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

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

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Facial esthetic outcome of functional followed by fixed orthodontic treatment of class II division 1 patients

Progress in Orthodontics ◽

10.1186/s40510-019-0294-9 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Mary-Eleni Zouloumi ◽

Kleopatra Tsiouli ◽

Simeon Psomiadis ◽

Olga-Elpis Kolokitha ◽

Nikolaos Topouzelis ◽

...

Keyword(s):

Class Ii ◽

Control Group ◽

Orthodontic Appliances ◽

Facial Appearance ◽

Twin Block ◽

Fixed Orthodontic Appliances ◽

Division 1 ◽

Wilks Lambda ◽

Facial Changes ◽

Class Ii Division 1

Abstract Objectives To assess the perceived facial changes in class II division 1, convex profile patients treated with functional followed by fixed orthodontic appliances. Subjects and methods The study sample consisted of 36 pairs of pre- and post-treatment photographs (frontal and profile, at rest) of 12 patients treated with activator, 12 with twin-block, and 12 controls with normal profiles, treated without functional appliances. All photographs were presented in pairs to 10 orthodontists, 10 patients, 10 parents, and 10 laypersons. Visual analog scale (VAS) ratings of changes in facial appearance were assessed. Results The patient groups were similar in sex distributions, age, and treatment duration. The different rater groups showed strong to excellent agreement. There were no significant differences among treatment groups (F = 0.91; P = 0.526; Wilks lambda = 0.93), raters (F = 1.68; P = 0.054; Wilks lambda = 0.83), and when testing the combined effect of treatment and rater on the results (F = 0.72; P = 0.866; Wilks lambda = 0.85). The raters detected slightly more positive changes in the activator and twin-block groups, compared to the control group, regarding the lower face and the lips, but these findings did not reach significance. Furthermore, their magnitude hardly exceeded 1/20th of the total VAS length. Limitations Retrospective study design. Conclusions The perceived facial changes of convex profile patients treated with functional, followed by fixed orthodontic appliances, did not differ from those observed in normal profile patients, when full-face frontal and profile photos were simultaneously assessed. Consequently, professionals should be skeptical regarding the improvement of a patient’s facial appearance when this treatment option is used.

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Antimicrobial resistance of bacterial strains in patients undergoing orthodontic treatment with and without fixed appliances

The Angle Orthodontist ◽

10.2319/120720-990.1 ◽

2021 ◽

Author(s):

Bruno Andrade Pellissari ◽

Gabriela Sergini Pereira Sabino ◽

Roberto Nepomuceno de Souza Lima ◽

Rogério Heládio Lopes Motta ◽

Selly Sayuri Suzuki ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Orthodontic Treatment ◽

Bacterial Resistance ◽

Control Group ◽

Orthodontic Appliances ◽

Bacterial Strains ◽

Fixed Orthodontic Appliances ◽

Fixed Appliances ◽

Group 2 ◽

Group 1

ABSTRACT Objectives To identify microorganisms isolated from patients wearing fixed orthodontic appliances and to evaluate the resistance of isolated bacterial strains to different antimicrobials. Materials and Methods Seventeen healthy patients wearing a fixed orthodontic appliance (group 1) and six nonwearers (group 2, control group) were evaluated. The biofilm that formed around the orthodontic brackets was collected, and the samples were then plated in a chromogenic medium (chromIDT, bioMérieux). Colony-forming units (CFUs) were isolated and inoculated in blood-agar medium. Automated biochemical tests (VITEK 2, bioMérieux) were carried out to identify the genus and species of the microorganisms and the resistance provided by 43 drugs (37 antibacterial and 6 antifungal). Results The most prevalent microbial genera identified in group 1 were Streptococcus (24.0%), Staphylococcus (20.0%), Enterobacter (12.0%), Geobacillus (12.0%), and Candida (12.0%), and the most frequent species were Enterobacter cloacae complex (13.6%) and Staphylococcus hominis (13.6%). In group 2, the most prevalent genera were Streptococcus (57.1%), Staphylococcus (14.2%), Sphingomonas (14.2%), and Enterobacter (14.2%). With regard to antimicrobial resistance, 14 of 19 (74%) isolated bacterial strains were found to be resistant to at least 1 of the tested antimicrobials. Conclusions The findings of the present study suggest that patients undergoing orthodontic treatment with fixed appliances have a more complex biofilm with a higher level of bacterial resistance.

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

The Angle Orthodontist ◽

10.2319/052912-450.1 ◽

2012 ◽

Vol 83 (2) ◽

pp. 334-340 ◽

Cited By ~ 40

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.

