scholarly journals Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion

2012 ◽  
Vol 83 (2) ◽  
pp. 334-340 ◽  
Author(s):  
Lorenzo Franchi ◽  
Chiara Pavoni ◽  
Kurt Faltin ◽  
James A. McNamara ◽  
Paola Cozza
Keyword(s):  
Treatment Group ◽  
Class Ii ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Treatment Timing ◽  
Class Ii Treatment ◽  
Lateral Cephalograms ◽  
Functional Appliances ◽  
Fixed Appliances

ABSTRACT Objective: To analyze the long-term skeletal and dentoalveolar effects and to evaluate treatment timing of Class II treatment with functional appliances followed by fixed appliances. Materials and Methods: A group of 40 patients (22 females and 18 males) with Class II malocclusion consecutively treated either with a Bionator or an Activator followed by fixed appliances was compared with a control group of 20 subjects (9 females and 11 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start of treatment (mean age 10 years), end of treatment with functional appliances (mean age 12 years), and long-term observation (mean age 18.6 years). The treated sample also was divided into two groups according to skeletal maturity. The early-treatment group was composed of 20 subjects (12 females and 8 males) treated before puberty, while the late-treatment group included 20 subjects (10 females and 10 males) treated at puberty. Statistical comparisons were performed with analysis of variance followed by Tukey's post hoc tests. Results: Significant long-term mandibular changes (Co-Gn) in the treated group (3.6 mm over the controls) were associated with improvements in the skeletal sagittal intermaxillary relationship, overjet, and molar relationship (∼3.0–3.5 mm). Treatment during the pubertal peak was able to produce significantly greater increases in total mandibular length (4.3 mm) and mandibular ramus height (3.1 mm) associated with a significant advancement of the bony chin (3.9 mm) when compared with treatment before puberty. Conclusion: Treatment of Class II malocclusion with functional appliances appears to be more effective at puberty.

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

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.

scholarly journals Long-term stability of miniscrew anchored maxillary molar distalization in Class II treatment

2020 ◽  
Vol 90 (3) ◽  
pp. 362-368 ◽  
Author(s):  
Till Edward Bechtold ◽  
Young-Chel Park ◽  
Kyung-Ho Kim ◽  
Heekyu Jung ◽  
Ju-Young Kang ◽  
...  
Keyword(s):  
Class Ii ◽  
Vertical Movement ◽  
Occlusal Plane ◽  
Control Group ◽  
Long Term Stability ◽  
Class Ii Treatment ◽  
Lateral Cephalograms ◽  
Maxillary Molar ◽  
Group A

ABSTRACT Objective To investigate treatment stability of miniscrew-anchored maxillary distalization in Class II malocclusion. Materials and Methods This retrospective study included a distalization (n = 19) and a control (n = 19) group; a patient group with minor corrections served the control. Lateral cephalograms of 38 adult patients were taken before (T0), immediately after (T1), and 3–4 years after (T2) treatment. Horizontal and vertical movement and tipping of the maxillary first molars (U6) and central incisors (U1) were measured along with skeletal craniofacial parameters at three time points to compare the two groups regarding the achieved treatment effects and their stability. Results Total arch distalization therapy led to 4.2 mm of distal movement of U6 without distal crown tipping (0.6° of axis change) and 3.3° of occlusal plane steepening. Over an average retention period of 42 months, maxillary total arch distalization provided high stability of treatment results, showing the same amount of mesial movement (0.7 mm) as the control group. Conclusions In Class II treatment, miniscrew-anchored maxillary total arch distalization can provide stable distal movement of the maxillary first molars and central incisors.

scholarly journals A Retrospective Cephalometric Evaluation of Dental Changes with Activator and Activator Headgear Combination in the Treatment of Skeletal Class II Malocclusion

2011 ◽  
Vol 12 (1) ◽  
pp. 14-18 ◽  
Author(s):  
G Anil Kumar ◽  
Amit Maheshwari
Keyword(s):  
Class Ii ◽  
Combination Group ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Mandibular Incisor ◽  
Lower Incisor ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Lateral Cephalograms ◽  
Functional Appliances

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.

