Facial attractiveness of skeletal Class II patients before and after mandibular advancement surgery as perceived by people with different backgrounds

AbstractThe literature offers different perspectives for and against two-phase treatment of skeletal Class II malocclusion. Facial attractiveness is an important aspect to take into account, given that children with skeletal Class II are often bullied by their peers and have low self-esteem and a lower social perception. The aim of the present study was to evaluate the aesthetic perception of facial profiles by a large number of observers, before and after treatment with a functional appliance, compared to untreated controls. The pre- and post-treatment cephalograms of 20 Class II subjects treated with Sander’s bite-jumping appliance and 20 untreated historical controls were collected and transformed into black and white silhouettes depicting only the lower third of the face. An online questionnaire comprising the silhouettes of the two groups, three “calibration” profiles and an “ideal” profile was submitted to dentists, orthodontists, undergraduates and laypeople, asking them to rate the profile’s attractiveness using a Visual Analogue Scale (VAS). The effect of treatment, and observers’ age, expertise and gender were analysed. The calibration images and the ideal profiles were used to evaluate the coherence of each observer’s judgement. The protocol was approved by the local Ethics Committee. Nine-hundred and ten questionnaires were collected. Treated subjects showed a larger improvement of facial attractiveness compared to controls. A significant effect of gender on the observer’s ratings was observed. Some observers showed incoherent judgement, which had a significant effect on the regression model. In conclusion, early treatment with functional appliances seems to improve patients’ facial aesthetics. This improvement is perceived equally by dental professionals and laypeople.

Download Full-text

A combined Surgical-Orthodontic treatment in skeletal Class II malocclusion patients

Journal of Dental Panacea ◽

10.18231/j.jdp.2021.018 ◽

2021 ◽

Vol 3 (2) ◽

pp. 82-87

Author(s):

Prathyaksha Shetty ◽

Dipjyothi Baruah ◽

Amit Rekhawat ◽

Karthik Cariappa ◽

Sujala Ganapati Durgekar ◽

...

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

Mandibular Advancement ◽

Class Ii Malocclusion ◽

Skeletal Class ◽

Sagittal Split Osteotomy ◽

Skeletal Class Ii ◽

Facial Esthetics ◽

Bilateral Sagittal Split Osteotomy ◽

Common Problems

Skeletal Class II malocclusion with mandibular deficiency is one of the most common problems that patients seek treatment. Adult patients with severe skeletal Class II malocclusion need orthognathic surgery for successful treatment. Bilateral sagittal split osteotomy (BSSO) is the most often preferred technique for these patients. This case report briefs about two male patient of age 24 years presented with Class II Skeletal relation, mesoprosopic facial form, horizontal growth pattern and Angle’s Class II div 1 malocclusion who were treated with Bilateral sagittal split osteotomy (BSSO) mandibular advancement. The ideal anteroposterior relation was established along with a Class I molar, incisor, canine relationship and ideal overjet, overbite and the overall facial esthetics were significantly improved. Combined surgical-orthodontic treatment aims to obtain a more harmonious facial, skeletal, dental and soft tissue relationship with an added patient self esteem.

Download Full-text

Surgical Orthodontic Treatment of Severe Skeletal Class II

Case Reports in Dentistry ◽

10.1155/2013/397809 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6

Author(s):

Fahad F. Alsulaimani ◽

Maisa O. Al-Sebaei ◽

Ahmed R. Afify

Keyword(s):

Orthodontic Treatment ◽

Anterior Segment ◽

Class Ii ◽

Mandibular Advancement ◽

Sagittal Split Ramus Osteotomy ◽

Skeletal Class ◽

Maxillary Osteotomy ◽

Skeletal Class Ii ◽

Segment 8 ◽

Jaw Surgery

This paper describes an adult Saudi male patient who presented with a severe skeletal class II deformity. The case was managed with a combination of presurgical orthodontic treatment followed by a double jaw orthognathic surgery and then another phase of orthodontic treatment for final occlusal detailing. Extraction of the four first premolars was done during the presurgical orthodontic phase of treatment to decompensate upper and lower incisors and to give room for surgical setback of the maxillary anterior segment. Double jaw surgery was performed: bilateral sagittal split ramus osteotomy for 8 mm mandibular advancement combined with three-piece Le Fort I maxillary osteotomy, 6 mm setback of the anterior segment, 8 mm impaction of the maxilla, and 5 mm advancement genioplasty. Although the anteroposterior discrepancy and the facial convexity were so severe, highly acceptable results were obtained, both esthetically as well as occlusally.

