scholarly journals Effects of Invisalign (G5) with virtual bite ramps for skeletal deep overbite malocclusion correction in adults

2021 ◽  
Author(s):  
Douglas Henick ◽  
Willy Dayan ◽  
Robert Dunford ◽  
Stephen Warunek ◽  
Thikriat Al-Jewair
Keyword(s):  
Comprehensive Treatment ◽  
Deep Bite ◽  
Fixed Appliance ◽  
Skeletal Changes ◽  
Mandibular Plane ◽  
Lateral Cephalograms ◽  
Sex Type ◽  
The Mean ◽  
Overbite Depth Indicator ◽  
Extraction Treatment

ABSTRACT Objectives To investigate the skeletal and dentoalveolar effects of Invisalign's G5 protocol with virtual bite ramps in the treatment of adults with skeletal deep bites. Materials and Methods This retrospective study was conducted on consecutively treated adults presenting with skeletal deep bites as defined by the Overbite Depth Indicator (ODI). Subjects were divided into 2 groups: Invisalign group (n = 24) treated with the Invisalign G5 protocol and a full fixed appliance (FFA) group (n = 24) treated with edgewise FFAs and matched to the Invisalign group by ODI, sex, type of malocclusion, and non-extraction treatment. Pretreatment (T1) and post–comprehensive treatment (T2) lateral cephalograms were obtained and analyzed. Results Both the Invisalign and FFA groups showed significant changes from T1 to T2 in ODI and other skeletal and dentoalveolar measurements. The mean change in ODI was −1.5° (P < .001) for the Invisalign group and −2.0° (P < .001) for the FFA group. The mean decrease in overbite was 1.3 mm (P < .001) and 2.0 mm (P < .001) for the Invisalign and FFA groups, respectively. The mean increase in mandibular plane angle (Sn-GoGn) was 0.65° (P = .003) for the Invisalign group and 1.15° (P < .001) for the FFA group. When the groups were compared with each other, both ODI (P = .03) and overbite (P = .003) were significantly different in addition to other measurements. Conclusions Although FFA treatment had more apparent skeletal changes for deep bite adult patients when compared with Invisalign, both systems were effective in opening deep bites at dentoalveolar and skeletal levels.

scholarly journals Factors associated with long-term vertical skeletal changes induced by facemask therapy in patients with Class III malocclusion

2017 ◽  
Vol 88 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Hee-Jong Kwak ◽  
Hae-Jin Park ◽  
Yoon-Ji Kim ◽  
Dong-Yul Lee
Keyword(s):  
Multivariate Linear Regression Analysis ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Short Term ◽  
Gonial Angle ◽  
Skeletal Changes ◽  
Mandibular Plane ◽  
Lateral Cephalograms ◽  
The Mean

ABSTRACT Objectives: This study investigated the long-term vertical skeletal changes induced by facemask therapy in patients with Class III malocclusion and different vertical skeletal patterns. Materials and Methods: A total of 54 patients (20 boys and 34 girls; mean age, 7.7 ± 2.0 years) with Class III malocclusion who were successfully treated with facemask therapy were included in this study. Vertical skeletal changes (overbite depth indicator, angle between the Sella-Nasion (SN) plane and Gonion-Gnathion (GoGn) line, angle between the Frankfort horizontal (FH) plane and mandibular plane, gonial angle, and angle between the SN plane and palatal plane) were measured on lateral cephalograms from before treatment (T0) to after facemask therapy (T1) and from T0 to after retention (T2). Multivariate linear regression analysis was used to study the associations of the patients' skeletal patterns with the short-term (T0–T1) and long-term (T0–T2) vertical skeletal changes as a result of facemask therapy. Results: The mean treatment period of facemask therapy (T0–T1) was 1.4 ± 0.6 years, and the mean retention period (T1–T2) was 6.9 ± 2.6 years. Age at T0 was significantly correlated with vertical skeletal changes from T0 to T1. Differences in the treatment results between sexes were not significant. The angle between point A-point B line and mandibular plane to mandibular plane angle at T0 and the angle between the FH plane and mandibular plane at T0 were significant predictors for short-term and long-term changes. Changes in the Sella-Nasion-point A from T0 to T1 and from T1 to T2 significantly affected vertical changes in the short term and long term, respectively. Conclusions: Vertical skeletal changes as a result of facemask therapy are significantly associated with severity of the skeletal Class III malocclusion and mandibular plane angulation before treatment and the amount of forward maxillary growth during the treatment and retention periods.

