CBCT Evaluation of Condylar Changes in Class II Hyperdivergent Adult Patients Following Posterior Maxillary Intrusion Using Miniscrews/Miniplates—A Prospective Study

Aim & Objectives: To evaluate using CBCT, the condylar changes taking place in retrognathic, hyperdivergent Class II adult patients following maxillary intrusion using miniscrew assembly. Materials and methods: In this prospective study design, 20 class II div I high angle cases in the age group of 20-25 years with Class II molar and canine relationship; Overjet > 5mm; ANB angle > 4°; FMA angle >25°; SNGoGn > 35°; Jaraback ratio< 60° and Lower Gonial angle>75° were taken. Each patient had a miniscrew assembly in the maxilla through which intrusive force was applied to the maxilla. Two additional miniscrews were placed between the first mandibular molars and second premolars to prevent extrusion of lower molars. CBCT images were taken at the beginning of the treatment (T1) and at the end of 6-9 months of molar intrusion (T2). Statistical analysis was carried out using student T- test. Results: Prior to treatment, the patients showed significant mandibular retrusion associated with increased maxillary posterior heights. Following maxillary intrusion with miniscrew assembly, CBCT evaluation revealed that the distance from the centre of condyle to the posterior border of the external auditory meatus was 19.2±1.67 mm on right side and 18.1±1.54mm on left side in T1 which increased to 19.6±1.45mm on right side and 18.5±1.36mm on left side in T2. The average forward displacement of condyle was .5mm which was statistically significant. The distance from the centre of condyle to superior border of external acoustic meatus was 3.1±1.7 mm on right side and 3.5 ±1.8 mm on left side in T 1 which increased to 3.8±1.9 mm on right side and 4.1 ±1.3mm on left side in T 2. The average downward displacement was .7mm which was statistically significant. Conclusion: Significant Maxillary intrusion can be achieved using miniscrews/ miniplate in adult hyperdivergent skeletal class II patients.

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Orthodontic Camouflage Treatment of Class II Malocclusion in Non-growing Patient - A Case Report

Orthodontic Journal of Nepal ◽

10.3126/ojn.v5i1.14501 ◽

2015 ◽

Vol 5 (1) ◽

pp. 46-49 ◽

Cited By ~ 1

Author(s):

Lubna Khan ◽

Hemant Kumar Halwai ◽

Rajiv Yadav ◽

Ourvind Jeet Singh Birring

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Asian Population ◽

Class Ii ◽

Adult Patients ◽

Treatment Modalities ◽

Class Ii Malocclusion ◽

Facial Profile ◽

Skeletal Class ◽

Skeletal Class Ii

The prevalence of skeletal Class II malocclusion is high amongst Asian population. Various treatment modalities have been presented for the treatment of Class II malocclusions in adult patients. We come across many adult patients who desire a costeffective and non-surgical correction and they accept dental camouflage as a treatment option to mask skeletal discrepancy. This case report presents a 26-year-old non-growing female who had a skeletal Class II malocclusion with prognathic maxilla and retrognathic mandible with an overjet of 7 mm, severe crowding, but did not want surgical treatment. We considered the camouflage treatment by extracting upper first premolars. Following the treatment, a satisfactory result was achieved with an acceptable static and functional occlusion, facial profile, smile and lip competence with patient satisfaction.

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Treatment of a skeletal Class II malocclusion using fixed functional appliance with miniplate anchorage

European Journal of Dentistry ◽

10.4103/1305-7456.130637 ◽

2014 ◽

Vol 08 (02) ◽

pp. 276-280 ◽

Cited By ~ 15

Author(s):

Mevlut Celikoglu ◽

Tuba Unal ◽

Mehmet Bayram ◽

Celal Candirli

Keyword(s):