Download Full-text

Characteristics of mandibular advancement surgery dependent on lower facial height differences in study of skeletal Class II patients with long-term stability

Orthodontic Waves ◽

10.1016/j.odw.2007.01.001 ◽

2007 ◽

Vol 66 (1) ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Kazunori Fukui ◽

Raymond M. Sugiyama ◽

Ronald M. Kaminishi ◽

Yoshiaki Matsuyama ◽

Eiko Kuroda ◽

...

Keyword(s):

Class Ii ◽

Mandibular Advancement ◽

Skeletal Class ◽

Term Stability ◽

Long Term Stability ◽

Facial Height ◽

Skeletal Class Ii

Download Full-text

Evaluation of Upper Airway Dimensional Changes and Hyoid Position Following Mandibular Advancement in Patients With Skeletal Class II Malocclusion

Journal of Craniofacial Surgery ◽

10.1097/scs.0b013e318270fafd ◽

2012 ◽

Vol 23 (6) ◽

pp. e623-e627 ◽

Cited By ~ 15

Author(s):

Nanda Kishore Sahoo ◽

Balakrishnan Jayan ◽

N. Ramakrishna ◽

Sukbir Singh Chopra ◽

Gagandeep Kochar

Keyword(s):

Upper Airway ◽

Class Ii ◽

Mandibular Advancement ◽

Class Ii Malocclusion ◽

Skeletal Class ◽

Dimensional Changes ◽

Skeletal Class Ii

Download Full-text

Evaluation of Postsurgical Stability And Condylar Morphology In Skeletal Class II Patients With Condylar Resorption Following Orthognathic Surgery

10.21203/rs.3.rs-1185890/v1 ◽

2021 ◽

Author(s):

Minjiao Wang ◽

Hanjiang Zhao ◽

Xiangyu Wang ◽

Yifeng Qian ◽

Hongbo Yu ◽

...

Keyword(s):

Orthognathic Surgery ◽

Class Ii ◽

Mandibular Advancement ◽

Class Ii Malocclusion ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Condylar Morphology ◽

Ramus Height ◽

Condylar Volume

Abstract Background: To retrospectively evaluate postsurgical stability and condylar morphology for skeletal class II malocclusion patients with condylar resorption (CR) treated with orthognathic surgery.Methods: Thirty-five patients treated with combined orthodontic and orthognathic surgery between 2014 and 2018 were enrolled in this retrospective study. CT scans were acquired preoperatively (T0), 2–7 days after surgery (T1), and 1 year postoperatively (T2). The amount of mandibular advancement, postsurgical relapse, condylar morphology and joint spaces were analysed respectively. Statistical analysis was performed using R, version 3.4.3 (R Development Core Team 2010).Results: The average mandibular advancement and counter-clockwise rotation were 5.51 mm and -2.82 degrees respectively. The average relapse was 1.08 mm (19.6% of the advancement) and 1.13 degrees. The condylar volume showed a postoperative reduction of 161.86 mm3(13.7% of initial condylar volume). AJS increased after surgery and gradually returned to its original state, while SJS and PJS decreased and remained stable. Surgical advancement of B point was significantly correlated with skeletal relapse. The optimal cut-off values were as follows: MP-FH (40.75°); ramus height (51.125 mm); SJS (1.63 mm); surgical displacement (4.72 mm); CCR (-4.3°); AJSC (1.07 mm).Conclusions: Skeletal class II patients with CR have a high risk of postsurgical condylar resorption, which was most related to nonsurgical risk factors such as gender(female) and condylar angle. Condylar had moved posteriorly to the concentric position after surgery and remained quite stable through the 1-year follow-up. Preoperative skeletal patterns such as lower ramus height and surgical procedures such as larger advancement of the mandible were closely associated with sagittal relapse of the mandible.