Comparison of Treatment Effects with Modified C-Palatal Plates vs Greenfield Molar Distalizer Appliances in Adolescents

2020 ◽  
Vol 44 (3) ◽  
pp. 202-208
Author(s):  
Mohammed Alfaifi ◽  
Jae Hyun Park ◽  
Kiyoshi Tai ◽  
Ja Hyeong Ku ◽  
Nikhilesh R Vaid ◽  
...  
Keyword(s):  
Treatment Effects ◽  
Group Differences ◽  
Class Ii Malocclusion ◽  
Molar Distalization ◽  
Skeletal Changes ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Maxillary Molar ◽  
The Mean ◽  
Maxillary Incisors

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.

scholarly journals A prospective clinical trial of the effects produced by the Connecticut intrusion arch on the maxillary dental arch

2020 ◽  
Vol 90 (4) ◽  
pp. 500-506
Author(s):  
Alessandro Schwertner ◽  
Renato Rodrigues de Almeida ◽  
Renata Rodrigues de Almeida-Pedrin ◽  
Thais Maria Freire Fernandes ◽  
Paula Oltramari ◽  
...  
Keyword(s):  
Correction Method ◽  
Maxillary Incisor ◽  
Dental Arch ◽  
Deep Bite ◽  
Lateral Cephalograms ◽  
Distal Surface ◽  
The Mean ◽  
Maxillary Incisors ◽  
Group 2 ◽  
Group 1

ABSTRACT Objective To assess and compare the effects produced in the maxillary dental arch by means of Connecticut intrusion arch (CIA) with or without a cinch back on the distal end of the tube of the first molars. Materials and Methods This study included 44 patients with a mean age of 13.1 ± 1.8 years treated for deep bite with a CIA randomly divided into two groups: group 1 (G1), 22 patients with initial mean age of 12.72 ± 1.74 years treated with the CIA in the upper arch without a cinch back on the distal surface of the tube of the first molars, and group 2 (G2), 22 patients with an initial mean age of 13.67 ± 2.03 years treated with the CIA with a cinch back. Lateral cephalograms were available before treatment (T1) and after intrusion of maxillary incisors (T2). The mean treatment period was 5.5 ± 1.45 months. Intragroup and intergroup changes in the maxillary incisor and molar positions were analyzed by paired and independent t-tests associated with the Holm-Bonferroni correction method for multiple comparisons (P < .05). Results There were significant differences between groups in terms of maxillary incisor displacement. The maxillary incisors flared labially (2.17°) and proclined (1.68 mm) in group 1, whereas a palatal inclination (−1.99°) and retroclination (−1.13 mm) was observed in group 2. No significant differences were found for the molar positions between the groups. Conclusions The presence or absence of a distal bend in CIA affects incisor tipping and proclination during intrusion mechanics.

scholarly journals Long-term evaluation of the molar movements following Pendulum and fixed appliances

2012 ◽  
Vol 83 (3) ◽  
pp. 447-454 ◽  
Author(s):  
Alberto Caprioglio ◽  
Mattia Fontana ◽  
Elena Longoni ◽  
Mauro Cozzani
Keyword(s):  
Class Ii ◽  
Individual Growth ◽  
Fixed Appliance ◽  
Skeletal Changes ◽  
Growth Increase ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Term Evaluation ◽  
Long Term Observation

ABSTRACT Objective: To describe the molar movements and skeletal changes associated with Pendulum-fixed appliance treatment and the long-term postretention period. Subjects and Methods: The treatment sample consisted of 76 Class II patients, 35 males and 41 females. Lateral cephalograms were obtained at the start of treatment (T1); the end of distalization (T2); the end of orthodontic fixed appliance therapy (T3); and long-term observation (7 years 2 months later; T4). Mean age was 12 years 11 months at T1, 13 years 8 months at T2, 15 years 4 months at T3, and 22 years 5 months at T4. The average amount of Class II molar relationship was 3.1 mm, with a mean overjet of 5.9 mm at the beginning of treatment. A paired t-test was used to identify significant between-group differences between T2–T4 and T3–T4. Results: Distal molar movement was obtained during the distalization phase (T2), and more than half of the distalizing effect was maintained at the end of maxillary growth (T4). Most of the relapse occurred during fixed appliance therapy (T3), whereas no significant change was detected in the postretention period (T4). The molar relationship did not show any significant difference between T2 and T4. The vertical facial dimension increased during the distalization phase (T2) and fixed appliance therapy (T3) but returned to the initial values during the postretention period (T4). Conclusions: The Pendulum appliance induces significant dentoalveolar effects, which can be partially maintained during the long-term period. The Class I molar relationship does not change during completion of individual growth. Increase in vertical facial dimension represents a temporary effect.

