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

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.

2019 ◽  
Vol 2019 ◽  
pp. 1-16
Author(s):  
Giuseppe Perinetti

A deficient mandibular growth on the sagittal plane is the most frequent diagnostic finding in dentoskeletal Class II malocclusion. Evidence indicated that functional treatment for such malocclusion is efficient only if performed during the pubertal growth spurt, as identified through radiographical growth indicators. With the aim of reducing the radiation to the patients and to follow longitudinally individual growth phases, the use of the sole third finger middle phalanx maturation (MPM), as a 5-stage method, has been proposed. Herein, three clinical cases of skeletal Class II malocclusion in growing patients treated by removable functional appliances (with or without full-fixed appliance treatment) are reported. Timing of intervention was strictly planned according to the MPM method, and skeletal effects have been recorded up to 21 months of follow-up. In all the cases, noteworthy skeletal effects have been achieved in terms of mandibular elongation, with relevant occlusal and aesthetic outcomes. It has also been showed that results are stable or slightly improved after functional treatment. These results would be achieved irrespective of the appliance used and support the use of the MPM method in everyday clinical practice.


1996 ◽  
Vol 23 (2) ◽  
pp. 103-108 ◽  
Author(s):  
H. C. Moseley ◽  
E. N. Horrocks ◽  
R. R. Welfare

A case is described in which a Class II malocclusion with severe Class II skeletal pattern was treated with a modified Twin Block Appliance. The patient, an II-year-old girl, had initially presented with an ameloblastoma located in the right maxilla. The subsequent defect produced by surgery was obturated by the appliance during her orthodontic treatment, which was undertaken during her pubertal growth spurt Two years later the result was stable, allowing the provision of a more definitive prothesis to restore the occlusion.


2016 ◽  
Vol 17 (4) ◽  
pp. 286-293
Author(s):  
Ali AM Jouybari ◽  
Valiallah Arash ◽  
Saeid Tavanafar ◽  
Soraya Khafri ◽  
Zahra Dehghan

ABSTRACT Aim To investigate the skeletal, dental, and soft tissue changes in girls with class II division 1 malocclusion after growth spurt peak under the effect of activator appliance. Materials and methods In this clinical trial study, 15 female patients, with skeletal class II and mandibular growth deficiency and at least 5 mm overjet, were randomly selected 6 months after their menarche. The mean of their ages at the beginning was 12.33 ± 0.81 years, and in the end it was 13.73 ± 0.79 years; the mean duration of treatment was 12.2 ± 3.18 months. Lateral, cephalometric radiographs were taken from all the patients before and after the treatment. Data were analyzed with Statistical Package for the Social Sciences (SPSS) 20 using paired t-test. Results On an average, the ANB angle, the angle of the upper incisors with the S-N, facial convexity, and overjet decreased by 2.6° ± 0.9, 5.4° ± 0.8, 3.8° ± 3.4, and 5.6 ± 1.8 mm respectively. The SNB angle, the angle of the lower incisors with the N-B, the labiomental angle, the total length of the mandible, the lower anterior facial height, the lower lip distance, the first molar of the mandible, and the soft tissue pogonion to the vertical line from the S point increased by 2.8° ± 1.8, 3.4° ± 3, 14.7 ± 15, 3.7 ± 2.6, 2.1 ± 1.6, 6.3 ± 2.5, 4.4 ± 2.4, and 6 ± 3.3 mm respectively. All these figures were statistically significant (p = 0.000). Conclusion The functional appliance improved the dental–skeletal relations and the soft tissue profile of patients after growth spurt peak of puberty in a group of Iranian girls, whereas dental changes were more than skeletal ones. Clinical significance Functional appliances can be used for correction of skeletal class II malocclusion 6 months after menarche in girls. How to cite this article Jouybari AAM, Arash V, Tavanafar S, Khafri S, Dehghan Z. The Effects of Functional Appliances on Female Patients with Skeletal Class II Malocclusion 6 Months after Menarche. J Contemp Dent Pract 2016;17(4):286-293.


Author(s):  
Fareena Ghaffar ◽  
Abdullah Jan ◽  
Obaid Akhtar ◽  
Alaina T. Mughal ◽  
Rooma Shahid ◽  
...  

