Effects of Class II elastics during growth on the functional occlusal plane according to skeletal pattern and extraction vs nonextraction

ABSTRACT Objectives To investigate the effect of Class II intermaxillary elastics on the functional occlusal plane (FOP) of growing patients. Materials and Methods A total of 50 participants aged 11 to 16 years were selected from a university clinic archive >1-year after treatment and after undergoing 6 months of Class II elastic wear, taking pretreatment (T0) and posttreatment (T1) lateral cephalometric radiographs, and consenting to participate at recall (T2). Participants were divided into 3 groups according to skeletal pattern or into 2 groups according to treatment with extraction (E) or nonextraction (NE). Angular changes of FOP relative to the Sella-Nasion (SN), mandibular plane (MP), and Frankfort horizontal (FH) were compared within and between groups. Results A statistically significant reduction of FOP-SN/FH, but not of FOP-MP, was found from T0–T1–T2 when all patients were grouped together. FOP-SN/MP/FH was significantly the largest in the patients with a hyperdivergent skeletal pattern, but lowest in the patients with a hypodivergent skeletal pattern at T0, T1, and T2 (P < .032). FOP-MP at T0–T2 was statistically larger in group E than in group NE (P < .02). No differences were found for FOP changes (change before treatment minus after treatment and change after treatment minus 1 year after treatment) between different skeletal patterns (P > .433) and treatment groups (P > .193). Conclusions Use of Class II elastics during the growth period was not found to show adverse effects on FOP rotation. Neither skeletal pattern nor treatment modality differed in the response to Class II elastics with regard to FOP changes. Individual patient growth pattern must be taken into consideration when treatment planning the use of Class II elastics. Orthodontists should take into account individual skeletal and growth patterns while using Class II elastics.

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RELATIONSHIP BETWEEN OCCLUSAL PLANE ORIENTATION AND SAGITTAL MALOCCLUSIONS: STUDY OF AN ORTHODONTIC POPULATION

Innovare Journal of Social Sciences ◽

10.22159/ijss.2021.v9i3.41058 ◽

2021 ◽

pp. 1-6

Author(s):

INES DALLEL ◽

SANA KANOUN ◽

MARIEM NAHDI ◽

MONCEF OMMEZINE ◽

SAMIR TOBJI ◽

...

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

Significant Rise ◽

Class I ◽

Occlusal Plane ◽

Class Iii ◽

Angle Class ◽

Mandibular Plane ◽

Significant Difference ◽

Skeletal Pattern

Objective: The aim of this study was to evaluate the association of the skeletal pattern and angle class with the occlusal plane (OP). This study also examined the effect of orthodontic treatment on this plane. Methods: Lateral cephalometric radiographs of a sample of 135 patients were collected. The angles between the Frankfort horizontal, palatal plane (PP), mandibular plane (MP), and the OP were analyzed and compared between several groups and subsequently before and after treatment. Results: The statistical comparison between 3 skeletal frame groups demonstrates that the cant of the OP showed a major difference. This difference was greater in class III subjects. Examination revealed that the OP was not meaningfully affected within the Angle classification. Statistically, a significant correlation was found between OP steepness and the vertical skeletal pattern. A significant rise of OP/sella-nasion (SN) for class I (p=0.019) and II (p=0.015) after orthodontic treatment. In addition, patients treated with elastics showed a significant decrease of OP/MP (mandibular plane) in Angle class III and considerable increase of OP/SN and OP/PP in Angle class II. Observations of the group treated with bimaxillary extractions showed that OP/SN (sella nasion line) and OP/PP differ in a meaningful way. Conclusion: This study confirms the association between the skeletal pattern and the OP inclination in adults. Concerning the Angle classification, there was no significant difference between the groups. Orthodontic therapy had an influence on the inclination of this plane for the different malocclusions. Premolars extraction in class I cases significantly modified the OP. For class II and III malocclusions, the OP inclination was mainly altered by the use of intermaxillary traction elastics.