Class Ii ◽

Class Ii Malocclusion ◽

Functional Appliance ◽

Present Case Report ◽

Skeletal Class ◽

Fixed Functional Appliance ◽

Skeletal Class Ii ◽

Fixed Appliances ◽

Mandibular Retrusion ◽

Leveling And Alignment

ABSTRACTBased on our literature search, we found that the use of miniplate anchorage with Forsus fatigue-resistance device (FRD) has not yet been reported. Therefore, the aim of the present case report was to present the treatment of a patient with skeletal Class II malocclusion with mandibular retrusion using Forsus FRD with miniplate anchorage. Fixed appliances with 0.022-inch slots were attached to the maxillary teeth and after 8 months of the leveling and alignment of the upper arch, 0.019 × 0.025-inch stainless steel archwire was inserted and cinched back. Two weeks after the placement of the miniplates bilaterally at the symphysis of the mandible, Forsus FRD was adjusted to the miniplates with a 35-mm length of rod chosen. Nine months after the skeletal anchored Forsus worn, Class I canine and molar relations were achieved and overjet was eliminated.

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Twin block appliance: Effect on pharyngeal airway

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v7i4.23299 ◽

2018 ◽

Vol 7 (4) ◽

pp. 147-152

Author(s):

Vivek Bikram Thapa ◽

Amrita Shrestha ◽

Prabesh Sherchan ◽

Prakash Poudel ◽

Luna Joshi

Keyword(s):

Soft Palate ◽

Class Ii ◽

Class Ii Malocclusion ◽

Twin Block ◽

Skeletal Class ◽

Pharyngeal Airway ◽

Skeletal Class Ii ◽

Obstructive Sleep ◽

Lateral Cephalograms ◽

Mandibular Retrusion

Background: Mandibular retrusion is the main cause of Skeletal Class II malocclusion characterized by skeletal retrusion of mandible with skeletal or dentoalveolar protrusion of maxillary. Objectives: This study was conducted to evaluate effect of treatment with twin-block appliances on pharyngeal dimensions. Methodology: This study was conducted in in the Department of Orthodontics & Dentofacial Orthopedics in Kathmandu Medical College. Twenty patients of age group 7 to 14 years with skeletal class II malocclusion with mandibular retrusion were selected. Variables evaluated were depth of nasopharynx; height of nasopharynx; depth of oropharynx; depth of hypopharynx; soft palate length; soft palate thickness and soft palate inclination. The lateral cephalograms were obtained for all subjects before the start of treatment and after a follow-up period of approximately three months in treatment. Results: Results showed that depth of nasopharynx increased by 1 mm, height of nasopharynx increased by 0.78 mm, depth of nasopharynx increased by 1.97 mm, depth of hypopharynx increased by 0.79 mm, soft palate length decreased by 4 mm, soft palate thickness increased by 2 mm and soft palate inclination decreased by 7.01 mm. The results for depth of pharynx and soft palate thickness were statistically significant. Conclusion: This study concluded that the use of twin block appliance for class II patients corrects sagittal dimension of oropharynx and hypopharynx. Early intervention for mandibular retrognathism in class II malocclusion helps enlarge the airway dimensions and decrease potential risk of obstructive sleep apnea syndrome for growing patients in the future.

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No Compliance Correction of Class II Malocclusion in Growing Patients Whit HERBST Appliance: A Case Report

The Open Dentistry Journal ◽

10.2174/1745017901814010605 ◽

2018 ◽

Vol 12 (1) ◽

pp. 605-613 ◽

Cited By ~ 4

Author(s):

M. Portelli ◽

A. Militi ◽

M. Cicciù ◽

A. Lo Giudice ◽

G. Cervino ◽

...

Keyword(s):

Class Ii ◽

Class I ◽

Class Ii Malocclusion ◽

Herbst Appliance ◽

Functional Therapy ◽

Deep Bite ◽

Mandibular Growth ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Mandibular Retrusion