Download Full-text

Mode of correction is related to treatment timing in Class II patients treated with the mandibular advancement locking unit (MALU) appliance

The Angle Orthodontist ◽

10.2319/071316-549.1 ◽

2017 ◽

Vol 87 (3) ◽

pp. 363-370

Author(s):

Muhsin Candir ◽

Heidi Kerosuo

Keyword(s):

Group Treatment ◽

Treatment Initiation ◽

Class Ii ◽

Mandibular Advancement ◽

Skeletal Maturation ◽

Total Change ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Lateral Cephalograms ◽

Mandibular Incisors

ABSTRACT Objective: To investigate the proportion of skeletal/dentoalveolar components for correction of Class II malocclusion in relation to the pubertal growth peak (PGP) among patients treated with the mandibular advancement locking unit (MALU) appliance. Materials and Methods: We conducted a retrospective study of 27 orthodontic patients (age range: 12–18 years; mean age 14.9 years) with skeletal Class II Division 1 malocclusion who were treated with the MALU appliance until they reached Class I occlusion with overjet and overbite within normal range. Pretreatment (T1) and posttreatment (T2) lateral cephalograms were analyzed using standard cephalometrics and sagittal occlusion analysis to assess changes in the dentoalveolar and skeletal complex. The cervical vertebral maturation (CVM) method was used to determine participants' skeletal maturation in T1 cephalograms. Based on this maturation, participants were divided into two groups: the peak group (treatment initiation before or during PGP [peak group, n=15]) or the postpeak group (treatment initiation after the PGP [n = 12]). Results: No significant differences between groups were found at T1 for most of the skeletal and dental parameters investigated. At T2, the mean ANB angle and proclination of the mandibular incisors were significantly smaller in the peak group than in the postpeak group. In the peak group, skeletal correction comprised 54% and dental correction 46% of the total change at T2, while in the postpeak group the corresponding figures were 24% and 76%, respectively. Conclusions: Treatment initiated before or during PGP seems to result in a more favorable SNA/SNB relationship and less tipping of the mandibular incisors than when treatment is initiated after PGP.

Download Full-text

Long-term influence of mandibular advancement on the volume of the posterior airway in skeletal Class II-patients: a retrospective analysis

British Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.bjoms.2017.06.005 ◽

2017 ◽

Vol 55 (8) ◽

pp. 780-786 ◽

Cited By ~ 7

Author(s):

D. Dalla Torre ◽

D. Burtscher ◽

G. Widmann ◽

M. Rasse ◽

T. Puelacher ◽

...

Keyword(s):

Retrospective Analysis ◽

Class Ii ◽

Mandibular Advancement ◽

Skeletal Class ◽

Skeletal Class Ii

Download Full-text

Two Phase Therapy for Class II Division 1 Malocclusion - A Case Report

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1708726 ◽

2017 ◽

Vol 07 (03) ◽

pp. 058-062

Author(s):

Suraj Prasad Sinha ◽

Akhil Shetty ◽

M. S. Ravi ◽

U.S. Krishna Nayak

Keyword(s):

Case Report ◽

Class Ii ◽

Mandibular Advancement ◽

Second Phase ◽

Two Phase ◽

Twin Block ◽

Skeletal Class ◽

Good Function ◽

Skeletal Class Ii ◽

Division 1

AbstractA 13 year old growing male reported with a complaint of forwardly placed upper front teeth. The case was diagnosed to be Skeletal Class II due to retrognathic mandible. Since the patient was in the growing phase, two phase treatment was planned. The First phase comprised of mandibular advancement using TWIN BLOCK. The final finishing and detailing was achieved in the Second phase of treatment using 0.022 MBT Prescription (self-legating) to produce well-aligned arches in good function and aesthetics.

Download Full-text

Management of severe Class II malocclusion with sequential modified twin block and fixed orthodontic appliances

APOS Trends in Orthodontics ◽

10.4103/2321-1407.177966 ◽

2016 ◽

Vol 6 ◽

pp. 113-118

Author(s):

Sonal Chowdhary

Keyword(s):

Class Ii ◽

Mandibular Advancement ◽

Orthodontic Appliances ◽

Class Ii Malocclusion ◽

Functional Appliance ◽

Deep Bite ◽

Twin Block ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Fixed Orthodontic Appliances

Functional appliance is an effective way of treating skeletal Class II malocclusion in children and adolescents. A 12 months stepwise mandibular advancement protocol with Herbst appliance has been proved to enhance condylar growth and improve mandibular prognathism. The present case report documents a 12-year-old boy presenting with Angle’s Class II, division 1 malocclusion associated with excessive overjet (11 mm), 100% deep bite, and retrognathic mandible. He was treated by a phase I growth modification therapy using twin block appliance with lip pads in a stepwise mandibular advancement protocol followed by a phase II preadjusted Edgewise appliance therapy.

Download Full-text