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A Comparison of Craniofacial Characteristics between Two Different Adult Populations with Class II Malocclusion—A Cross-Sectional Retrospective Study

Biology ◽

10.3390/biology10050438 ◽

2021 ◽

Vol 10 (5) ◽

pp. 438

Author(s):

Arvind Sivakumar ◽

Prasad Nalabothu ◽

Huyen Nguyen Thanh ◽

Gregory S. Antonarakis

Keyword(s):

Growth Pattern ◽

Class Ii ◽

Class Ii Malocclusion ◽

South Indian Population ◽

The South ◽

Facial Height ◽

South Indian ◽

Mandibular Plane ◽

Lateral Cephalograms ◽

Craniofacial Characteristics

The dental, skeletal, and soft-tissue characteristics of a particular malocclusion can differ based on ethnicity, race, age, sex and geographical location with Class II malocclusion being one of the most prevalent malocclusions encountered in orthodontic clinical practice. The broad understanding of the characteristics of vertical skeletal and dental parameters in patients with Class II malocclusion can help clinicians to identify patterns and variations in the expression of this phenotype for better treatment outcomes. Hence, we compared the craniofacial characteristics of skeletal and dental Class II malocclusion traits from Indian and Vietnamese individuals to analyze the vertical skeletal and dental patterns in both population groups. The sample comprised of lateral cephalograms from 100 young adults with Class II malocclusion, of which fifty (25 males and 25 females) were from South India and the other 50 age- and sex-matched adults from Vietnam. The lateral cephalometric radiographs were digitized into anonymous image files and were traced and assessed for 16 vertical skeletal and dental parameters. The ANB angle was greater in males (+1.4 deg; p < 0.001) and females (+1.9 deg; p < 0.001) in the South Indian population. The Vietnamese males had a larger mandibular plane angle, articular angle, anterior facial height and lower anterior facial height compared to the Indian males. The Vietnamese females had larger mandibular plane and articular angles compared to the Indian females. The skeletal class II malocclusion was more severe in the South Indian compared to the Vietnamese adults. The Vietnamese sample showed a generalized tendency towards a more vertical skeletal growth pattern and in males this pattern seemed to be due to the dentoalveolar component. The Vietnamese females showed a tendency towards a vertical growth pattern, but without apparent contribution by the dentoalveolar component.

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Influence of Vertical Facial Growth Pattern on Herbst Appliance Effects in Prepubertal Patients: A Retrospective Controlled Study

International Journal of Dentistry ◽

10.1155/2020/1018793 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Maria Rita Giuca ◽

Marco Pasini ◽

Sara Drago ◽

Leonardo Del Corso ◽

Arianna Vanni ◽

...

Keyword(s):

Growth Pattern ◽

Class Ii ◽

Growth Patterns ◽

Response To Treatment ◽

Controlled Study ◽

Class Ii Malocclusion ◽

Facial Growth ◽

Herbst Appliance ◽

Lateral Cephalograms ◽

Vertical Growth Pattern

Introduction. The Herbst device is widely used for correction of class II malocclusions; however, most of the researches carried out on the Herbst appliance in literature do not take into account patients with a different mandibular divergence. The aim of this study was to investigate the effects of Herbst on dental and skeletal structures and to evaluate possible influence of vertical facial growth patterns. Methods. A retrospective study was conducted on lateral cephalograms of 75 growing patients (mean age: 9.9 ± 1.9 years) with class II malocclusion treated with Herbst. Subjects were divided into 3 groups using the mandibular divergence index (SN and GoMe angle). Cephalometric parameters were evaluated using the modified SO (sagittal occlusion) Pancherz’s analysis. A statistical analysis was conducted to evaluate differences among groups using ANOVA. Results. Our study showed differences in response to treatment depending on patient’s facial vertical growth pattern. Cranial base angle and mandibular rotation were significantly different (p<0.05) between hypodivergent patients and normodivergent patients and between hypodivergent and hyperdivergent subjects. Conclusion. Hypodivergent patients increased their mandibular divergence during treatment to a greater extent than normodivergents; moreover, hyperdivergent patients exhibited a decreased mandibular divergence at the end of the treatment.

