Effects of Orthodontic Functional Appliances in Relation to Skeletal Maturation of Cervical Vertebrae in Class II Malocclusion

2021 ◽  
Vol 45 (5) ◽  
pp. 352-358
Author(s):  
Francisco Guinot ◽  
Marina Ferrer ◽  
Lara Díaz-González ◽  
Cristina García ◽  
Isabel Maura

Aim: To evaluate the effects produced by functional orthodontic appliances at dental and skeletal level in relation to the level of skeletal maturation in class II patients. Study design: Longitudinal and observational study. Patients selected for the study had been wearing Sander Bite Jumping Appliance (SBJA) for at least 12 months; they were first diagnosed (T1) with skeletal class II according to Ricketts’ cephalometric analysis, and had had lateral cephalograms taken before and after orthopaedic treatment (T2). Variables studied at T1 and T2 were: facial convexity, inclination of the upper and lower incisors, and facial depth. Results were compared between T1 and T2 for each variable and in relation to cervical maturation stage (CVS) according to the Lamparski analysis. Statistical analysis was performed using Shapiro–Wilk, t-student, Analysis of Variance (ANOVA) and multiple comparison tests, taking as statistically significant a p-value <0.05. Results: A final sample of 235 patients was obtained. Statistically significant differences were found in the inclination of the mandibular incisors between T1 and T2 and among the different cervical stages when the functional appliances were placed in CVS1 (p = 0.000), CVS2 (p = 0.04) or CVS5 (p = 0.048). For the remaining variables, significant differences were also found between T1 and T2, but these differences were similar in all cervical stages. Conclusions: A significant proclination of the mandibular incisors was found when the functional appliance was placed during CVS1, CVS2, or CVS5. Time of placement of the functional appliances was not statistically significant for the remaining variables studied.

2017 ◽  
Vol 87 (3) ◽  
pp. 363-370
Author(s):  
Muhsin Candir ◽  
Heidi Kerosuo

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.


2015 ◽  
Vol 4 (2) ◽  
pp. 23-26
Author(s):  
Sufia Nasrin Rita ◽  
SM Anwar Sadat

Class II malocclusion is the condition in which the mandibular first molars occlude distal to the normal relationship with the maxillary first molar. The etiology of class II malocclusion varied between skeletal, soft tissues, dental factors and habits. Skeletal class II could be because of protrusion of maxilla, retrusion of mandible and combination of both. The treatment modalities of any skeletal problem include Growth modification, Dental camouflage and Orthognathic surgery. The optimal time for treatment of patients with Class II malocclusions therapy should be initiated at the beginning of cervical vertebrae maturation stage CS3 to maximize the treatment effects. Age of treatment is approximately 8-14 years. The growth modification of moderate to severe skeletal class II malocclusion can be done by head gear, bionator, activator, twin block, herbest appliance, Frankel II regulator. The ultimate goal of growth modification depends on treatment timing, length of treatment, working mechanism of appliance, patient’s skeletal and dental condition we want to treat and the compliance of the patient.Update Dent. Coll. j: 2014; 4 (2): 23-26


2011 ◽  
Vol 12 (1) ◽  
pp. 14-18 ◽  
Author(s):  
G Anil Kumar ◽  
Amit Maheshwari

ABSTRACT Aim The aims of this study were to evaluate the dental changes brought about by activator and activator headgear combination (ACHG) and to determine whether we can achieve control over the lower incisor proclination which is a side effect of using functional appliances; or not, while treating cases of skeletal class II malocclusions. Methods Lateral cephalograms of 45 skeletal class II division 1 patients were selected for the study. Fifteen of them were successfully treated with an Andresen activator and the other 15 with an activator headgear combination. Fifteen class II subjects who had declined treatment served as the control group. Cephalometric landmarks were marked by one author to avoid interobserver variability. Results The results revealed that both the activator and the activator headgear combination significantly (p < 0.001) affected dental variables measured. The mandibular incisor proclination was effectively controlled in the activator headgear combination group. Conclusion An activator headgear combination would offer itself as a better option compared with activator alone in the treatment of skeletal class II malocclusions especially in cases with proclined mandibular incisors. Clinical significance When one of the treatment goals is to achieve a greater control over mandibular incisor proclination in the treatment of Skeletal Class II malocclusions, employing a combination of activator and headgear may substantially improve clinical outcomes. How to cite this article Lall R, Kumar GA, Maheshwari A Kumar M. A Retrospective Cephalometric Evaluation of Dental Changes with Activator and Activator Headgear Combination in the Treatment of Skeletal Class II Malocclusion. J Contemp Dent Pract 2011;12(1):14-18.


2015 ◽  
Vol 86 (6) ◽  
pp. 955-961 ◽  
Author(s):  
Susan Rizk ◽  
Valmy Pangrazio Kulbersh ◽  
Riyad Al-Qawasmi

ABSTRACT Objective: To evaluate the effects of functional appliance treatment on the oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position of growing Class II patients. Materials and Methods: Twenty Class II white patients (mean age, 11.7 ± 1.75 years) treated with the MARA followed by fixed appliances were matched to an untreated control sample by cervical vertebrae maturation stage at pretreatment (T1) and posttreatment (T2) time points. Cone beam computed tomography scans were taken at T1 and T2. Dolphin3D imaging software was used to determine oropharyngeal airway volume, dimensions, and anteroposterior hyoid bone position. Results: Multivariate ANOVA was used to evaluate changes between T1 and T2. Oropharyngeal airway volume, airway dimensions, and A-P position of the hyoid bone increased significantly with functional appliance treatment. SNA and ANB decreased significantly in the experimental group (P ≤ .05). Changes in SNB and Sn-GoGn failed to reach statistical significance. Conclusions: Functional appliance therapy increases oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position in growing patients.