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A single-centre investigator-blinded randomised parallel group clinical trial to investigate the effect of probiotic strainsStreptococcus salivariusM18 andLactobacillus acidophiluson gingival health of paediatric patients undergoing treatment with fixed orthodontic appliances: study protocol

BMJ Open ◽

10.1136/bmjopen-2019-030638 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030638 ◽

Cited By ~ 2

Author(s):

Eleftherios G Kaklamanos ◽

Rania Nassar ◽

Sotirios Kalfas ◽

Manal Al Halabi ◽

Mawlood Kowash ◽

...

Keyword(s):

Treatment Group ◽

Oral Hygiene ◽

Oral Microbiome ◽

Control Group ◽

Orthodontic Appliances ◽

Single Centre ◽

Paediatric Patients ◽

Gingival Health ◽

Parallel Group ◽

Fixed Orthodontic Appliances

BackgroundThere is limited data on the beneficial effects of probiotics on the gingival health of patients undergoing treatment with fixed orthodontic appliances. This study aims to compare the effect of probiotic tablets combined with regular oral hygiene versus regular oral hygiene alone on gingival status in these patients. The effect of probiotic intake on plaque formation and salivary microbiome composition will be also assessed.Methods and analysisThis is a 3 month single-centre, single blind (clinical and laboratory examiners), parallel group randomised controlled two arm superiority trial. Fifty paediatric patients attending the Postgraduate Orthodontic Clinic at the Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates, who meet the eligibility criteria will be recruited. Block randomisation with 1:1 allocation and concealment of allocation will be carried out. The treatment group will receive probiotic tablets containingStreptococcus salivariusM18 andLactobacillus acidophilustogether with regular oral hygiene versus the control group on regular oral hygiene alone. Clinical examination and collection of saliva for microbiome assay will be carried out at baseline and end of study. Self-reporting by patients will be used to document acceptability and adverse effects. Statistically significant decrease in gingival bleeding on probing in the treatment group will be classified as primary outcome of treatment success. Statistically significant reduction in Plaque Index, Gingival Index and shift in the composition of the oral microbiome in favour of beneficial bacteria are secondary outcomes indicative of efficacy of probiotic intake.Ethics and disseminationEthical approval for the study has been granted by the HBMCDM, MBRU, Institutional Review Board (Reference #: MBRU-IRB-2018–015). Study findings will be disseminated via publication in peer-reviewed journal.Trial registration numberISRCTN95085398

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Dental and skeletal changes in mild to moderate Class II malocclusions treated by either a Twin-block or Xbow appliance followed by full fixed orthodontic treatment

The Angle Orthodontist ◽

10.2319/092814-696.1 ◽

2015 ◽

Vol 85 (6) ◽

pp. 997-1002 ◽

Cited By ~ 5

Author(s):

Sayeh Ehsani ◽

Brian Nebbe ◽

David Normando ◽

Manuel O Lagravere ◽

Carlos Flores-Mir

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

Control Group ◽

Block Group ◽

Two Phase ◽

Mandibular Incisor ◽

Twin Block ◽

Treatment Groups ◽

Skeletal Changes ◽

Length Increase

ABSTRACT Objective: To compare the short-term skeletal and dental effects of two-phase orthodontic treatment including either a Twin-block or an XBow appliance. Materials and Methods: This was a retrospective clinical trial of 50 consecutive Class II cases treated in a private practice with either a Twin-block (25) or XBow (25) appliance followed by full fixed orthodontic treatment. To factor out growth, an untreated Class II control group (25) was considered. Results: A MANOVA of treatment/observation changes followed by univariate pairwise comparisons showed that the maxilla moved forward less in the treatment groups than in the control group. As for mandibular changes, the corpus length increase was larger in the Twin-block group by 3.9 mm. Dentally, mesial movement of mandibular molars was greater in both treatment groups. Although no distalization of maxillary molars was found in either treatment group, restriction of mesial movement of these teeth was seen in both treatment groups. Both treatment groups demonstrated increased mandibular incisor proclination with larger increases for the XBow group by 3.3°. The Wits value was decreased by 1.6 mm more in the Twin-block group. No sex-related differences were observed. Conclusions: Class II correction using an XBow or Twin-block followed by fixed appliances occurs through a relatively similar combination of dental and skeletal effects. An increase in mandibular incisor inclination for the XBow group and an increased corpus length for the Twin-block group were notable exceptions. No overall treatment length differences were seen.