scholarly journals Cephalometric evaluation of adult anterior open bite non-extraction treatment with Invisalign

2017 ◽  
Vol 22 (5) ◽  
pp. 30-38 ◽  
Author(s):  
Shuka Moshiri ◽  
Eustáquio A. Araújo ◽  
Julie F. McCray ◽  
Guilherme Thiesen ◽  
Ki Beom Kim
Keyword(s):  
Open Bite ◽  
Therapeutic Modality ◽  
Occlusal Plane ◽  
Anterior Open Bite ◽  
Lower Incisor ◽  
Mandibular Plane ◽  
Lateral Cephalograms ◽  
Treatment Changes ◽  
Extraction Treatment ◽  
Lower Molar

ABSTRACT Objective: The purpose of this study was to evaluate, by means of cephalometric appraisal, the vertical effects of non-extraction treatment of adult anterior open bite with clear aligners (Invisalign system, Align Technology, Santa Clara, CA, USA). Methods: Lateral cephalograms of 30 adult patients with anterior open bite treated using Invisalign (22 females, 8 males; mean age at start of treatment: 28 years and 10 months; mean anterior open bite at start of treatment: 1.8 mm) were analyzed. Pre- and post-treatment cephalograms were traced to compare the following vertical measurements: SN to maxillary occlusal plane (SN-MxOP), SN to mandibular occlusal plane (SN-MnOP), mandibular plane to mandibular occlusal plane (MP-MnOP), SN to mandibular plane (SN-MP), SN to palatal plane (SN-PP), SN to gonion-gnathion plane (SN-GoGn), upper 1 tip to palatal plane (U1-PP), lower 1 tip to mandibular plane (L1-MP), mesiobuccal cusp of upper 6 to palatal plane (U6-PP), mesiobuccal cusp of lower 6 to mandibular plane (L6-MP), lower anterior facial height (LAFH), and overbite (OB). Paired t-tests and descriptive statistics were utilized to analyze the data and assess any significant changes resulting from treatment. Results: Statistically significant differences were found in overall treatment changes for SN-MxOP, SN-MnOP, MP-MnOP, SN-MP, SN-GoGn, L1-MP, L6-MP, LAFH, and OB. Conclusions: The Invisalign system is a viable therapeutic modality for non-extraction treatment of adult anterior mild open bites. Bite closure was mainly achieved by a combination of counterclockwise rotation of the mandibular plane, lower molar intrusion and lower incisor extrusion.

scholarly journals Evaluation and Comparison of Skeletal and Dental Components of Deep Overbite Malocclusion with Normal Occlusion

2021 ◽  
Vol 10 (20) ◽  
pp. 1519-1524
Author(s):  
Harshil Naresh Joshi
Keyword(s):  
Treatment Plan ◽  
Test Results ◽  
Contributing Factors ◽  
Deep Bite ◽  
Curve Of Spee ◽  
Mandibular Plane ◽  
Normal Occlusion ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Mandibular First Molar

BACKGROUND A deep overbite may be due to an underlying skeletal or dentoalveolar component that may influence the treatment plan. The purpose of this study was to evaluate and compare the different components of deep bite malocclusion and normal occlusion. METHODS This was a case control study. Lateral cephalograms and study casts of normal (N = 50) and deep overbite (N = 50) subjects were used to evaluate skeletal and dentoalveolar components. Data was analysed statistically by independent t - test. RESULTS The significant skeletal contributing factors were gonial angles, mandibular plane, maxillary plane angle & ramus / Frankfort horizontal. An increased curve of Spee and decreased mandibular first molar height were predominant dental variables in the deep overbite group. The inclination of the upper incisors & lower incisors height did not show a statistically significant difference between the two groups. CONCLUSIONS The counterclockwise rotation of the mandible and the increased curve of Spee were the dominant features of deep bite malocclusion. This analysis of deep overbite components could help clinicians design individualised mechanotherapy based on the underlying cause rather than being prejudiced toward conventional mechanics when correcting with a deep overbite malocclusion. KEY WORDS Skeletal and Dental Components, Deep Overbite, Ramus / Frankfort Horizontal

scholarly journals Effect of Clark's twin-block appliance (CTB) and non-extraction fixed mechano-therapy on the pharyngeal dimensions of growing children

