scholarly journals Incisal and Soft Tissue Effects of Maxillary Premolar Extraction in Class II Treatment

2007 ◽  
Vol 77 (5) ◽  
pp. 808-816 ◽  
Author(s):  
Nevenka Tadic ◽  
Michael G. Woods
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Individual Response ◽  
Lower Lip ◽  
Fixed Appliance ◽  
Premolar Extraction ◽  
Class Ii Treatment ◽  
Nasolabial Angle ◽  
Lateral Cephalograms ◽  
Wide Range

Abstract Objective: This retrospective study was designed to show likely upper incisal and soft tissue lip changes accompanying Class II fixed appliance treatment with only two upper premolar extractions and to assess whether the lips, especially, are predictably and directly affected with such treatment. Materials and Methods: Pretreatment and posttreatment lateral cephalograms and study casts from 61 growing Class II patients (aged 11 to 18 years; 39 division 1 and 22 division 2) were assessed. Upper and lower lip curve depths, nasolabial angle, and upper incisal position and angulation were all assessed and compared with changes in other cephalometric variables. Results: A wide range of individual response in both lip and upper incisor behavior were noted. The observed soft tissue lip changes were most likely to be related to the preexisting morphology of the lips themselves, while upper incisal changes were mainly related to their own pretreatment positions and changes occurring with treatment in the underlying bony structures. Conclusion: Orthodontic treatment involving the extractions of only two upper premolars is likely to result in a wide range of variation in lip and upper incisor behavior. The preexisting soft tissue morphology is likely to be the greatest determinant of lip behavior.

scholarly journals Maxillary premolars extraction or molar distalization with or without TADs: cephalometric evaluation of soft tissue changes in Class II treatment

2020 ◽  
Vol 7 (1) ◽  
pp. 4-11
Author(s):  
Lorenz Moser ◽  
Enrica Di Lorenzo ◽  
Marco Serafin ◽  
Giuliano Maino ◽  
Ute Schneider-Moser ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Growth Spurt ◽  
Class Ii Malocclusion ◽  
Premolar Extraction ◽  
Class Ii Treatment ◽  
Lateral Cephalograms ◽  
Tissue Changes ◽  
Pendulum Appliance ◽  
Soft Tissue Changes

Introduction: Problem solving in Class II malocclusion treatment performed with premolars extractions or distalizing techniques in relation to the profile modification. Aim: To cephalometrically compare soft tissue changes produced either by maxillary premolar extraction, tooth-borne Pendulum appliance or bone-borne MGBM appliance. Materials and Methods: Both pre- (T1) and post-treatment (T2) lateral cephalograms of 89 skeletal Class II patients (36 M, 53 F), treated during pubertal growth spurt, were retrospectively selected. Three groups were formed based on the therapy performed: 30 patients had been treated with maxillary first premolars extraction (U4), 31 patients with a conventional tooth-borne distalizing with Pendulum appliance (PA), and 28 patients with a skeletally anchored distalizing appliance (MGBM). Soft tissue was analyzed comparing upper (UL) and lower (LL) lip’s points with regard to True Vertical Line (TVL) and Esthetic plane (E-plane). Skeletal and dental values have been recorded in order to cephalometrically compare ΔT2-T1 changes among groups and to correlate dental and skeletal changes to profile modifications. One-way ANOVA was employed to compare groups at T1. Paired sample t-tests were employed to assess significant intra- and intergroup differences between T2 and T1. Significance level was set at 0.05 Results: UL and LL showed a slight but not significant retrusion relative to TVL in all three groups. UL and LL distances to E-plane were not statistically significant among U4, PA, and MGBM groups. Independently of the treatment, UL was tangent to TVL in all groups. No statistically significant differences have been shown in skeletal records. Significant differences were recorded in Overjet among U4 than PA and MGBM groups. Conclusions: Class II malocclusion treatment with maxillary first premolar extraction, conventional or skeletal distalization did not significantly affect the profile producing similar changes in the soft tissue.

scholarly journals DENTOSKELETAL, SOFT TISSUE AND AIRWAY EFFECTS OF THE ADVANSYNC2 IN PATIENTS WITH CLASS II DIV 1 MANDIBULAR RETROGNATHISM: A RETROSPECTIVE STUDY

2020 ◽  
pp. 1-3
Author(s):  
Pasupureddi Keerthana ◽  
Prasad Chitra
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Lower Lip ◽  
Skeletal Class Ii ◽  
Nasolabial Angle ◽  
Soft Tissue Profile ◽  
Lateral Cephalograms ◽  
Mandibular Retrognathism