scholarly journals Morphometric analysis of long-term dentoskeletal effects induced by treatment with Balters bionator

2014 ◽  
Vol 85 (5) ◽  
pp. 790-798 ◽  
Author(s):  
Renato Bigliazzi ◽  
Lorenzo Franchi ◽  
André Pinheiro de Magalhães Bertoz ◽  
James A. McNamara ◽  
Kurt Faltin ◽  
...  
Keyword(s):  
Class Ii ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Long Term Effects ◽  
Lateral Cephalograms ◽  
Long Term Follow Up ◽  
Long Term Observation ◽  
Mandibular Retrusion ◽  
Shape Changes

ABSTRACT Objective:  To evaluate the long-term effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). Materials and Methods:  Twenty-three Class II patients (8 male, 15 female) were treated consecutively with the Balters bionator (bionator group). The sample was evaluated at T0, start of treatment; T1, end of bionator therapy; and T2, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T0); at posttreatment, 12 years 3 months (T1); and at long-term follow-up, 18 years 2 months (T2). The control group consisted of 22 subjects (11 male, 11 female) with untreated Class II malocclusion. Lateral cephalograms were analyzed at the three time points for all groups. TPS analysis evaluated statistical differences (permutation tests) in the craniofacial shape and size between the bionator and control groups. Results:  TPS analysis showed that treatment with the bionator is able to produce favorable mandibular shape changes (forward and downward displacement) that contribute significantly to the correction of the Class II dentoskeletal imbalance. These results are maintained at a long-term observation after completion of growth. The control group showed no statistically significant differences in the correction of Class II malocclusion. Conclusions:  This study suggests that bionator treatment of Class II malocclusion produces favorable results over the long term with a combination of skeletal and dentoalveolar shape changes.

scholarly journals Treatment Effects of the Herbst Appliance in Class II Malocclusion Patients after the Growth Peak

2020 ◽  
Author(s):  
Rodrigo Hermont Cançado ◽  
Guilherme Janson ◽  
Bryan Tompson ◽  
José Carlos de Castro Alvares ◽  
Fabrício Pinelli Valarelli ◽  
...  
Keyword(s):  
Class Ii ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Control Groups ◽  
Lateral Cephalograms ◽  
Treatment Changes ◽  
Fixed Appliances ◽  
And Control ◽  
Experimental Group ◽  
Mandibular Incisors

Abstract Objective The aim of this study was to evaluate dentoskeletal changes in the treatment of Class II malocclusion with the Herbst Cantilever Bite Jumper (CBJ) appliance, associated with multibracket appliances after the growth peak, at pretreatment. Materials and Methods  A sample of 37 individuals was divided into two groups: the experimental group comprised 16 patients treated consecutively for a mean period of 2.52 years with the Herbst CBJ appliance associated with multibracket appliances. A total of 21 subjects (10 males and 11 females) with Class II malocclusion and mean age at T1 of 16.08 years were followed for a mean period of 2.12 years composed the control group. Comparisons between the two groups were performed using initial and final lateral cephalograms. Comparisons between experimental and control groups at pretreatment and of the treatment changes were performed by Mann–Whitney or independent t-tests. Results Experimental group exhibited a significantly greater labial inclination of the mandibular incisors in comparison to the control group. Additionally, significantly greater corrections in overbite, overjet, and molar relationship were observed in the experimental than in the control groups. Conclusion The effects of the Herbst CBJ appliance, associated with fixed appliances after the growth peak in Class II malocclusion treatment are correction in molar relationship toward a Class I relationship, decrease of the overjet, decrease of the overbite, and mandibular incisors labial inclination.

scholarly journals Stability of Class II Malocclusion Treatment with the Austro Repositioner Followed by Fixed Appliances in Brachyfacial Patients

2021 ◽  
Vol 18 (18) ◽  
pp. 9793
Author(s):  
Maria Dolores Austro-Martinez ◽  
Ana I. Nicolas-Silvente ◽  
Eugenio Velasco-Ortega ◽  
Alvaro Jimenez-Guerra ◽  
Jose A. Alarcon
Keyword(s):  
Test Group ◽  
Class Ii ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Fixed Appliance ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Lateral Cephalograms ◽  
Fixed Appliances ◽  
One Year

