scholarly journals Skeletal and dental effects of molar distalization using a modified palatal anchorage plate in adolescents

2014 ◽  
Vol 85 (4) ◽  
pp. 657-664 ◽  
Author(s):  
Noor Laith Sa'aed ◽  
Chong Ook Park ◽  
Mohamed Bayome ◽  
Jae Hyun Park ◽  
YoonJi Kim ◽  
...  

ABSTRACT Objective:  To evaluate and compare skeletal effects and the amount of molar distalization in maxilla using modified palatal anchorage plate (MPAP) vs headgear appliances in adolescent patients. Materials and Methods:  Pre- and posttreatment lateral cephalograms of 45 Class II malocclusion patients were analyzed; 24 were treated with MPAP appliances (age, 12.4 years) and 21 with headgear (age, 12.1 years). Fixed orthodontic treatment started with the distalization process in both groups. Thirty-two variables were measured and compared between both groups using multivariate analysis of covariates. Results:  There was no significant main effect of the appliance type on the treatment results (P  =  .063). Also, there was no significant main effect of the appliance type on both pre- and posttreatment comparisons (P  =  .0198 and .135, respectively). The MPAP and headgear groups showed significant distalization of maxillary first molars (3.06 ± 0.54 mm and 1.8 ± 0.58 mm, respectively; P < .001). Sagittal skeletal maxillomandibular differences were improved after treatment (P < .001), with no significant differences between the two groups. No significant difference in treatment duration was found between the groups. Conclusions:  The MPAP showed a significant skeletal effect on the maxilla. Both MPAP and headgear resulted in distalization of maxillary first molars. Therefore, it is recommended that clinicians consider the application of MPAP, especially in noncompliant Class II patients.

2020 ◽  
Author(s):  
Chang Yoon Jung ◽  
Jae Hyun Park ◽  
Ja Hyeong Ku ◽  
Nam-Ki Lee ◽  
Yoonji Kim ◽  
...  

ABSTRACT Objectives To compare the dental and skeletal treatment effects after total arch distalization using modified C-palatal plates (MCPPs) on adolescent patients with hypo- and hyperdivergent Class II malocclusion. Materials and Methods The study group included 40 patients with Class II malocclusion (18 boys and 22 girls, mean age = 12.2 ± 1.4 years) treated with MCPPs. Fixed orthodontic treatment started with the distalizing process in both groups. Participants were divided into hypo- or hyperdivergent groups based on their pretreatment Frankfort mandibular plane angle (FMA) ≤22° or ≥28°, respectively. Pre- and posttreatment lateral cephalograms were digitized, and 23 variables were measured and compared for both groups using paired and independent t-tests. Results The hyper- and hypodivergent groups showed 2.7 mm and 4.3 mm of first molar crown distalizing movement, respectively (P < .001). The hypodivergent group had a slight 2.2° crown distal tipping of first molars compared with 0.3° in the hyperdivergent group. After distalization, the FMA increased 3.1° and 0.3°, in the hypodivergent and hyperdivergent groups, respectively (P < .001). SNA decreased in the hypodivergent group, while other skeletal variables presented no statistically significant differences in the changes between the groups. Conclusions The hypodivergent group showed more distal and tipping movement of the maxillary first molar and increased FMA than the hyperdivergent group. Therefore, clinicians must consider vertical facial types when distalizing molars using MCPPs in Class II nonextraction treatment.


2020 ◽  
Vol 91 (1) ◽  
pp. 22-29
Author(s):  
Chang Yoon Jung ◽  
Jae Hyun Park ◽  
Ja Hyeong Ku ◽  
Nam-Ki Lee ◽  
Yoonji Kim ◽  
...  

ABSTRACT Objectives To compare the dental and skeletal treatment effects after total arch distalization using modified C-palatal plates (MCPPs) on adolescent patients with hypo- and hyperdivergent Class II malocclusion. Materials and Methods The study group included 40 patients with Class II malocclusion (18 boys and 22 girls, mean age = 12.2 ± 1.4 years) treated with MCPPs. Fixed orthodontic treatment started with the distalizing process in both groups. Participants were divided into hypo- or hyperdivergent groups based on their pretreatment Frankfort mandibular plane angle (FMA) ≤22° or ≥28°, respectively. Pre- and posttreatment lateral cephalograms were digitized, and 23 variables were measured and compared for both groups using paired and independent t-tests. Results The hyper- and hypodivergent groups showed 2.7 mm and 4.3 mm of first molar crown distalizing movement, respectively (P < .001). The hypodivergent group had a slight 2.2° crown distal tipping of first molars compared with 0.3° in the hyperdivergent group. After distalization, the FMA increased 3.1° and 0.3°, in the hypodivergent and hyperdivergent groups, respectively (P < .001). SNA decreased in the hypodivergent group, while other skeletal variables presented no statistically significant differences in the changes between the groups. Conclusions The hypodivergent group showed more distal and tipping movement of the maxillary first molar and increased FMA than the hyperdivergent group. Therefore, clinicians must consider vertical facial types when distalizing molars using MCPPs in Class II nonextraction treatment.