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Two Different Applications of Class II Elastics with Nonextraction Segmental Techniques

The Angle Orthodontist ◽

10.2319/071006-283 ◽

2007 ◽

Vol 77 (4) ◽

pp. 694-700 ◽

Cited By ~ 4

Author(s):

Aslihan Uzel ◽

Ilter Uzel ◽

M. Serdar Toroglu

Keyword(s):

Treatment Time ◽

Control Period ◽

Class Ii ◽

Control Group ◽

Treatment Groups ◽

Facial Height ◽

Lateral Cephalograms ◽

Division 1 ◽

The Mean ◽

Class Ii Elastics

Abstract Objective: To evaluate the relative effects of Class II elastics applied directly with utility arches (UAs) or with the Reciprocal Mini–Chin Cup (RMCC) appliance. Materials and Methods: Thirty patients with Class II division 1 malocclusion were included. Fifteen of them were treated with the RMCC appliance and the other 15 treated with Class II elastics on UAs. Lateral cephalograms of an additional 15 untreated persons having the same characteristics as the treatment groups were used as a control group. Results: The mean control period was 10 months. Class I molar and canine relationships were achieved in a mean treatment time of 4.6 months with the RMCC appliance and in 8.5 months with the elastics on UAs. The amount of overjet reduction was 4.7 mm in the RMCC group (87.87% dental) and 5.2 mm in the UA group (80.76% dental). The molar correction was 4.5 mm in the RMCC group (87.36% dental) and 2.0 mm in the UA group (51.47% dental). The anterior lower facial height increased in both of the treatment groups. Conclusions: The RMCC appliance is a valuable alternative for Class II elastic use in Class II cases in which the upper molars need to be moved to the distal more than the upper incisors.

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Occlusal plane canting reduction accompanies mandibular counterclockwise rotation in camouflaging treatment of hyperdivergent skeletal Class II malocclusion

The Angle Orthodontist ◽

10.2319/101512-801.1 ◽

2013 ◽

Vol 83 (5) ◽

pp. 758-765 ◽

Cited By ~ 2

Author(s):

Rui Ye ◽

Yu Li ◽

Xue Li ◽

Juan Li ◽

Jue Wang ◽

...

Keyword(s):

Class Ii ◽

Occlusal Plane ◽

Maxillary Incisor ◽

Class Ii Malocclusion ◽

Clockwise Rotation ◽

Skeletal Class ◽

Counterclockwise Rotation ◽

Clinically Normal ◽

Skeletal Class Ii ◽

Skeletal Pattern

ABSTRACT Objective To investigate the occlusal configurations of the hyperdivergent skeletal Class II malocclusion and their alterations during the camouflaging treatment in an attempt to identify occlusal changes that might be related to mandibular counterclockwise rotation. Materials and Methods Cephalograms of 126 subjects with hyperdivergent skeletal Class II malocclusion and 126 subjects with a clinically normal skeletal pattern were chosen. Several measurements were calculated and compared between the groups. To examine the effects of treatment, two groups were established according to mandibular rotation: counterclockwise rotation (CCR) and the opposite clockwise rotation (CR). After 40 subjects were excluded, the other 86 Class II subjects were assigned to CCR (n = 22) and CR (n = 64). Their pretreatment (T1), posttreatment (T2), and postretention (T3) cephalograms were obtained. Measurement changes (T3-T1) were analyzed in each group and compared between groups. Results Compared with the normal skeletal pattern, the cant of the occlusal plane (OP) of the study subjects was significantly steeper and the vertical heights of the incisors were significantly larger for the malocclusion. Compared with the changes in CR, there was a prominent reduction of the OP canting with remarkable intrusion of the maxillary incisor in CCR. Conclusion Increased OP canting with overerupted incisors is evident in the hyperdivergent skeletal Class II malocclusion. During the camouflaging treatment, reduction of OP canting could occur. It was accompanied by mandibular counterclockwise rotation and intrusion of the maxillary incisor.

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Comparative Study of the Bionator and Multi. P Appliances in the Treatment of Class II Malocclusion: a Cephalometric Study

Galen Medical Journal ◽

10.31661/gmj.v2i1.36 ◽

2013 ◽

Vol 2 (1) ◽

pp. 1-11

Author(s):

Morteza Oshagh ◽

Mahtab Memarpour ◽

Hooman Zarif Najafi ◽

Somayeh Heidary

Keyword(s):

