Treatment of a severe Class II  malocclusion with pre-existing  root resorption - A judicious use of orthodontic appliances

The orthodontic treatment of patients with pre-existing root resorption (RR) is often difficult due to the increased risk of progression and often a compromised treatment outcome can be expected. The treatment plan in such situations should comprise of a root sparing strategy, which includes reducing the treatment duration with fixed appliances, non-extraction treatment, reducing force levels, avoiding intrusion of at-risk teeth, reducing the amount of apical movement of the affected teeth and intermittent force application where possible. The following case report shows the use of a root sparing strategy in the treatment of a severe Class II malocclusion with pre-existing root resorption of the 11 and 21.

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Identification of Orthodontic Extraction Predictors in End-On Class II Malocclusion

Journal of The Pakistan Dental Association ◽

10.25301/jpda.303.178 ◽

2021 ◽

Vol 30 (03) ◽

pp. 178-182

Author(s):

Batool Ali ◽

◽

Waqar Jeelani ◽

Attiya Shaikh ◽

Tabassum Ahsan Quadeer ◽

...

Keyword(s):

Treatment Plan ◽

Binary Logistic Regression ◽

Class Ii ◽

Binary Logistic Regression Analysis ◽

Class Ii Malocclusion ◽

Upper Lip ◽

Lower Incisor ◽

Factors Affecting ◽

Treatment Predictors ◽

Extraction Treatment

BJECTIVE: This study was designed to determine the different treatment predictors which help in the extraction and non-extraction decision of an end-on Class II malocclusion case. METHODOLOGY: The pretreatment records of 240 adult subjects aged 15-40 years with bilateral end-on Class II molar relationship were retrospectively selected and categorized under extraction (120) and non-extraction (120) treatment categories. The extraction cases were planned for different combinations of premolar extractions. The independent variables i.e., the cephalometric and orthodontic cast measurements were obtained from the recruited sample. Binary logistic regression analysis was applied using SPSS software. RESULTS: Increased upper and lower incisor inclinations (p < 0.001) and procumbent upper lip (p = 0.004) was statistically significant in the extraction group. According to the regression model, the odds of extraction treatment were 1.12 times greater than non-extraction treatment for every one degree increase in upper and lower incisor inclinations, respectively. The chances of extraction treatment were 1.6 times higher than non-extraction treatment for every 1 mm increase in the distance of upper lip to S-plane. CONCLUSIONS: The upper and lower incisors inclinations and upper lip position are the critical factors affecting the extraction decision in adult patients with end-on Class II molar relationships. Overjet, dental crowding and the vertical growth pattern were found to be clinically insignificant in opting for an extraction treatment plan for such cases. KEYWORDS: Treatment, Angle Class II, tooth extraction, non-extraction

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Class II malocclusion treatment using Jasper Jumper appliance associated to intermaxillary elastics: a case report

Dental Press Journal of Orthodontics ◽

10.1590/s2176-94512013000200010 ◽

2013 ◽

Vol 18 (2) ◽

pp. 22-29 ◽

Cited By ~ 1

Author(s):

Francyle Simões Herrera-Sanches ◽

José Fernando Castanha Henriques ◽

Guilherme Janson ◽

Leniana Santos Neves ◽

Karina Jerônimo Rodrigues Santiago de Lima ◽

...

Keyword(s):

Class Ii ◽

Dental Arch ◽

Orthodontic Appliances ◽

Class Ii Malocclusion ◽

Facial Profile ◽

Division 1 ◽

Efficient Alternative ◽

Fixed Appliances ◽

One Year ◽

Lingual Retainer

INTRODUCTION: Skeletal, dental and profile discrepancies can be amended by using functional orthodontic appliances. OBJECTIVE: This study is a report of the treatment of a patient, 11 years and 4 months old, with Class II, division 1, malocclusion, convex profile, protrusion of upper incisors, pronounced overjet and overbite, and mild crowding. METHODS: The patient was treated with a Jasper Jumper associated to fixed appliances for 6 months and Class II intermaxillary elastics (3/16in) during the last 4 months. After debonding, a Hawley retainer was used during daytime and a modified Bionator for night use during one year. In the lower dental arch a bonded lingual retainer was used. This treatment combination improved the profile, as well as the overjet, overbite and molar relation. RESULTS: There was clockwise mandibular rotation and increase of lower anterior facial height. The lower incisors were protruded and extruded and the lower molars were extruded. The centric occlusal relation was checked and it was coincident to the maximum usual intercuspation. CONCLUSION: It was demonstrated that the Jasper Jumper is an efficient alternative to Class II malocclusion treatment, providing improvement in the facial profile, although the changes are more dentoalveolar than skeletal.