One of the goals of functional-appliance devices is to modify the vertical growth pattern, solving several kinds of malocclusion. This study aimed to evaluate Class II malocclusion treatment’s stability with Austro Repositioner, followed by fixed appliances, and assess its capacity to modify vertical dimensions in brachyfacial patients. A test group of 30 patients (16 boys and 14 girls, mean 11.9 years old) with Class II malocclusion due to mandibular retrognathism and brachyfacial pattern treated with Austro Repositioner and fixed appliance were compared to a matched untreated Class II control group of 30 patients (17 boys and 13 girls, mean age 11.7 years old). Lateral cephalograms were taken at T1 (initial records), T2 (end of treatment), and T3 (one year after treatment). Statistical comparisons were performed with a paired-sample t-test and two-sample t-tests. Significant improvements in the skeletal Class II relationship were observed in the treated group. The ANB angle decreased (4.75°), the SNB angle increased (3.92°), and the total mandibular length (Co-Pg) increased (8.18 mm) (p < 0.001). Vertical dimensions were also significantly modified, the FMA angle increased (3.94°), LAFH-distance increased (3.15 mm), and overbite decreased (3.35 mm). These changes remained stable one year after treatment. The Austro Repositioner was adequate for treating the skeletal Class II malocclusion resulting from the mandible retrusion in brachyfacial patients.

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

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 &lt; .0001; FH-NA = −3.042°, P &lt; .0001; linear measurement A-point to Vertical Reference = −3.859 mm, P &lt; .0001) and reduction of the ANB angle (−1.767°, P &lt; .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.

Class II treatment in early mixed dentition with the eruption guidance appliance: effects and long-term stability

2019 ◽  
Vol 42 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Katri Keski-Nisula ◽  
Leo Keski-Nisula ◽  
Juha Varrela
Keyword(s):  
Treatment Group ◽  
Class Ii ◽  
Post Treatment ◽  
Mixed Dentition ◽  
Term Stability ◽  
Long Term Stability ◽  
Class Ii Treatment ◽  
Significant Correction ◽  
The Mean

Summary Objectives Our aim was to analyse dentoskeletal effects and long-term stability of Class II treatment carried out with an eruption guidance appliance (EGA) in early mixed dentition. Materials and methods Sixty-five Class II patients (38 females and 27 males), treated with an EGA in early mixed dentition, were compared with 58 children (26 females and 32 males) with untreated Class II malocclusion. The mean age in the treatment group at the start (T1) and end of treatment (T2) was 5.4 years (±0.4) and 8.5 years (±0.9), respectively, and at the final examination in the early permanent dentition (T3) 16.7 years (±0.4). In the control group, the mean age at T1 and T2 were 5.1 years (±0.5) and 8.4 years (±0.5), respectively. The independent and dependent sample t-tests, Chi-square test, and Fisher’s test were used in the statistical evaluation. Results In the treatment group, the frequency of Class II decreased from 100 to 14% during the treatment (T1–T2) and a significant correction took place in all occlusal variables. At T2, the treatment and control groups showed statistically significant differences (P &lt; 0.05) in all occlusal variables. In the treated children, mandibular length increased 5 mm more (P &lt; 0.001) from T1 to T2 compared to the control children, and the ANB angle became significantly smaller (P = 0.006). During the post-treatment period (T2–T3), the frequency of Class II in the treatment group decreased from 14 to 2% (P &lt; 0.05), overbite increased from 2.2 to 3.1 mm (P &lt; 0.05), and lower crowding increased from 2to 14% (P &lt; 0.05). Post-treatment changes in overjet and upper crowding were not statistically significant. At T3, the mean values of the SNA, SNB, and ANB angles were 83.0° (SD 3.9°), 81.3° (SD 3.8°), and 2.4° (SD 1.5°), respectively. Conclusions A clinically significant correction of the molar relationship, overjet, overbite, incisor alignment, and growth enhancement of the mandible were observed after treatment in early mixed dentition. The treatment results remained largely stable in the early permanent dentition. However, an increase was observed in overbite and lower crowding. None of the children treated in early mixed dentition needed a second treatment phase.

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