Objective: To evaluate dentoskeletal, soft tissue and airway changes in Class II malocclusion patients treated with AdvanSync2 Class II corrector in conjunction with fixed appliances. Methods: Forty-five subjects with skeletal and dental Class II malocclusion requiring fixed functional therapy were included. Pre-treatment cephalograms served as control group (Group 1), post treatment cephalograms of patients treated using AdvanSync2, as experimental group (Group 2). Changes in skeletal, dental, soft tissue profile and airway were analyzed on lateral cephalograms using 21 variables from multiple cephalometric analysis. Results were tabulated and data was analyzed using Wilcoxon signed rank test for linear parameters and paired student t test for angular parameters. Results: Maxillary skeletal and dental effects included restriction of growth, upper incisor retrusion and retroclination at p<0.001. Mandibular incisors proclined during treatment. Forward mandibular relocation was noted, though not statistically significant. Upper and lower lip repositioning was achieved, establishing lip competency. Changes in Z angle and nasolabial angle were positive, reducing facial convexity. Significant airway dimensional improvements were noted. Conclusion: AdvanSync2 Class II corrector was effective in treating skeletal Class II malocclusions with mandibular retrognathism. It produced its effects mainly through maxillary restriction and mandibular dentoalveolar changes which furthermore helped in achieving good soft tissue profiles in patients. Positive airway changes were also noted.

scholarly journals Prediction of Individual Mandibular Changes Induced by Functional Jaw Orthopedics Followed by Fixed Appliances in Class II Patients

2006 ◽  
Vol 76 (6) ◽  
pp. 950-954 ◽  
Author(s):  
Lorenzo Franchi ◽  
Tiziano Baccetti
Keyword(s):  
Class Ii ◽  
Skeletal Maturation ◽  
Fixed Appliance ◽  
Mandibular Growth ◽  
Class Ii Treatment ◽  
Lateral Cephalograms ◽  
Sagittal Parameters ◽  
Fixed Appliances ◽  
Functional Jaw Orthopedics ◽  
Individual Responsiveness

Abstract Objective: To identify pretreatment cephalometric variables for the prediction of individual mandibular outcomes of functional jaw orthopedics (FJO) followed by fixed appliances in Class II patients treated at the peak in mandibular growth. Materials and Methods: The study was performed on 51 subjects (24 females, 27 males) with Class II malocclusion. First-phase therapy was accomplished with a twin block in 16 subjects, a stainless steel crown Herbst in 15 subjects, and an acrylic splint Herbst in 20 subjects. Lateral cephalograms were available at the start of treatment with FJO and at the completion of fixed appliance therapy. All subjects received FJO at the peak in mandibular growth (CS 3 at T1). Individual responsiveness to Class II treatment including FJO was defined on the basis of the T2-T1 increment in total mandibular length (Co-Gn) when compared with untreated Class II subjects. Results: Discriminant analysis identified a single predictive parameter (Co-Go-Me°) with a classification power of 80%. Pretreatment vertical and sagittal parameters were not able to improve the prediction based upon the mandibular angle. Conclusions: A Class II patient at the peak in skeletal maturation (CS 3) with a pretreatment Co-Go-Me° smaller than 125.5° is expected to respond favorably to treatment including FJO. A Class II patient at CS 3 with a pretreatment value for Co-Go-Me° greater than 125.5° is expected to respond poorly to treatment including FJO.

scholarly journals Soft Tissue Profile Response in Adult Orthodontic Patients following Extractions

2019 ◽  
Vol 07 (02) ◽  
pp. 074-080
Author(s):  
Mandeep Bhullar ◽  
Amita Badhan ◽  
Sanjay Mittal ◽  
Isha Aggarwal ◽  
Divya Singla ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Adult Patients ◽  
Hard Tissue ◽  
Premolar Extraction ◽  
Nasolabial Angle ◽  
Soft Tissue Profile ◽  
Lateral Cephalograms ◽  
Angular Measurements ◽  
Tissue Alteration ◽  
Cephalometric Changes