Class Ii ◽

Mandibular Advancement ◽

Class Ii Malocclusion ◽

Treatment Groups ◽

Class Ii Treatment ◽

Mandibular Plane ◽

End Of Treatment ◽

Lateral Cephalograms ◽

Functional Appliances ◽

Cephalometric Study

Background: Functional appliances such as Bionator have been used to treat Class II malocclusion. The purpose of this study was to compare the skeletal, dental and soft tissue effects of Bionator appliances with Multi-P (a newly developed appliance) in the treatment of Class II malocclusion. Subjects and methods: 45 class II children were chosen and randomly assigned to either the Bionator or Multi-P treatment group. After excluding 13 patients from the study, 21 patients in Bionator and 11 patients in Multi-P group have participated in the study. Lateral cephalograms were analyzed at the beginning (To) and at the end of treatment (T1) to evaluate the changes in both groups. The paired t.test and Leven’s test were enrolled for statistical analysis.Results: Reduction of ANB angle was detected in both treatment groups. The Bionator group underwent insignificant greater mandibular advancement as measured by the SNB angle. (p= 0.737) The mandibular plane angle increased insignificantly in both groups. (p> 0.05) The inclination of upper incisors decreased significantly in Multi-P group. (p= 0.042)Conclusion: Both appliances are effective therapeutic means for class II treatment associated with mandibular deficiency and may lead to normalization of the dentoskeletal parameters at the end of the treatment.

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Evaluation of the Immediate Dentofacial Changes in Late Adolescent Patients Treated with the ForsusTM FRD

European Journal of Dentistry ◽

10.1055/s-0039-1698915 ◽

2011 ◽

Vol 05 (04) ◽

pp. 423-432 ◽

Cited By ~ 24

Author(s):

Esen Ali Gunay ◽

Tulin Arun ◽

Didem Nalbantgil

Keyword(s):

Soft Tissue ◽

Growth Period ◽

Class Ii ◽

Permanent Teeth ◽

Occlusal Plane ◽

Control Group ◽

Dental Arch ◽

Late Adolescent ◽

Soft Tissue Profile ◽

Adolescent Patients

ABSTRACTObjectives: The purpose of this study was to evaluate the short-term dentoalveolar and soft tissue changes in late adolescent patients treated with the ForsusTM FRD. Methods: A prospective study was carried out on 54 lateral cephalometric radiograms that were taken before placement and after removal of the appliance in the treatment group (15 subjects) and at the beginning and six months after in the control group (12 subjects). The patient selection criteria were as follows: skeletal and dental Class II malocclusion due to retrognatic mandible, normal or low-angle growth pattern, post-peak growth period, no extracted or congenitally missing permanent teeth, and minimum crowding in the lower dental arch. Results: The statistical assesment of the data suggested the following results: No sagital and vertical skeletal changes were induced. The mandibular incisors were protruded and intruded, while the maxillary incisors were retruded and extruded. The occlusal plane was rotated in clockwise direction as a result of these dentoalveolar changes. Overbite and overjet were reduced in all patients. Soft tissue profile slightly improved. Conclusions: The results revealed that, in late-adolescent patients ForsusTM FRD corrected Class II discrepancies through maxillary and mandibular dentoalveolar changes. (Eur J Dent 2011;5:423-432)

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Mesiodistal angulation of posterior teeth in orthodontic patients with different facial growth patterns

Journal of Dental Research Dental Clinics Dental Prospects ◽

10.15171/joddd.2019.041 ◽

2019 ◽

Vol 13 (4) ◽

pp. 267-273

Author(s):

Mohammadreza Badiee ◽

Asghar Ebadifar ◽

Sanaz Sajedi

Keyword(s):