Abstract Objective This study aimed to compare dentoskeletal changes in skeletal class-II malocclusion with removable twin block appliance and fixed AdvanSync2 appliance. Materials and Methods A prospective randomized clinical trial was conducted over a span of 1 year at AFID at Rawalpindi. Thirty patients with skeletal class-II malocclusion, 16 males (53.3%) and 14 females (46.6%), were randomly selected and divided in two equal groups (15 each) to be treated with either fixed functional appliances (FFAs) or with removable functional appliances (RFAs). Out of 30 patients, 15 between cervical vertebral maturation (CVM) stages of 2 and 3 were treated with RFA (twin block appliances) and remaining 15 between CVM stages of 4 and 5 were treated with FFA (AdvanSync2 appliances). Pretreatment (T1) and posttreatment (T2), angular variable, and linear variable were measured to compare the dentoskeletal effects between the two groups. Statitical Analysis Paired sample t-test was used to assess significant difference between variables at T1 (Pre-treatment) and T2 (Post-treatment) stage for both RFA and FFA group. Comparison among the RFA and FFA group was made using non-parametric Mann-Whitney U Test. IBM SPSS version 25.0 was used for evaluation. Results No significant difference was found in angular variables between the RFA and FFA groups (p > 0.05) with the exception of linear variables. Sella-posterior nasal spine (S-PNS) length significantly increased and Jarabak's ratio significantly decreased for FFA group (p = 0.010 and 0.045, respectively), when compared with RFA group. Conclusion Both the appliances, twin block (RFA) and AdvanSync2 (FFA), are effective for correction of skeletal class-II malocclusion. Both the appliances produced similar effects in the sagittal plane but for better vertical control twin block should be the appliance of choice. AdvanSync2 appliance could be preferred over twin block appliance when dentoalveolar and slight retrusive effect on the maxilla is desired especially for individuals in postpubertal growth spurt.


2020 ◽  
Vol 13 (52) ◽  
pp. 40-51
Author(s):  
Renato Barcellos Rédua

Class II malocclusion has a high incidence in the population, which may compromise smile aesthetics, occlusion function and stability. Skeletal Class II may affect facial aesthetics and upper airway volume. Class II malocclusion is routinely associated with skeletal Class II condition, having as treatment alternatives the use of Extra Buccal Appliance (EBA) or removable or fixed propulsor appliance. This article describes a case of a patient who did not accept the use of EBA and so it was fitted a Flex Developer propulsor for Class II correction and discussed the advantages and disadvantages of therapeutic alternatives for Class II correction.


1993 ◽  
Vol 20 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Johannes Kirchner ◽  
Stephen Williams

Analysis of sagittal jaw relationship is important in orthodontic diagnosis and treatment planning, and can be investigated by angular or linear parameters. In the present study an analysis was performed using profile cephalograms of 40 children with skeletal Class II malocclusion. A correlation analysis is presented, involving five different methods of expressing sagittal jaw relationships. Whilst some degree of agreement could be noted, it was not possible to suggest a pair of measurements, which in combination, could give a more accurate picture of sagittal jaw relationships.


2021 ◽  
Vol 14 (53) ◽  
pp. 97-106
Author(s):  
Roberto Hideo Shimizu ◽  
Isabela Almeida Shimizu ◽  
Ana Cláudia M. Melo Toyoffuku ◽  
Rebecca Marquesini ◽  
Tatiane Travizan Lima ◽  
...  

Adequate planning and early treatment of Angle Class II malocclusion with maxillary atresia and anterior open bite provides harmonization of maxillomandibular bone bases in the three planes of space. Orthodontic aligners have emerged as an alternative treatment having the following advantages: being more aesthetic and more comfortable for the patient, less treatment time when they are correctly indicated, less chairside time, less complications, possibility of remote monitoring, easier feeding, and dental hygiene. On the other hand, they offer difficulties to treat adults with severe skeletal Class II malocclusions, posterior crossbite and anterior open bite. Therefore, the objective of this clinical case report is to early correct skeletal Class II malocclusion with maxillary atresia through the use of mechanical orthopedics and devices that help eliminate habits and close the anterior open bite, and later the use of orthodontic aligners to finish the treatment. It was concluded that the early interceptive treatment of malocclusion was efficient to harmonize the bone bases in the anteroposterior, vertical, and transversal directions, changing this malocclusion from high to low complexity and, consequently, highly predictable and with an excellent prognosis for treatment with orthodontic aligners. The treatment with ClearCorrect aligners corrected the occlusion in a shorter period of time when compared to corrective orthodontics and with a high predictability in relation to the virtual setup.


2019 ◽  
Vol 56 (2) ◽  
pp. 341-345 ◽  
Author(s):  
Luminita Ligia Vaida ◽  
Raluca Dima ◽  
Emilia Albinita Cuc ◽  
Bianca Maria Negrutiu ◽  
Abel Emanuel Moca ◽  
...  

The aim of this study was to evaluate the efficiency in using intermaxillary elastics to stimulate mandibular growth and advancement in orthodontic patients diagnosed with skeletal Class II malocclusion as well as to compare the use of these Class II elastics in two different therapeutic approaches. The sample consisted of 60 orthodontic patients aged 10-15 years, 34 girls and 26 boys. The sample was divided into two equal groups (each consisting of 30 patients). Patients belonging to the first group (Group 1) were subjected to 1/4�� - 6.0 oz elastics and were advised to change the elastic every 24 hours. Patients belonging to the second group (Group 2) were subjected to 1/4�- 4.5 oz elastics but with a recommendation to change the elastics every 12 hours. In order to evaluate the effectiveness of these two types of Class II elastics on mandibular growth and advancement, the value of the SNB angle at the beginning of the treatment (T1) was compared with the value of the SNB angle after 5 months of wearing intermaxillary elastics (T2). All patients showed statistically significant increased values of the SNB angle during the orthodontic treatment (p[0.001). Patients in Group 2 showed a significantly higher statistical increase (p[0.05) than patients in Group 1.


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