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Orthodontic Management of A Girl With Class Ii Div-2 Malocclusion With Deep Bite & Crowding: A Case Report

Bangladesh Journal of Orthodontics and Dentofacial Orthopedics ◽

10.3329/bjodfo.v6i1.42399 ◽

2016 ◽

pp. 29-34

Author(s):

Shamima Nargish ◽

Md Zakir Hossain

Keyword(s):

Case Report ◽

Anterior Segment ◽

Class Ii ◽

Class I ◽

Deep Bite ◽

Canine Retraction ◽

Fixed Appliances ◽

Leveling And Alignment

We describe the treatment of a girl, age 18 years with Class II div-2 malocclusion with deep bite and crowding. Treatment consisted mainly of bite opening, 1st premolars extractions, canine retraction, arch co-ordination, leveling and alignment with Edgewise fixed appliances by multiloop technique. However the treatment resulted in Class I incisor relation with proper alignment of upper and lower anterior segment, an ideal overjet, overbite and incisor angulations. Ban J Orthod & Dentofac Orthop, April 2016; Vol-6 (1-2), P.29-34

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MODEL PBL BERBASIS SIMULASI VIRTUAL DAN PRAKTIKUM, HASIL BELAJAR DAN KETERAMPILAN PROSES SAINS.

Vidya Karya ◽

10.20527/jvk.v34i2.7579 ◽

2020 ◽

Vol 34 (2) ◽

pp. 148

Author(s):

Agung Ma'rufin ◽

Syahmani Syahmani ◽

Mella Mutika Sari

Keyword(s):

Learning Outcomes ◽

Class Ii ◽

Class I ◽

Control Group ◽

Process Skills ◽

Control Group Design ◽

Science Process Skills ◽

Group Design ◽

Class Viii ◽

And Control

Abstract. This study aims to determine the differences in learning outcomes and students' science process skills between classes using PBL models based on virtual simulations, PBL models based on practicum, and conventional learning. This quasi-experimental research uses nonequivalent control group design. The population of this research is VIII grade students of MTsN 2 Banjarmasin. The research sample is class VIII E as the control class, class VIII F as the experimental class I, and class VIII G as the experimental class II. Data collection uses test and observation techniques. Data analysis techniques use the Kruskall-Wallis test and descriptive analysis. The results showed that (1) There were differences in knowledge learning outcomes between experimental class I, experimental class II, and control class (2) There were differences in students' science process skills between experimental class I, experimental class II, and control class. Keywords: Problem Based Learning, Virtual Simulation, Practicum, Knowledge Learning Results, Science Process Skills Abstrak. Penelitian ini bertujuan untuk mengetahui perbedaan hasil belajar dan keterampilan proses sains siswa antara kelas dengan menggunakan model PBL berbasis simulasi virtual, model PBL berbasis praktikum, dan pembelajaran konvensional. Penelitian eksperimen semu ini menggunakan nonequivalent control group design. Populasi penelitian ini adalah siswa kelas VIII MTsN 2 Banjarmasin. Sampel penelitian adalah kelas VIII E sebagai kelas kontrol, kelas VIII F sebagai kelas eksperimen I, dan kelas VIII G sebagai kelas eksperimen II. Pengumpulan data dengan menggunankan teknik tes dan observasi. Teknik analisis data menggunakan uji Kruskall-Wallis dan analisis deskriptif. Hasil penelitian menunjukkan bahwa (1) Terdapat perbedaan hasil belajar pengetahuan antara kelas eksperimen I, kelas eksperimen II, dan kelas kontrol (2) Terdapat perbedaan keterampilan proses sains siswa antara kelas eksperimen I, kelas eksperimen II, dan kelas kontrol. Kata kunci: Problem Based Learning, Simulasi Virtual, Praktikum, Hasil Belajar Pengetahuan, Keterampilan Proses Sains

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Changes in Distribution of Dental Biofilm after Insertion of Fixed Orthodontic Appliances

Journal of Clinical Medicine ◽

10.3390/jcm10235638 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5638

Author(s):

Urszula Kozak ◽

Agnieszka Lasota ◽

Renata Chałas

Keyword(s):

Oral Hygiene ◽

Dental Plaque ◽

General Health ◽

Control Group ◽

Orthodontic Appliances ◽

Fixed Appliance ◽

Dental Biofilm ◽

Supragingival Plaque ◽

Fixed Orthodontic Appliances ◽

The Impact

Good oral hygiene is an important factor in oral and general health, especially in orthodontic patients, because fixed appliances might impede effective oral hygiene and thus increase the risks of tooth decay, periodontal disease and general health complications. This study investigated the impact of fixed orthodontic appliances on the distribution of dental biofilm in teenagers. Supragingival plaque was assessed at T0, T1 and T2. The distribution of the biofilm was analyzed. Approximal Plaque Index (API) and Bonded Bracket Index (BBI) were used to measure the presence of dental plaque. After insertion of the fixed appliance, the dental plaque indices values in the orthodontically treated group were significantly higher (p < 0.05) than in the control group. Fixed orthodontic appliances caused significant changes in the distribution of the biofilm. This was characterized by the change of location of the dental plaque. In the orthodontic group, we observed an increase in the amount of the supragingival plaque on the vestibular surface of the teeth.

