A Three Dimensional Study of Upper Airway in Adult Skeletal Class II Patients with Different Vertical Growth Patterns

ABSTRACT Objectives: To characterize upper airway volume and morphology in patients with different skeletal patterns of Class II malocclusion compared to Class I. Materials and Methods: A total of 197 individuals who had cone-beam computed tomography were allocated into groups according to ANB, SNA, and SNB angles (Class I, Class II maxillary protrusion, Class II mandibular retrusion), each subdivided into hypodivergent, normal, and hyperdivergent. Nasopharynx (NP), oropharynx (OP), and hypopharynx (HP) were assessed with three-dimensional image reconstruction software. Results: Intergroup comparison did not detect significant differences in volume and morphology of NP, OP, and HP. The males displayed larger OP and HP volume than the females. Positive correlations between age and NP, OP, HP volume and between craniocervical angle and OP and HP volume were observed. Linear regression analysis detected a tendency for OP and HP volume to increase as maxillary and mandibular length increased. Conclusions: Upper airway volume and morphology were similar in different skeletal patterns of Class II malocclusion. Actual upper and lower jaw lengths were more closely related to upper airway volume and morphology than the angles that reflected their position relative to the cranial base.

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Uso de propulsor mandibular fixo Flex Developer como recurso no tratamento da Classe II em paciente não colaborador

Orthodontic Science and Practice ◽

10.24077/2020;1352-4051 ◽

2020 ◽

Vol 13 (52) ◽

pp. 40-51

Author(s):

Renato Barcellos Rédua

Keyword(s):

Upper Airway ◽

Class Ii ◽

Class Ii Malocclusion ◽

Skeletal Class ◽

Advantages And Disadvantages ◽

Skeletal Class Ii ◽

High Incidence ◽

Therapeutic Alternatives ◽

Smile Aesthetics ◽

Treatment Alternatives

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.

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Alveolar and symphysis regions of patients with skeletal class II division 1 anomalies with different vertical growth patterns

European Journal of Dentistry ◽

10.1055/s-0039-1698941 ◽

2012 ◽

Vol 06 (02) ◽

pp. 123-132 ◽

Cited By ~ 6

Author(s):

Elcin Esenlik ◽

Fidan Alakus Sabuncuoglu

Keyword(s):

Normal Subjects ◽

Class Ii ◽

Growth Patterns ◽

Control Group ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Lateral Cephalograms ◽

Division 1 ◽

Main Factor ◽

Class Ii Division 1

ABSTRACTObjectives: The aim of this study was to investigate the alveolar and symphysis region properties in hyper-, hypo-, and normodivergent Class II division 1 anomaliesMethods: Pretreatment lateral cephalograms of 111 young adult female patients with skeletal Class II division 1 anomalies were compared to those of 54 Class I normal subjects (control group). Class II cases were divided into hyperdivergent (n = 58), hypodivergent (n = 19), and normodivergent groups (n = 34). The heights and widths of the symphysis and alveolus and the depth of maxillary palate were measured on the lateral cephalogramsResults: Mean symphysis width was wider in the hypodivergent Class II group than in the other groups, while mean symphysis height was similar among all groups. Maxillary palatal depth, upper incisor angle, upper and lower molar alveolar heights, and Id–Id′ width were also similar among groupsConclusion: Symphysis width is the main factor in the differential diagnosis of Class II division 1 anomaly rather than symphysis height and hypodivergent Class II Division 1 anomaly is more suitable for mandibular incisors movements. (Eur J Dent 2012;6:123-132)

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Nonsurgical and nonprosthetic camouflage treatment of skeletal Class II open bite with bilaterally missing lower first molars

The Angle Orthodontist ◽

10.2319/030718-189.1 ◽

2018 ◽

Vol 89 (3) ◽

pp. 505-517. ◽

Cited By ~ 1

Author(s):

Tung Nguyen ◽

Eui Seon Baek ◽

Soonshin Hwang ◽

Kyung-Ho Kim ◽

Chooryung J. Chung

Keyword(s):

Treatment Outcome ◽

Three Dimensional ◽

Class Ii ◽

Open Bite ◽

Third Molars ◽

Second Molar ◽

Skeletal Class ◽

Long Term Stability ◽

Skeletal Class Ii

ABSTRACT This report illustrates the successful nonsurgical and nonprosthetic camouflage treatment of a skeletal Class II open bite malocclusion combined with missing mandibular first molars bilaterally. In the mandible, the second and third molars were uprighted and protracted, substituting for the missing first molars. In the maxilla, anterior bodily retraction and full-arch intrusion were achieved following premolar and second molar extraction, which also induced autorotation of the mandible. The treatment outcome and prognosis were confirmed with three-dimensional superimposition techniques, along with long-term stability.

