded in the RME/FM group. No statistically significant changes could be found in vertical skeletal measurements. In the dentoalveolar region, the RME/FM group showed a significantly greater correction of the molar relationship (−1.5 mm, p = 0.021). Early treatment of Class III malocclusion with RME/FM protocol in comparison with RMR protocol showed a greater maxillary advancement and greater improvements in sagittal skeletal Class III relationships.

scholarly journals Reliability of Growth Indicators and Efficiency of Functional Treatment for Skeletal Class II Malocclusion: Current Evidence and Controversies

2017 ◽  
Vol 2017 ◽  
pp. 1-19 ◽  
Author(s):  
Giuseppe Perinetti ◽  
Luca Contardo
Keyword(s):  
Class Ii ◽  
Functional Treatment ◽  
Current Evidence ◽  
Growth Spurt ◽  
Class Ii Malocclusion ◽  
Pubertal Growth Spurt ◽  
Skeletal Class ◽  
Pubertal Growth ◽  
Skeletal Class Ii ◽  
Growth Indicators

Current evidence on the reliability of growth indicators in the identification of the pubertal growth spurt and efficiency of functional treatment for skeletal Class II malocclusion, the timing of which relies on such indicators, is highly controversial. Regarding growth indicators, the hand and wrist (including the sole middle phalanx of the third finger) maturation method and the standing height recording appear to be most reliable. Other methods are subjected to controversies or were showed to be unreliable. Main sources of controversies include use of single stages instead of ossification events and diagnostic reliability conjecturally based on correlation analyses. Regarding evidence on the efficiency of functional treatment, when treated during the pubertal growth spurt, more favorable response is seen in skeletal Class II patients even though large individual responsiveness remains. Main sources of controversies include design of clinical trials, definition of Class II malocclusion, and lack of inclusion of skeletal maturity among the prognostic factors. While no growth indicator may be considered to have a full diagnostic reliability in the identification of the pubertal growth spurt, their use may still be recommended for increasing efficiency of functional treatment for skeletal Class II malocclusion.

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