Abstract Introduction The position of the incisors is considered as a key landmark in treatment planning to provide the patient with the most attractive and well-balanced smile. It is important to quantify the relationship between anteroposterior position of incisors to overlying soft tissue structures. Aim The purpose of this study was to evaluate cephalometric changes on the soft tissue profile of the adult patients after first premolar extraction. Materials and Methods The study included pretreatment and posttreatment lateral cephalograms of 24 adult patients (Class II div 1 malocclusion and Class I bimaxillary protrusion) treated with preadjusted edgewise appliance following first premolar extractions. Seven angular and twelve linear soft tissue parameters were evaluated. Six hard tissue parameters were evaluated. Results All the linear and angular measurements pertaining to soft tissue and hard tissue showed significant changes. When posttreatment values were compared with pretreatment values, certain parameters (nasolabial angle, Z angle, UL and LL length, and UL strain) were found to be increased, whereas other parameters showed decrease in their posttreatment values. The tissue alteration showed statistically significant increase in nasolabial angle, Z angle, and decrease in soft tissue profile and interlabial gap. Conclusion Facial profile improvement can be enhanced by dentoalveolar and soft tissue retraction following premolar extraction.

scholarly journals Effects of mandibular protraction appliance associated to fixed appliance in adults

2013 ◽  
Vol 18 (5) ◽  
pp. 46-52 ◽  
Author(s):  
Bruno D'Aurea Furquim ◽  
José Fernando Castanha Henriques ◽  
Guilherme Janson ◽  
Danilo Furquim Siqueira ◽  
Laurindo Zanco Furquim
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
T Test ◽  
Adult Patients ◽  
Class Ii Malocclusion ◽  
Fixed Appliance ◽  
Facial Height ◽  
Nasolabial Angle ◽  
Division 1 ◽  
Before And After

OBJECTIVE: This retrospective study aimed to conduct a cephalometric evaluation of the skeletal, dental and soft tissue effects resulting from treatment of adult patients presenting Class II malocclusion, performed with a Mandibular Protraction Appliance (MPA) combined with a fixed orthodontic appliance. METHODS: The sample consisted of teleradiographs obtained before and after treatment of 9 adult patients (initial mean age of 22.48 years) with bilateral Class II, division 1, malocclusion. Paired t test (p < 0.05) was applied to compare initial and final values. RESULTS: t test revealed an increase in anteroinferior facial height and posterior facial height. The dental changes include: extrusion of upper incisors, buccal inclination, protrusion of lower incisors, mesialization and extrusion of mandibular molars. Regarding the soft tissue component, there was an increase in nasolabial angle in addition to upper lip retrusion. CONCLUSIONS: The effects of treating Class II malocclusion adult patients, by means of using Mandibular Protraction Appliance (MPA) combined with a fixed appliance were mostly observed in the mandibular arch, and consisted of buccal inclination, protrusion and intrusion of incisors, and mesialization and extrusion of the molars.

scholarly journals Dental and skeletal changes in patients with mandibular retrognathism following treatment with Herbst and pre-adjusted fixed appliance

2014 ◽  
Vol 19 (1) ◽  
pp. 46-54 ◽  
Author(s):  
Fabio de Abreu Vigorito ◽  
Gladys Cristina Dominguez ◽  
Luís Antônio de Arruda Aidar
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Class Ii ◽  
Initial Position ◽  
Occlusal Plane ◽  
Mandibular Movement ◽  
Fixed Appliance ◽  
Lateral Cephalograms ◽  
T1 And T2 ◽  
Mandibular Retrognathism

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.

Soft-Tissue Profile Changes during Widening and Protraction of the Maxilla in Patients with Cleft Lip and Palate Compared with Normal Growth and Development

1993 ◽  
Vol 30 (5) ◽  
pp. 454-468 ◽  
Author(s):  
Rolf S. Tindlund ◽  
Per Rygh
Keyword(s):  
Soft Tissue ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lower Lip ◽  
Maxillary Protraction ◽  
Transverse Expansion ◽  
Short Period ◽  
Soft Tissue Profile ◽  
Lateral Cephalograms ◽  
Maxillary Deficiency

During the last 15 years, cleft lip and palate (CLP) patients with maxillary deficiency in the care of the Bergen CLP team have undergone an interceptive orthopedic treatment phase during the deciduous and mixed dentition period. The present study includes 68 patients who received maxillary transverse expansion by use of a modified quad-helix appliance and 98 cases given maxillary protraction by a facial mask. All cases were treated until an acceptable normal occlusion was attained. Lateral cephalograms were taken immediately before and after the active treatment periods. Sagittal changes of the soft-tissue profile during transverse expansion and protraction were analyzed separately for unilateral complete cleft lip and palate (UCLP) patients and bilateral complete cleft lip and palate (BCLP) patients. The soft-tissue profiles of the groups were compared to growth changes of noncleft age-matched children (NORM group). During the short period of maxillary transverse expansion (mean period, 3.5 months) no significant change of the soft-tissue profile was found, except in the protrusion of the lower lip in the BCLP group. During the period of maxillary protraction (mean periods, 12 months in the UCLP group and 15 months in the BCLP group) the soft-tissue profile improved significantly by reducing the characteristic tendency towards a concave profile in CLP patients with maxillary deficiency. Significant Increases of the sagittal maxillomandlbular lip relation (angle SS-N-SM: mean Increase, 2.5 degrees) and the Holdaway-angle (H-angle: mean increase, 3.0 degrees) were found to be similar in the UCLP and BCLP groups. However, the use of different reference lines for evaluation of treatment effects upon the soft-tissue profile resulted in conflicting findings suggesting that anteriorly situated reference lines are more suitable for the evaluation of CLP patients. Thus, the esthetic line (E.line) indicated a favorable position of the lips after treatment; the subspinale-pogonlon line (ss.pg) revealed an Improved soft-tissue profile; the soft-tissue-facial line (N.PG) showed a retruded nose and upper lip; whereas basal references such as the nasion-sella line (NSL) and the occlusal-line perpendicular (OLP) mainly showed major differences between the CLP groups and the NORM groups.