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Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis

Progress in Orthodontics ◽

10.1186/s40510-020-00334-4 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Allen Abbing ◽

Vasiliki Koretsi ◽

Theodore Eliades ◽

Spyridon N. Papageorgiou

Keyword(s):

Treatment Duration ◽

Meta Analysis ◽

Risk Of Bias ◽

Adult Patients ◽

Comprehensive Treatment ◽

Orthodontic Appliances ◽

Duration Of Treatment ◽

Quality Of Evidence ◽

Fixed Appliances

Abstract Objectives Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents. Materials and methods Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. Results A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = − 0.8 month; 95% CI = − 4.2 to 2.6 months; P = 0.65; I2 = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias. Conclusions While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies. Trial registration PROSPERO: (CRD42019148169)

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Comparative analysis of the effectiveness of the use of various orthodontic appliances in the correction of malocclusion of the II class in children and adolescents

Стоматология для всех ◽

10.35556/idr-2021-1(94)12-15 ◽

2021 ◽

pp. 12-15

Author(s):

N.D. Pilipenko ◽

S.Yu Maksyukov

Keyword(s):

Comparative Analysis ◽

Children And Adolescents ◽

Treatment Process ◽

Class Ii ◽

Orthodontic Appliances ◽

Class Ii Malocclusion ◽

Twin Block ◽

Lower Jaw ◽

Jaw Position

This study is dedicated to a comparative analysis of effectiveness of using orthodontic appliances when treating class II malocclusion in children and adolescents. It was shown that treatment with the Invisalign system with a change of the lower jaw position is the most effective method for correcting class II malocclusion in growing patients. Using Invisalign aligners showed not only the best efficacy according to teleroentgenograms. but also made the treatment process comfortable for patients at all its stages. Moreover, higher level of compliance was demonstrated with treatment using the Invisalign system compared to the Twin-block appliance.

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Class II malocclusion with complex problems treated with a novel combination of lingual orthodontic appliances and lingual arches

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/j.ajodo.2013.08.022 ◽

2014 ◽

Vol 146 (1) ◽

pp. 98-107 ◽

Cited By ~ 7

Author(s):

Takeshi Yanagita ◽

Masahiro Nakamura ◽

Noriaki Kawanabe ◽

Takashi Yamashiro

Keyword(s):

Class Ii ◽

Orthodontic Appliances ◽

Class Ii Malocclusion ◽

Complex Problems

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Infra-Zygomatic Mini Screws Compared to High Pull Headgear for Distalization And Intrusion of Maxillary Molars in Growing Patients with Class II Malocclusion: A Randomized Clinical Trial

European Journal of Dental and Oral Health ◽

10.24018/ejdent.2021.2.1.40 ◽

2021 ◽

Vol 2 (1) ◽

pp. 14-19

Author(s):

Ahmed K. Afify ◽

Amr E. El-Dakroury ◽

Sherif A. El-Kordy ◽

Mostafa M. El-Dawlatly

Keyword(s):

Clinical Trial ◽

Clinical Study ◽

Treatment Duration ◽

Class Ii ◽

Class Ii Malocclusion ◽

Maxillary Molars ◽

Randomized Clinical Study ◽

Molar Intrusion ◽

Before And After ◽

Patient Cooperation

Objective: The aim of the present randomized clinical study was to evaluate the distalization and intrusion effect of an Infra-zygomatic mini-screws supported appliance and compare it with high pull headgear appliance in treatment of growing patients with class II malocclusion. Methodology: 22 growing boys aged between (10 to 12 years) with class II div 1 malocclusion randomly divided to 2 equal groups. The first group treated with high pull headgear with acrylic splint and the second one treated with an Infra-zygomatic mini-screws supported appliance. The treatment duration was 8 months for both groups. Lateral cephalometric radiographs were taken before and after the treatment for each patient to be analyzed. Results: The maxillary first molar distalization was 2.58±2.31 mm in head gear group and 1.53±2.83 mm in mini-screws group. There was no significant maxillary first molar intrusion in both groups. There were no significant differences between the two groups. Conclusions: the mini-screws supported appliance can be used as the fixed replacement of the removable high pull headgear appliance with no need for patient cooperation.

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Long-term skeletal effects of high-pull headgear followed by fixed appliances for the treatment of Class II malocclusions

The Angle Orthodontist ◽

10.2319/091517-620.1 ◽

2018 ◽

Vol 88 (5) ◽

pp. 530-537

Author(s):

E. Erin Bilbo ◽

Steven D. Marshall ◽

Karin A. Southard ◽

Verrasathpurush Allareddy ◽

Nathan Holton ◽

...

Keyword(s):

Class Ii ◽

Class I ◽

Control Group ◽

Orthodontic Appliances ◽

Skeletal Changes ◽

Fixed Orthodontic Appliances ◽

Horizontal Growth ◽

Skeletal Effects ◽

Fixed Appliances

ABSTRACT Objectives: The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group. Materials and Methods: Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models. Results: Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = −1.925°, P < .0001; FH-NA = −3.042°, P < .0001; linear measurement A-point to Vertical Reference = −3.859 mm, P < .0001) and reduction of the ANB angle (−1.767°, P < .0001), with no effect on mandibular horizontal growth or maxillary and mandibular vertical skeletal changes. A-point horizontal restriction and forward mandibular horizontal growth accompanied the study group correction to Class I molar, and these changes were stable long term. Conclusions: One phase treatment for Class II malocclusion with high-pull headgear followed by fixed orthodontic appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.

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