2020 ◽  
Vol 44 (3) ◽  
pp. 202-208
Author(s):  
Mohammed Alfaifi ◽  
Jae Hyun Park ◽  
Kiyoshi Tai ◽  
Ja Hyeong Ku ◽  
Nikhilesh R Vaid ◽  
...  

Objectives: The aim of study was to evaluate skeletodental and soft tissue treatment effects and the amount of maxillary molar distalization with modified C-palatal plates vs. Greenfield molar distalizer appliances in adolescents. Study design: The samples consisted of pre- and posttreatment lateral cephalograms collected from 39 patients with Class II malocclusion. The MCPP group was comprised of 21 patients (mean age: 11.7 ± 1.3 years) treated with MCPP appliances while the GMD group included 18 patients (mean age: 11.2 ± 0.9 years) treated with GMD. Fixed orthodontic treatment started with the distalization process in both groups. From each cephalograpm, twenty-nine variables were measured for analysis and then the two groups were compared. Descriptive statistics, a paired t-test, and multivariate analysis of variance were performed to compare the treatment effects within and between the groups. Results: There was significant treatmentrelated change in the sagittal position of the maxilla and the mandible within each group. However, there were no statistically significant inter-group differences. The mean maxillary first molar distalization was 3.96 mm in the MCPP group vs. 2.85 mm in the GMD group. Both groups showed minimal distal tipping, but the maxillary incisors were significantly extruded by 3.04 ± 0.89 mm (P < .001) in GMD group. There was no significant difference in treatment duration between the groups. Conclusions: The maxillary first molars of both the MCPP and GMD groups were effectively distalized and there were significant skeletal changes in the maxilla. However, the maxillary incisors were significantly extruded in the GMD group.


2020 ◽  
Vol 8 (1) ◽  
pp. 26
Author(s):  
Vincenzo Quinzi ◽  
Enrico Marchetti ◽  
Luigi Guerriero ◽  
Floriana Bosco ◽  
Giuseppe Marzo ◽  
...  

Dentoskeletal class II malocclusion due to a protruded upper dental arch is a major reason for an orthodontic treatment. In these cases, the correction of class II can be hindered by molar distalization, obtained with ‘no-compliance therapy’ that involves the use of appliances which minimize the need for such co-operation and attempt to maximize the predictability of results. The aim of this review was to outline the effectiveness of no-compliance fixed orthodontic devices in the molar distalization. After selection according to the inclusion/exclusion criteria, 16 articles from 2000 to 2019 were qualified for the final analysis. The literature shows various no-compliance fixed devices whose effect is to distalize the maxillary molars. The present revision allows to conclude that there is a need to increase the number of studies, especially with regard to the most recently introduced devices in the literature. The analysed studies allow to hypothesize that these appliances act with a minimal variability of molar distalization and disto-inclination among them, although different effects among the appliances can be observed as regards to the anchorage.


2020 ◽  
Vol 90 (4) ◽  
pp. 571-577 ◽  
Author(s):  
Alexa Helena Kohler Moresca ◽  
Nathaly Dias de Moraes ◽  
Francielle Topolski ◽  
Carlos Flores-Mir ◽  
Alexandre Moro ◽  
...  

ABSTRACT Objective To evaluate the esthetic perceptions of orthodontists and laypersons for facial profile changes after orthodontic treatment using Herbst or Forsus appliances. Materials and Methods Pre- and posttreatment facial profile contour images of 20 Class II patients treated with Herbst (group H; n = 10) and Forsus (group F; n = 10) appliances were analyzed by 30 orthodontists and 30 laypersons, who graded them from 1 (unattractive) to 10 (very attractive) using a visual analog scale. Two assessments were carried out with a 15 day-interval. In the first evaluation, 40 images were presented in a random sequence. In the second evaluation, initial and final facial profile images of each patient were randomly presented side by side. To compare groups in relation to treatment method, Mann-Whitney tests were used. To evaluate differences between time points, Wilcoxon tests were used. Results In the first evaluation, there was a significant difference between initial and final images only for group H, for both laypersons (P = .017) and orthodontists (P = .037). There was also a significant difference between laypersons and orthodontists in their ratings of posttreatment Herbst appliance profiles (P = .028). There was no significant difference between initial and final facial profile images for group F and no significant differences between or within evaluator groups in their ratings of initial or final Forsus appliance profiles. In the second evaluation, there was a significant difference between appliance groups only for laypersons, who considered cases treated with the Herbst appliance more attractive than those treated with the Forsus (P = .031). Laypersons also considered Herbst profiles more attractive than did orthodontists (P = .047). Conclusions Class II malocclusion treatment using the Herbst appliance may produce a more esthetically improved facial profile silhouette compared with Forsus appliances. The magnitude of perceived changes may not be considered clinically relevant.