scholarly journals Development of a Prediction Model for Short-Term Success of Functional Treatment of Class II Malocclusion

2020 ◽  
Vol 17 (12) ◽  
pp. 4473
Author(s):  
Elisabetta Cretella Lombardo ◽  
Lorenzo Franchi ◽  
Giorgio Gastaldi ◽  
Veronica Giuntini ◽  
Roberta Lione ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Outcome Variable ◽  
P Value ◽  
Functional Therapy ◽  
Twin Block ◽  
Predictive Variables ◽  
Lateral Cephalograms ◽  
Patient Responsiveness ◽  
Forward Stepwise

(1) Background: The nature of the changes that contribute to Class II correction with functional appliances is still controversial. A broad variation in treatment responses has been reported. The purpose of this study was to find cephalometric predictors for individual patient responsiveness to twin-block treatment in patients with Class II Division 1 malocclusion; (2) Methods: The study was performed on a sample of 39 pubertal patients (21 females, 18 males) treated with the twin block appliance. Lateral cephalograms were available at the start of the treatment (T1) and at the end of functional therapy (T2). The outcome variable was the T2–T1 change in the sagittal position of the soft tissue pogonion with respect to the vertical line perpendicular to the Frankfort plane and passing through point subnasale. The predictive variables were age, gender at T1, and all the cephalometric parameters measured T1. Forward stepwise linear regression with p value to enter 0.05 and p value to leave 0.10 was applied; (3) Results: The only significant predictive variable that was selected was the Co–Go–Me angle (p = 0.000); (4) Conclusions: A greater advancement of the soft tissue chin on the profile is expected with smaller pretreatment values of Co–Go–Me angle.

scholarly journals The duration of pubertal growth peak among three skeletal classes

2016 ◽  
Vol 21 (5) ◽  
pp. 67-74 ◽  
Author(s):  
Waqar Jeelani ◽  
◽  
Mubassar Fida ◽  
Attiya Shaikh ◽  
◽  
...  
Keyword(s):  
Class Ii ◽  
Growth Potential ◽  
Class I ◽  
Maturation Stage ◽  
Class Iii ◽  
Pubertal Growth ◽  
Lateral Cephalograms ◽  
Wide Range ◽  
Significant Difference ◽  
The Mean

ABSTRACT Introduction: Pubertal growth peak is closely associated with a rapid increase in mandibular length and offers a wide range of therapeutic modifiability. Objective: The aim of the present study was to determine and compare the mean ages of onset and duration of pubertal growth peak among three skeletal classes. Methods: A retrospective cross-sectional study was conducted using lateral cephalograms of 230 subjects with growth potential (110 males, 120 females). Subjects were categorized into three classes (Class I = 81, Class II = 82, Class III = 67), according to the sagittal relationship established between the maxilla and the mandible. The cervical vertebral maturation stage was recorded by means of Baccetti's method. The mean ages at CS3 and CS4 and the CS3-CS4 age interval were compared between boys and girls and among three skeletal classes. Results: Pubertal growth peak occurred on average four months earlier in girls than boys (p = 0.050). The average duration of pubertal growth peak was 11 months in Class I, seven months in Class II and 17 months in Class III subjects. Interclass differences were highly significant (Cohen's d > 0.08). However, no significant difference was found in the timing of pubertal growth peak onset among three skeletal classes (p = 0.126 in boys, p = 0.262 in girls). Conclusions: Girls enter pubertal growth peak on average four months earlier than boys. Moreover, the duration of pubertal growth peak is on average four months shorter in Class II and six months longer in Class III subjects as compared to Class I subjects.

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