Background:Class II malocclusion is the most common sagittal skeletal discrepancy, with a prevalent skeletal pattern of mandibular retrusion. The correction of mandibular retrusion with functional removable appliance needs a good patient’s compliance; for this reason, some clinicians prefer to use no compliance apparatus.Objective:Objective of the present therapy note is to demonstrate that the use of no compliance apparatus can provide a good correction of skeletal class II malocclusion.Methods:In the present study, authors report a therapy note referred to a 10 years old patient, woman, affected by Class II, with mandibular retrusion and deep bite, treated in 2013 at the Dep. of Orthodontics of Messina University. An orthodontic treatment has been planned with the aim of stimulating mandibular growth; an Herbst appliance with a cantilever design, bonded on first maxillary and mandibular molars, has been used. After eleven months of functional therapy a bilateral molar class I have been obtained.Results:In the therapy note proposed, authors obtained a resolution of mandibular retrusion, a correction of overjet, overbite and dental crowding in both arches, and a bilateral molar and canine class I has been achieved.Conclusion:Herbst appliance seems to be efficient in the correction of II Class Malocclusion, independently from patient’s cooperation; moreover , early correction of Class II malocclusion with functional appliances produces several clinical advantages.

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Treatment of a Class II Division 2 Patient with Severe Skeletal Discrepancy by Using a Custom Made TPA Proclination Spring

The Open Dentistry Journal ◽

10.2174/1874210620130807002 ◽

2013 ◽

Vol 7 (1) ◽

pp. 109-117 ◽

Cited By ~ 2

Author(s):

Sergio Paduano ◽

Gianrico Spagnuolo ◽

Giuseppe di Biase ◽

Iacopo Cioffi

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

Facial Profile ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Custom Made ◽

Fixed Appliances ◽

Mandibular Retrusion ◽

Division 2 ◽

Transpalatal Arch

This case report describes the orthodontic treatment of a boy, aged 15.3 years, with permanent dentition, mesofacial typology, affected with a severe sagittal skeletal Class II division 2 malocclusion, due to a mandibular retrusion. His chief compliant was the position of the maxillary incisors, displaced too palatally, and an impaired facial profile. Herbst and multi-bracket straightwire fixed appliances, together with a custom made modified transpalatal arch (i.e. TPA proclination spring), were used to correct the sagittal discrepancy and to improve the attractiveness of the impaired facial profile.

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Skeletal class II malocclusion caused by mouth breathing in a pediatric patient undergoing treatment by interceptive guidance of occlusion

Journal of International Medical Research ◽

10.1177/03000605211021037 ◽

2021 ◽

Vol 49 (6) ◽

pp. 030006052110210

Author(s):

Lihua Lyu ◽

Zheshan Zhao ◽

Qianwei Tang ◽

Jingjing Zhao ◽

Hua Huang

Keyword(s):

Class Ii ◽

Mouth Breathing ◽

Interventional Treatment ◽

Class Ii Malocclusion ◽

Maxillary Expansion ◽

Nasal Breathing ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Temporomandibular Joints ◽

Mandibular Retrusion

A 7-year 10-month-old boy was evaluated for mouth breathing and snoring habits. Examination revealed soft convex tissues, maxillary protrusion, mandibular retrusion, and a class II sagittal osteofascial pattern. The patient failed a water holding test. He was clinically diagnosed with skeletal class II malocclusion caused by mouth breathing. Under interceptive guidance of occlusion (iGo), the malocclusion improved with fixed maxillary expansion using functional appliances and interventional treatment of mouth breathing by lip closure exercises. These treatments enabled the patient to gradually return to nasal breathing and guided him to develop physiological occlusion for a coordinated jaw-to-jaw relation. At the 5-year 2-month post-correction follow-up visit (at the age of 13 years), the patient had stable occlusion, a coordinated osteofascial pattern, and normal dentition, periodontium, and temporomandibular joints.