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Three-dimensional effects of the mini-implant–anchored Forsus Fatigue Resistant Device: A randomized controlled trial

The Angle Orthodontist ◽

10.2319/012515-55.1 ◽

2015 ◽

Vol 86 (2) ◽

pp. 292-305 ◽

Cited By ~ 12

Author(s):

Sherif A. Elkordy ◽

Amr M. Abouelezz ◽

Mona M. Salah Fayed ◽

Khaled H. Attia ◽

Ramy Abdul Rahman Ishaq ◽

...

Keyword(s):

Controlled Trial ◽

Three Dimensional ◽

Class Ii ◽

Control Group ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Skeletal Effects ◽

Implant Anchorage ◽

Mandibular Incisors ◽

Forsus Fatigue Resistant Device

ABSTRACT Objective: To detect three-dimensionally the effects of using mini-implant anchorage with the Forsus Fatigue Resistant Device (FFRD). Materials and Methods: The sample comprised 43 skeletal Class II females with deficient mandibles. They were randomly allocated into three groups: 16 patients (13.25 ± 1.12 years) received FFRD alone (Forsus group), 15 subjects (13.07 ± 1.41 years) received FFRD and mini-implants (FMI group), and 12 subjects (12.71 ± 1.44 years) were in the untreated control group. Three-dimensional analyses of cone beam computed tomographic images were completed, and the data were statistically analyzed. Results: Class I relationship and overjet correction were achieved in 88% of the cases. None of the two treatment groups showed significant mandibular skeletal effects. In the FMI group, significant headgear effect, decrease in maxillary width, and increase in the lower facial height were noted. In the FMI group, retroclination of maxillary incisors and distalization of maxillary molars were significantly higher. Proclination and intrusion of mandibular incisors were significantly greater in the Forsus group. Conclusions: FFRD resulted in Class II correction mainly through dentoalveolar effects and with minimal skeletal effects. Utilization of mini-implant anchorage effectively reduced the unfavorable proclination and intrusion of mandibular incisors but did not produce additional skeletal effects.

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Evaluation of the position and morphology of tongue and hyoid bone in skeletal Class II malocclusion based on cone beam computed tomography

BMC Oral Health ◽

10.1186/s12903-021-01839-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wener Chen ◽

HungEn Mou ◽

Yufen Qian ◽

Liwen Qian

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Hyoid Bone ◽

Class Ii ◽

Growth Patterns ◽

Class I ◽

Cone Beam ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Average Angle

Abstract Background The aim of the study was to analyze the morphology and position of the tongue and hyoid bone in skeletal Class II patients with different vertical growth patterns by cone beam computed tomography in comparison to skeletal Class I patients. Methods Ninety subjects with malocclusion were divided into skeletal Class II and Class I groups by ANB angles. Based on different vertical growth patterns, subjects in each group were divided into 3 subgroups: high-angle group (MP-FH ≥ 32.0°), average-angle group (22.0° ≤ MP-FH < 32°) and low-angle group (MP-FH < 22°). The position and morphology of the tongue and hyoid bone were evaluated in the cone beam computed tomography images. The independent Student’s t‐test was used to compare the position and morphology of the tongue and hyoid bone between skeletal Class I and Class II groups. One-way analysis of variance (ANOVA) was used to compare the measurement indexes of different vertical facial patterns in each group. Results Patients in skeletal Class II group had lower tongue posture, and the tongue body was smaller than that of those in the Class I group (P < 0.05). The position of the hyoid bone was lower in the skeletal Class II group than in Class I group (P < 0.05). The tongue length and H-Me in the skeletal Class I group with a low angle were significantly larger than those with an average angle and high angle (P < 0.05). There was no significant difference in the position or morphology of the tongue and hyoid bone in the skeletal Class II group with different vertical facial patterns (P > 0.05). Conclusion Patients with skeletal Class II malocclusion have lower tongue posture, a smaller tongue body, and greater occurrence of posterior inferior hyoid bone position than skeletal Class I patients. The length of the mandibular body in skeletal Class I patients with a horizontal growth type is longer. The position and morphology of the tongue and hyoid bone were not greatly affected by vertical facial development in skeletal Class II patients.