Growth Pattern ◽

Growth Patterns ◽

Open Bite ◽

Occlusal Plane ◽

Facial Growth ◽

Posterior Teeth ◽

Deep Bite ◽

Orthodontic Patients ◽

The Mean ◽

Mandibular Posterior Teeth

Background. Mesiodistal and buccolingual angulations of teeth are variable in different malocclusion classes. This study aimed to assess the mesiodistal angulation of posterior teeth in orthodontic patients with vertical, normal, and horizontal facial growth patterns. Methods. This descriptive, cross-sectional study evaluated 150 lateral cephalograms of orthodontic patients. According to cephalometric analysis, facial growth patterns were divided into three groups of normal, horizontal, and vertical (n=50). The angulation of maxillary and mandibular posterior teeth was then measured. Data were analyzed using SPSS 22. Results. The results showed an increase in the mean angle of maxillary and mandibular posterior teeth relative to palatal and mandibular planes in patients with a vertical facial growth pattern. Conversely, their angulation decreased relative to the bisected occlusal plane (BOP). The angulation of posterior teeth decreased relative to palatal and mandibular planes and increased relative to the occlusal plane with an increase in overbite. The mean angle of all maxillary teeth relative to the palatal plane was significantly greater in open bite patients compared to normal and deep bite patients. This value in patients with normal bite was significantly greater than that in deep bite patients (P<0.05). Conclusion. The current results revealed that in patients with a vertical growth pattern, all the posterior teeth had a forward inclination. Conversely, in patients with a horizontal growth pattern, the teeth had a backward inclination.

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Distalization pattern of the maxillary arch depending on the number of orthodontic miniscrews

The Angle Orthodontist ◽

10.2319/032212-123.1 ◽

2012 ◽

Vol 83 (2) ◽

pp. 266-273 ◽

Cited By ~ 36

Author(s):

Till E. Bechtold ◽

Jin-Wook Kim ◽

Tae-Hyun Choi ◽

Young-Chel Park ◽

Kee-Joon Lee

Keyword(s):

Class Ii ◽

Dual Group ◽

Occlusal Plane ◽

Single Group ◽

Force Vector ◽

Mandibular Plane ◽

Group A ◽

Group B ◽

Displacement Patterns ◽

Maxillary Arch

ABSTRACT Objective: To determine the effects of linear force vector(s) from interradicular miniscrews on the distalization pattern of the maxillary arch in adult Class II patients. Materials and Methods: Twenty-five adult patients with mild to moderate Class II dentition and minimal crowding were collected. Either single (group A, n = 12) or dual (group B, n = 13) miniscrews were inserted on the posterior interradicular area to deliver a distalizing force to the main archwire. The displacement patterns of maxillary incisors and molars were measured and compared. Results: Significant distalization in the molars and incisors was shown in both groups. Significantly greater distalization and intrusion of the first molar and intrusive displacement of the incisor, together with significant reduction of the mandibular plane, were noted in group B, in contrast to the rotation of the occlusal plane in group A. Conclusions: Interradicular miniscrews predictably induced total arch distalization, leading to the correction of Class II. Additional miniscrews in the premolar area appear to facilitate intrusion and distalization of the entire arch according to the position of the force vectors.

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A CBCT Evaluation of Midpalatal Bone Density in Various Skeletal Patterns

Sensors ◽

10.3390/s21237812 ◽

2021 ◽

Vol 21 (23) ◽

pp. 7812

Author(s):

Jong-Moon Chae ◽

Leah Rogowski ◽

Suchita Mandair ◽

R. Curtis Bay ◽

Jae Hyun Park

Keyword(s):

Bone Density ◽

Age Groups ◽

Class Ii ◽

Horizontal Line ◽

Class Iii ◽

Midpalatal Suture ◽

Mandibular Plane ◽

Skeletal Pattern ◽

Pattern Differentiation ◽

Angle Class Iii

The purpose of this study was to evaluate midpalatal bone density (BD) by using cone-beam computed tomography (CBCT) according to gender, age, and vertical and horizontal skeletal patterns. CBCT images from 126 subjects (64 females and 62 males) were reoriented and analyzed in order to attain BD values at the midpalatal suture. Four age groups were used for classification (adolescence, 10 ≤ early < 14 years, 14 ≤ middle ≤ 17 years, and 17 < late ≤ 21 years; adult > 21 years). Vertical skeletal pattern categories were differentiated by the Frankfort horizontal line to mandibular plane angle (hypodivergent < 22°, 22° ≤ normovergent ≤ 28°, and 28° < hyperdivergent). Horizontal skeletal pattern differentiation was defined by ANB angle (Class III < 0°, 0° ≤ Class I ≤ 4°, and 4° < Class II). Females showed significantly higher BD than males (p < 0.001). As age increased, BD increased significantly (p < 0.001). There were no significant differences between vertical skeletal patterns. Class II showed significantly less BD than Class III (p < 0.05). With this information, clinicians can better understand BD trends of the midpalatal suture and, thus, better understand our patient’s anatomy and potential hurdles in successful treatment.

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