2021 ◽  
Vol 10 (34) ◽  
pp. 2951-2953
Author(s):  
Namrata Dogra ◽  
Archana Jaglan ◽  
Sidhu M. S. ◽  
Seema Grover ◽  
Suman Suman

Treatment of complex malocclusion poses a challenge for the orthodontist because of its multifactorial aetiology. Class II malocclusion is the most frequently encountered and treated malocclusion in orthodontic practice and affects approximately 14.6 % of the North Indian population.1 A common reason for Class II malocclusion is mandibular skeletal retrusion which is the most common characteristic, as reported by McNamara.2 This can be caused by genetic or hereditary factors. When evaluating treatment options for Class II patients, the extent of the skeletal discrepancy and the skeletal maturity of the patient needs to be considered. Treatment may range from dental compensation including camouflage with extractions to surgical procedures targeted at moving the jaw at fault. In growing patients, growth modification with functional appliances offers an intermediate treatment option. Functional appliances are basically of two types; Removable and Fixed. Removable functional appliances such as Activator, Bionator, Frankel Function regulator and Twin Block appliance change Class II relationship by the transmission of soft tissue tension to the dentition. Treatment success with these appliances relies heavily on patient compliance. Therefore, in non-compliant patients, fixed Class II correctors in conjunction with fixed orthodontic appliances are the best choice.3 Fixed functional appliances generate continuous stimuli for mandibular growth without break and permit better adaptation to functions like mastication, swallowing, speech and respiration.1 The Herbst fixed functional appliance has been used routinely for Class II patients and has undergone many design variations over time.4 The AdvanSync2 Class II corrector is a recently introduced fixed functional appliance. It has a much smaller size than the conventional Herbst appliances, is easier to place, activate and remove and most importantly, can be used in conjunction with full-arch fixed appliances throughout.3 Here we describe a case report of a patient treated with the AdvanSync2 Class II corrector and the findings observed in the sagittal and vertical dimensions


2021 ◽  
pp. 030157422110054
Author(s):  
Prachi Gohil ◽  
Sonali Mahadevi ◽  
Bhavya Trivedi ◽  
Neha Assudani ◽  
Arth Patel ◽  
...  

We are in the process of discovery of new vistas for technological advances in terms of various appliances with a vision of making orthodontic treatment compliance free as well as successful. Due to improved technology, the enigma of treating the Class II syndrome is palliated. “Out of the box” thinking has become a norm to treat certain situations that were not corrected in noncompliant patients. Fixed functional appliances are valuable tools introduced to assist the correction of skeletal Class II malocclusion with mandibular retrognathia at the deceleration stage of growth for achieving stable results. In this direction a case series is reported of patients having the above conditions and undergoing orthodontic treatment using a Forsus FFA. Joining hands with technology is a win-win situation for both the patient and the orthodontist.


2014 ◽  
Vol 19 (1) ◽  
pp. 46-54 ◽  
Author(s):  
Fabio de Abreu Vigorito ◽  
Gladys Cristina Dominguez ◽  
Luís Antônio de Arruda Aidar

OBJECTIVE: To assess the dentoskeletal changes observed in treatment of Class II, division 1 malocclusion patients with mandibular retrognathism. Treatment was performed with the Herbst orthopedic appliance during 13 months (phase I) and pre-adjusted orthodontic fixed appliance (phase II). METHODS: Lateral cephalograms of 17 adolescents were taken in phase I onset (T1) and completion (T2); in the first thirteen months of phase II (T3) and in phase II completion (T4). Differences among the cephalometric variables were statistically analyzed (Bonferroni variance and multiple comparisons). RESULTS: From T1 to T4, 42% of overall maxillary growth was observed between T1 and T2 (P < 0.01), 40.3% between T2 and T3 (P < 0.05) and 17.7% between T3 and T4 (n.s.). As for overall mandibular movement, 48.2% was observed between T1 and T2 (P < 0.001) and 51.8% between T2 and T4 (P < 0.01) of which 15.1% was observed between T2 and T3 (n.s.) and 36.7% between T3 and T4 (P < 0.01). Class II molar relationship and overjet were properly corrected. The occlusal plane which rotated clockwise between T1 and T2, returned to its initial position between T2 and T3 remaining stable until T4. The mandibular plane inclination did not change at any time during treatment. CONCLUSION: Mandibular growth was significantly greater in comparison to maxillary, allowing sagittal maxillomandibular adjustment. The dentoalveolar changes (upper molar) that overcorrected the malocclusion in phase I, partially recurred in phase II, but did not hinder correction of the malocclusion. Facial type was preserved.


2018 ◽  
Vol 8 (1) ◽  
pp. 63-67
Author(s):  
Luv Agarwal ◽  
Kamlesh Singh ◽  
Ragni Tandon

Correction of skeletal Class II malocclusion has become a major challenge for orthodontists. Class II jaw discrepancies characterized by mandibular deficiency are treated with fixed functional appliances when there is no active growth present. This case report illustrates the application of PowerScope in 16 years young adolescent male having skeletal Class II Div 2 with mandibular deficiency who was reported with forwardly and irregularly placed upper front teeth with closed bite. The case was treated initially with MBT 0.022” prescription followed by PowerScope. Successful results were obtained with a substantial improvement in facial profile, skeletal jaw relationship and overall aesthetic appearance. PowerScope produced a significant forward movement of mandible which obliterated the need of extractions


2012 ◽  
Vol 06 (02) ◽  
pp. 123-132 ◽  
Author(s):  
Elcin Esenlik ◽  
Fidan Alakus Sabuncuoglu

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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