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Three-dimensional assessment of condylar position and joint spaces after maxillary first premolar extraction in skeletal Class II malocclusion

Orthodontics and Craniofacial Research ◽

10.1111/ocr.12141 ◽

2017 ◽

Vol 20 (2) ◽

pp. 71-78 ◽

Cited By ~ 7

Author(s):

M. S. Alhammadi ◽

M. S. Fayed ◽

A. Labib

Keyword(s):

Three Dimensional ◽

Class Ii ◽

Class Ii Malocclusion ◽

Skeletal Class ◽

Premolar Extraction ◽

Skeletal Class Ii ◽

Condylar Position ◽

Dimensional Assessment

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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

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Long Term Stability of Skeletal Class II Treatment with Modified Bionator Followed by Fixed Appliance - A Case Report

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/356 ◽

2021 ◽

Vol 10 (22) ◽

pp. 1726-1731

Author(s):

Harshil Naresh Joshi ◽

Jay Soni ◽

Santosh Kumar Goje ◽

Arth Patel ◽

Shireen Mann ◽

...

Keyword(s):

Case Report ◽

Class Ii ◽

Growth Patterns ◽

Growth Potential ◽

Human Populations ◽

Skeletal Class ◽

Class Ii Treatment ◽

Skeletal Class Ii ◽

Division 1 ◽

Class Ii Division 1

The most prevalent malocclusion seen in day-to-day practice is Class II division 1 malocclusion. Most patients with malocclusions in class II division 1 have an underlying skeletal difference between the maxilla and the mandible. The treatment of skeletal class II division 1 depends on the patient's age, the ability of growth potential, the seriousness of malocclusion, and the patient's adherence to treatment. Myofunctional equipment can be successfully used to treat rising patients with deficient mandible class II division 1 malocclusion. This case report shows a focus on Class II Division 1 care due to mandibular deficiency using modified bionator appliances accompanied by fixed mechanotherapy with growth modification approach. Class II Division 1 is one of the most widely encountered form of malocclusion in human populations. The common characteristic of Class II Div 1 malocclusion in growing children is mandibular retrusion, according to Dr. James McNamara.1 The prevalence of Skeletal Class II malocclusion is 15 % of the world's total population. Underlying difference between Maxillary & Mandibular jaw makes the Class II Div 1 malocclusion more complex than it appears. It’s due to a contribution of only maxilla, or only mandible, or a combination of both. The treatment of Class II division 1 relies on the patient's age, growth ability, degree of malocclusion, and patient compliance with therapy.1,2 The cases with retrognathic mandible must be addressed by altering the direction & amount of mandibular growth by using functional appliances.3 The Bionator is a tooth-borne appliance that significantly changes dental and skeletal component of the face through a repositioning of mandible in a more protrusive & balanced way, selective eruption of teeth and profile enhancement.4-7 The Balters Bionator was first introduced in 1960 by Wilhelm Balters as a functional appliance & still one of the most widely used removable appliances for correction of mandibular retrognathism.8 In functional orthopaedics, all aspects of genetically determined individual growth patterns are important, most particularly time, potential, and growth direction. Although during the prepubertal phase there is limited skeletal development, substantial growth occurs during puberty, but with great individual variation. To prevent damage to erupting teeth and to normalize jaw growth, early functional orthopaedic intervention in the prepubertal phase is used.9,10,11 The purpose of this case report is to illustrate how satisfactory results were obtained in the treatment of Class II division 1 malocclusion with modified Bionator in young patients. The positive facial, dental and cephalometric improvements are also illustrated, with the aid of proper diagnosis, amplified by excellent patient cooperation in case selection.

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