2015 ◽  
Vol 20 (6) ◽  
pp. 82-88 ◽  
Author(s):  
Batool Ali ◽  
Attiya Shaikh ◽  
Mubassar Fida
Keyword(s):  
Upper Airway ◽  
Mandibular Advancement ◽  
Rank Test ◽  
P Value ◽  
Severe Respiratory Distress ◽  
Fixed Appliance ◽  
Twin Block ◽  
Lateral Cephalograms ◽  
The Mean ◽  
Pre Treatment

Abstract Introduction: Narrow airway dimensions due to mandibular deficiency can predispose an individual to severe respiratory distress. Hence, treatment with mandibular advancement devices at an early age might help improving the pharyngeal passage and reduce the risk of respiratory difficulties. Therefore, the aim of the current study was to evaluate the mean changes in the pharyngeal dimensions of children with mandibular deficiency treated with Clark's twin-block appliance (CTB) followed by fixed orthodontic treatment. Methods: Orthodontic records of 42 children with mandibular deficiency were selected. Records comprised three lateral cephalograms taken at the start of CTB treatment, after CTB removal and at the end of fixed appliance treatment, and were compared with 32 controls from the Bolton-Brush study. Friedman test was used to compare pre-treatment, mid-treatment and post-treatment pharyngeal dimensions. Wilcoxon signed rank test was used to compare the airway between pre-treatment and post follow-up controls. Mann-Whitney U test was applied to compare the mean changes in pharyngeal dimensions between treatment group and controls from T2 to T0. Post-hoc Dunnet T3 test was used for multiple comparisons of treatment outcomes after CTB and fixed appliances, taking a p-value of ≤ 0.05 as statistically significant. Results: Superior pharyngeal space (p < 0.001) and upper airway thickness (p = 0.035) were significantly increased after CTB, and the change in superior pharyngeal space remained stable after fixed mechano-therapy. Conclusion: CTB can have a positive effect in improving pharyngeal space and the resultant increase in airway remains stable on an average of two and a half years.

scholarly journals Herbst–multibracket appliance treatment: is there an association between lower incisor position changes and the development of labial gingival recessions?

2021 ◽  
Author(s):  
S. Südwasser ◽  
N. C. Bock ◽  
J. Jost ◽  
S. Killat ◽  
S. Ruf
Keyword(s):  
Lower Incisor ◽  
Gingival Margin ◽  
Incisal Edge ◽  
Mandibular Plane ◽  
Potential Association ◽  
Lateral Cephalograms ◽  
Treatment Changes ◽  
The Mean ◽  
Multibracket Appliance ◽  
Extraordinary Treatment

Abstract Purpose To assess a potential association between lower incisor (LI) position changes during Herbst–multibracket appliance (Herbst–MBA) treatment and the development of labial gingival recessions (LGR). Methods All class II patients (Department of Orthodontics, University of Giessen, Giessen, Germany) who had undergone Herbst–MBA treatment until 2015 with study models and lateral cephalograms available from before (T0) and after treatment plus ≥24 months of retention (T3) were included (n = 259). Lateral cephalograms were evaluated regarding LI position changes: iiL/ML (angle between LI long axis and mandibular plane [MP]), ii-MLPg (distance between LI incisal edge and a line perpendicular to MP through pogonion), apex-MLPg (distance between LI apex and a line perpendicular to MP through pogonion), ii-MLii (distance between LI incisal edge and MP on a line perpendicular to MP through incisal edge). Using study models the distance between the cementoenamel junction and the deepest point of the gingival margin was defined as LGR. Results The following cephalometric mean changes were recorded (T0–T3): iiL/ML +5.9 ± 5.76° (p = 0.929), ii-MLPg −0.2 ± 0.25 mm (p = 0.430), apex-MLPg +0.1 ± 0.32 mm (p = 0.363), ii-MLii +0.1 ± 0.36 mm (p = 0.206). The mean increase of LGR magnitude measured on the study models was 0.1 ± 0.35 mm. However, no association with the cephalometric LI position changes was found (|R| ≤ 0.2). Conclusion There is no association between the amount of LI position changes and the development of LGR during Herbst–MBA treatment plus retention. Nevertheless, individual predisposition or excessive treatment changes and extraordinary treatment approaches, respectively, might still lead to development of LGR.