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Evaluation of tongue posture & dimensions in relation to skeletal Class I and Class II patterns- A cephalometric study

International Journal of Oral Health Dentistry ◽

10.18231/j.ijohd.2021.054 ◽

2021 ◽

Vol 7 (4) ◽

pp. 276-281

Author(s):

Puja Khanna ◽

Sumit Chhabra ◽

Preeti Munjal ◽

Sunny Mittal ◽

Nishtha Arora

Keyword(s):

Statistical Tests ◽

Class Ii ◽

Class I ◽

Control Group ◽

Skeletal Class ◽

Normal Occlusion ◽

Division 1 ◽

Skeletal Pattern ◽

Bonferroni Test ◽

Class Ii Division 1

Association of tongue posture with dental and facial skeletal pattern have been suggested in past. This study was undertaken to assess tongue posture and dimensions in Class I and Class II Dentoskeletal patterns to determine whether any correlation exists between tongue posture and skeletal pattern of an individual. Cephalograms of 150 individuals (aged 18-23 years), taken in Natural Head Position (NHP) and tongue at rest were divided into three groups i.e. Group 1 – Class I Normal occlusion, Group 2 – Class II Division 1 Normodivergent and Group 3 – Class II Division 1 Hypodivergent, consisting of 50 samples each. To ensure the rest position of tongue, patient was asked to relax for 30 seconds after coating the tongue with barium sulphate in midline and then to swallow, and the X-ray was taken at the end of swallowing. Each group was divided into two subgroups according to sex. Groups were constituted according to the Frankfort mandibular plane angle (FMA) angle. The subjects who had skeletal Class II pattern due to mandibular retrusion and not due to maxillary prognathism were only included in the study group. Statistical analysis was done using the software SPSS version 21.0. The statistical tests used were unpaired t-test and One-way ANOVA test with post-hoc bonferroni test. The p-value was considered significant if less than 0.05.The dorsum of the tongue was higher at back and lower in front in Class II Division 1 Hypodivergent group as compared to Class I Normal occlusion group (P<.05). Tongue height and tongue length were significantly reduced in Class II Division 1 Normodivergent and Class II Division 1 Hypodivergent malocclusion groups when compared to Class I control group (P<.05).The study supports the existence of a relationship between posture & dimensions of the tongue with Class I and Class II skeletal patterns.

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Effects of the cervical headgear in growing Angle Class II malocclusion patients: a prospective study

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.25.2.025-031.oar ◽

2020 ◽

Vol 25 (2) ◽

pp. 25-31

Author(s):

Anderson Jaña Rosa ◽

Rizomar Ramos do Nascimento ◽

José Nelson Mucha ◽

Oswaldo de Vasconcellos Vilella

Keyword(s):

Significant Variation ◽

Class Ii ◽

Control Group ◽

Class Ii Malocclusion ◽

Angle Class Ii ◽

Skeletal Changes ◽

Division 1 ◽

A Prospective Study ◽

Untreated Individuals ◽

Experimental Group

ABSTRACT Objective: Evaluate dental and skeletal changes resulting from the exclusive use of the cervical headgear for 15 ± 4 months in the treatment of patients with Class II division 1 malocclusion. Methods: Differences between the beginning (T1) and immediately after the end of the therapy (T2) with the cervical headgear in growing patients (Experimental Group, EG, n = 23) were examined and compared, during compatible periods, with those presented by a group of untreated individuals (Control Group, CG, n =22) with similar malocclusions and chronological age. The cephalometric variables evaluated were: ANB, GoGn.SN, AO-BO, S'-ANS, S'-A, S'-B, S'-Pog and S'-U6 (maxillary first molar). The Shapiro-Wilk and Levene tests were used to evaluate the results. Results: Significant differences were found relative to the ANB, S'-U6, AO-BO, S'-ANS, S'-A, S'-B and S'-Pog variables between T1 and T2 when comparing both groups. No statistically significant variation was found regarding the GoGn.SN angle. Conclusions: The use of cervical headgear promoted distal movement of the maxillary first molars and restricted the anterior displacement of the maxilla, without significantly affecting the GoGn.SN angle.

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