2016 ◽  
Vol 63 (4) ◽  
pp. 167-175
Author(s):  
Jovana Milutinović ◽  
Nenad Nedeljković

Summary Introduction The aim was to evaluate the difference in en-face anthropometric facial parameters and proportions of patients with Class II malocclusion, before and after orthodontic treatment as well as changes in linear parameters and facial proportions and their deviation from ideal values. Material and method In this study, en-face photographs before and after the treatment of 50 Class II malocclusion patients were used. Patients were divided in two groups; first group comprised 25 patients treated with multibracket appliance with extractions, and second group included 25 patients treated without extractions, using fixed functional Herbst and multibracket appliance. On each and every photo before and after the treatment facial points and lines were drawn, and linear parameters were determined, based on those markers. Results showed change in anthropometric parameters in both groups of patients. Statistically significant difference was found for parameters in the middle and lower facial third. Facial proportions changed after the treatment in both groups and they approached ideal values and golden proportion 1:1.618 in the lower facial third. Conclusion Patients with Class II, division 1 malocclusion, deviate from an ideal set of proportions, particularly in the lower facial third. After the orthodontic treatment, anthropometric parameters in the lower facial third were approaching ideal values.


2017 ◽  
Vol 11 (03) ◽  
pp. 323-329 ◽  
Author(s):  
Sushruth Shetty ◽  
Rajkumar Maurya ◽  
H. V. Pruthvi Raj ◽  
Anand Patil

ABSTRACT Objective: To compare two molar distalization devices, the Pendulum appliance (PA) and the Jones Jig (JJ) in dental Class II patients. Materials and Methods: Pretreatment and postdistalization lateral cephalograms and study models of 20 subjects (6 males, 14 females) Class II malocclusion subjects were examined. PA and JJ group both consisted of 10 patients each with a mean pretreatment age of 12 years 1 month for females and 12 years 5 months for males. The PA and the JJ appliance were activated once in a month until Class II molar relationship was corrected to a super Class I molar relationship in both groups. Initial and final measurements and treatment changes were compared by means of Paired t-test. Results: Maxillary first molar distalized an average of 3.85 mm in the PA and 2.75 mm in the JJ between T1 and T2; rate of molar distalization was 1.59 mm/month for PA, and the JJ appliance averaged 0.88 mm/month, distal molar tipping was greater in PA (6.2°) than in the JJ (3.9°). Average mesial movement of the premolars was 2.2 mm with PA and JJ both. JJ showed a greater rotation of first molars after distalization as compared to PA. The increase in vertical facial height was also greater for JJ as compared to PA. Conclusions: Both the appliances were effective in molar distalization with PA requiring less distalization time (16 days less than JJ). Some adverse effects were noted with both which one should strive to control.


2007 ◽  
Vol 77 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Arnim Godt ◽  
Matthias Kalwitzki ◽  
Gernot Göz

Abstract Objective: To test the questions “Does cervical headgear treatment necessarily lead to a reduction of overbite?” and “Are there differences in treatment results due to different growth patterns or the initial overbite?” Materials and Methods: Initial and intermediary casts of 247 patients who had been treated exclusively with headgear were analyzed for changes in the occlusal relationship of the first molars and overbite. Orthodontic treatment consisted of the application of cervical headgear with nonangulated external arms applied at a force of 3.5–4.0 N. Only patients showing dental changes of occlusal relationship ≥4 mm during at least a 6-month treatment duration were selected. Growth patterns were identified by the y-axis values measured on lateral cephalograms obtained at study entry. Six groups were formed on the basis of these growth patterns. Results: Headgear treatment induced bite deepening in patients with vertical growth patterns and bite opening in patients with horizontal growth patterns. Further subdivision based on initial overbite revealed bite deepening in patients with small initial overbite and bite opening in patients with large initial overbite. These differences were statistically significant (P < .05). Only minor changes were observed in patients with an initial overbite of 3–4 mm. Conclusions: Overbite reductions were not dependent on the growth pattern. Orthodontists should expect bite opening in deep-bite situations and bite deepening in open-bite situations. However, initial overbite situations of 3–4 mm should not be expected to change in a significant way.


2011 ◽  
Vol 1 (1) ◽  
pp. 36-41
Author(s):  
Jyoti Dhakal

The dentoskeletal characteristics of Class II malocclusion subjects were evaluated using cephalometric radiograph and dental cast of 60 untreated patients. The sample included 30 Class II Division 1 and 30 Class II Division 2 malocclusion patients. The inter-canine, inter-premolar, inter-molar, inter-canine alveolar, inter-premolar alveolar, inter-molar alveolar widths are measured on study models. The result showed statistically significant difference between the groups for mandibular inter-canine width only. The cephalometric analysis revealed that SNB angle was responsible for the skeletal sagittal difference between the two groups except for the position of maxillary incisors. No basic difference in dentoskeletal morphology existed between Class II Division 1 and Class II Division 2 malocclusions.


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