scholarly journals Comparison of Maxillary Molar Distalization with an Implant-Supported Distal Jet and a Traditional Tooth-Supported Distal Jet Appliance

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Mauro Cozzani ◽  
Marco Pasini ◽  
Francesco Zallio ◽  
Robert Ritucci ◽  
Sabrina Mutinelli ◽  
...  
Keyword(s):  
Treatment Time ◽  
Molar Distalization ◽  
Skeletal Changes ◽  
Wilcoxon Rank Sum Test ◽  
Lateral Cephalograms ◽  
Maxillary Molar ◽  
The Mean ◽  
Anchorage Loss ◽  
Distal Jet ◽  
Values Distribution

Aim. To investigate and compare the efficiency of two appliances for molar distalization: the bone-anchored distal screw (DS) and the traditional tooth-supported distal jet (DJ) for molar distalization and anchorage loss.Methods.Tests (18 subjects) were treated with a DS and controls (18 subjects) were treated with a DJ. Lateral cephalograms were obtained before and at the end of molar distalization and were analysed. Shapiro Wilk test, unpairedt-test, and Wilcoxon rank-sum test were applied according to values distribution. Theαlevel was fixed at 0.05.Results. Maxillary first molars were successfully distalized into a Class I relationship in all patients. The mean molar distalization and treatment time were similar in both groups. The DS group exhibited a spontaneous distalization (2.1±0.9 mm) of the first premolar with control of anchorage loss, distal tipping, extrusion, and skeletal changes.Conclusions. The DS is an adequate compliance-free distalizing appliance that can be used safely for the correction of Class II malocclusions. In comparison to the traditional DJ, the DS enables not only a good rate of molar distalization, but also a spontaneous distalization of the first premolars.

scholarly journals Class II subdivision treatment with the Forsus Fatigue Resistant Device vs intermaxillary elastics

2016 ◽  
Vol 87 (3) ◽  
pp. 371-376 ◽  
Author(s):  
Isil Aras ◽  
Aylin Pasaoglu
Keyword(s):  
Treatment Phase ◽  
Class Ii ◽  
Occlusal Plane ◽  
Comprehensive Treatment ◽  
Fixed Appliance ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Fixed Appliances ◽  
The Difference ◽  
Mandibular Incisors

ABSTRACT Objective: To compare the effectiveness of comprehensive fixed appliance treatments implemented in combination with Forsus or intermaxillary elastics in Class II subdivision subjects. Materials and Methods: Twenty-eight Class II subdivision patients were allocated to two groups using matched randomization: Forsus group (mean age, 14.19 ± 1.02 years) and elastics group (mean age, 13.75 ± 1.16 years). Patients received fixed appliance therapy in combination with either Forsus or intermaxillary elastics. The study was conducted on lateral cephalograms and digital models acquired before orthodontic treatment and 10–12 weeks after the fixed appliances were removed. Results: The treatment phase comprising the use of Forsus (4.53 ± 0.91 months) was significantly shorter compared with elastics application (6.85 ± 1.08 months). This was also true for comparing duration of overall comprehensive treatment in both groups. Extrusion and palatal tipping of maxillary incisors and clockwise rotation of the occlusal plane were greater in the elastics group (P &lt; .05). The mandibular incisors were proclined in both groups (P &lt; .001), but no significant difference was observed between groups (P &gt; .05). The mandibular incisors showed intrusion in the Forsus group and extrusion in the elastics group; the difference between groups was significant (P &lt; .05). Overbite was decreased in both groups (P &lt; .001) in similar amounts. Improvement in overjet, mandibular midline deviation, and correction of molar relationship on the Class II side were greater in the Forsus group (P &lt; .05). Conclusion: Forsus is more effective for correcting Class II subdivision malocclusion in a shorter treatment period with minimal patient compliance required.

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