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Stepwise Advancement Herbst Appliance versus Mandibular Sagittal Split Osteotomy

The Angle Orthodontist ◽

10.2319/110308-556r.1 ◽

2009 ◽

Vol 79 (6) ◽

pp. 1084-1094 ◽

Cited By ~ 20

Author(s):

A. Chaiyongsirisern ◽

A. Bakr Rabie ◽

Ricky W. K. Wong

Keyword(s):

Class Ii ◽

Adult Patients ◽

Herbst Appliance ◽

Skeletal Class ◽

Term Stability ◽

Long Term Stability ◽

Sagittal Split Osteotomy ◽

Skeletal Class Ii ◽

Mandibular Sagittal Split Osteotomy

Abstract Objective: To compare the treatment effects and long-term stability of the stepwise Herbst appliance and mandibular sagittal split osteotomy in skeletal Class II adult patients. Materials and Methods: Subjects comprised 16 patients in the Herbst group and another 16 patients in the surgery (mandibular sagittal split osteotomy) group. Lateral head films were taken before treatment (T0), after removal of the Herbst appliance/surgery (T1), after the fixed appliance treatment (T2), and 3 years after treatment (T3). All films were analyzed by standard cephalometrics and SO-analysis (analysis of changes in sagittal occlusion). Results: All Herbst and surgery patients were treated successfully to Class I occlusal relationships with normal overjet and overbite. Both groups showed a significant change in mandibular base advancement (SNB, SNPg, Pg/OLp), which resulted in a decrease in the ANB angle, the Wits appraisal, and facial convexity. However, the surgery group showed larger changes in the parameters mentioned above. In terms of long-term stability, both groups achieved stable results, and no significant difference occurred over time. Conclusion: Stepwise advancement Herbst appliance therapy can be used to treat borderline skeletal Class II adult patients with long-term stability.

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Surgical Orthodontic Treatment in Case of Severe High Angle Skeletal Class II Malocclusion and Mandibular Retrusion

The Bulletin of Tokyo Dental College ◽

10.2209/tdcpublication.2020-0022 ◽

2020 ◽

Vol 61 (4) ◽

pp. 243-253

Author(s):

Chie Tachiki ◽

Masae Yamamoto ◽

Takashi Takaki ◽

Yasushi Nishii

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

Class Ii Malocclusion ◽

High Angle ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Mandibular Retrusion

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Evaluation of the effects of skeletal anchoraged Forsus FRD using miniplates inserted on mandibular symphysis: A new approach for the treatment of Class II malocclusion

The Angle Orthodontist ◽

10.2319/051314-345.1 ◽

2014 ◽

Vol 85 (3) ◽

pp. 413-419 ◽

Cited By ~ 20

Author(s):

Tuba Unal ◽

Mevlut Celikoglu ◽

Celal Candirli

Keyword(s):

Class Ii ◽

Prospective Clinical Study ◽

Class Ii Malocclusion ◽

New Approach ◽

Mandibular Symphysis ◽

Skeletal Class ◽

Skeletal Changes ◽

Skeletal Class Ii ◽

Student’S T ◽

Mandibular Retrusion

ABSTRACT Objective: To evaluate the skeletal, dentoalveolar, and soft tissue effects of the Forsus Fatigue Resistant Device (FRD) appliance with miniplate anchorage for the treatment of skeletal Class II malocclusion. Material and Methods: The prospective clinical study group included 17 patients (11 girls and 6 boys; mean age 12.96 ± 1.23 years) with Class II malocclusion due to mandibular retrusion and treated with skeletal anchoraged Forsus FRD. After 0.019 × 0.025-inch stainless steel archwire was inserted and cinched back in the maxillary arch, two miniplates were placed bilaterally on the mandibular symphysis. Then, the Forsus FRD EZ2 appliance was adjusted to the miniplates without leveling the mandibular arch. The changes in the leveling and skeletal anchoraged Forsus FRD phases were evaluated by means of the Paired and Student's t-tests using the cephalometric lateral films. Results: The success rate of the miniplates was found to be 91.5% (38 of 42 miniplates). The mandible significantly moved forward (P < .001) and caused a significant restraint in the sagittal position of the maxilla (P < .001). The overjet correction (−5.11 mm) was found to be mainly by skeletal changes (A-VRL, −1.16 mm and Pog-VRL, 2.62 mm; approximately 74%); the remaining changes were due to the dentoalveolar contributions. The maxillary and mandibular incisors were significantly retruded (P < .001). Conclusion: This new approach was an effective method for treating skeletal Class II malocclusion due to the mandibular retrusion via a combination of skeletal and dentoalveolar changes.

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