The effects of tongue plate and tongue appliance on maxillary deficiency in growing patients

Objectives The purpose of this randomized trial study was to compare the effects of tongue plate and tongue appliance in the treatment of Class III malocclusion with maxillary deficiency in growing patients. Material and Methods 40 patients (19 males, 21 females) with maxillary deficiency were selected. 20 patients (9 boys, 11 girls) with the mean age of 9.3±1.2 were treated with tongue plate. 20 patients (10 boys, 10 girls) with the mean age of 10.1±0.7 were treated by tongue appliance. Lateral cephalograms obtained at the beginning and end of the study were analyzed. Results Paired t-tests and Wilcoxon test showed that SNA and ANB significantly increased in both groups. The Mann-Whitney test showed that there were no statistically significant differences between the two groups except for Jarabak ratio. Jarabak increased by 0.6±3.2° in the tongue appliance group and it decreased 0.4±1.6° in the tongue plate group (p<0.03). Conclusion Both treatment modalities were successful in moving the maxilla forward. The crib of the tongue appliance might bother the tongue and consequently parents are complaining about minor inflammation of the tongue. The smooth surface of the tongue plate might therefore confer some advantages to this system as compared to the tongue plate.

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Tandem Traction Bow Appliance for the Treatment of Skeletal Class III Malocclusion

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1708741 ◽

2018 ◽

Vol 08 (01) ◽

pp. 27-34

Author(s):

Shetty Prajwal K. ◽

Priyanka S Udeshi ◽

Kuttappa M. N. ◽

Nanda kishore P. ◽

Ravi M. S. ◽

...

Keyword(s):

Treatment Modalities ◽

Class Iii ◽

Class Iii Malocclusion ◽

Active Growth ◽

Lower Incisor ◽

Skeletal Class ◽

Lateral Cephalograms ◽

Incisor Retraction ◽

Maxillary Deficiency

AbstractBackground and Objectives: Skeletal class III is a growth related discrepancy which continues and becomes more severe until active growth is completed. Approximately three percent of Indian population exhibits class III malocclusion. This can be due to a mid face deficiency, a large mandible or their combination. Various treatment modalities are available for correction of class III malocclusion in growing children, one of which is the Tandem Traction Bow Appliance (TTBA). This study was planned and designed to evaluate the dental and skeletal effects of TTBA used for the correction of skeletal Class III malocclusion with maxillary deficiency. Materials and Methods: An in-vivo study designed to study the effects of TTBA on class III malocclusion with maxillary deficiency. The study was carried out on ten patients (age 6-12 years). Pre and post lateral cephalograms were traced and analyzed. Paired t test was used to compare values. Result: The significant changes seen in the dental and skeletal parameters were upper and lower incisor retraction, Increase in ANB angulations and forward and downward movement of the maxillary arch. Conclusion: TTBA is effective in early treatment of Skeletal Class III malocclusion. Being intraoral, patient compliance is improved, thus making TTBA easier to use, both for the clinician as well as for the patient.

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

The Angle Orthodontist ◽

10.2319/042717-282.1 ◽

2017 ◽

Vol 88 (2) ◽

pp. 157-162 ◽

Cited By ~ 2

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.

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Comparison of Profile Attractiveness between Class III Orthodontic Camouflage and Predictive Tracing of Orthognathic Surgery

International Journal of Dentistry ◽

10.1155/2020/7083940 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Mohamad Nagi Bou Wadi ◽

Karina Maria Salvatore Freitas ◽

Daniel Salvatore Freitas ◽

Rodrigo Hermont Cançado ◽

Renata Cristina Gobbi de Oliveira ◽

...

Keyword(s):

Orthognathic Surgery ◽

Orthodontic Treatment ◽

Growth Patterns ◽

Sample Population ◽

Class Iii ◽

Class Iii Malocclusion ◽

Subjective Analysis ◽

Lateral Cephalograms ◽

Significant Difference ◽

The Mean

Objective. The aim of this study was to compare the profile attractiveness between orthodontic camouflage of the Class III malocclusion and the predictive tracing simulating orthognathic surgery evaluated by dentists and laypeople. Settings and sample population. The sample consisted of 21 patients (9 male; 12 female) with Class III malocclusion treated with orthodontic camouflage and Class III intermaxillary elastics. Material and Methods. The mean initial age of the patients was 24.38 years (SD 3.32), and the mean ANB angle was −1.91° (SD 0.83°). Patients presented skeletal Class III and normal growth patterns. Initial and final lateral cephalograms of each patient were used. The initial cephalogram was used to perform the treatment simulation of orthognathic surgery, and its silhouette was compared to the silhouette obtained from the final cephalogram after Class III orthodontic camouflage. A subjective analysis of profile attractiveness was performed by 47 laypeople and 60 dentists, with scores from 1 (less attractive) to 10 (most attractive). Mann–Whitney tests were used to compare profile attractiveness between the orthodontic treatment and the predictive tracing groups and between dentists and laypeople. Results. The predictive tracing of orthognathic surgery showed to be statistically significantly more attractive (mean score 4.57, SD 2.47) than that of the Class III camouflage orthodontic treatment (mean score 4.22, SD 2.40), with a mean numerical but significant difference of 0.35 (SD 2.01) (P<0.001). Laypeople were more critical than dentists in evaluating profile attractiveness, but numerical difference between the groups was also small. Conclusion. The profile silhouette of predictive tracing simulating orthognathic surgery showed to be more attractive than that of Class III camouflage orthodontic treatment; however, differences were small but statistically significant. Laypeople showed to be more critical than dentists.

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Stability of bimaxillary surgery on Class III malocclusion treatment

Dental Press Journal of Orthodontics ◽

10.1590/s2176-94512012000600013 ◽

2012 ◽

Vol 17 (6) ◽

pp. 41-51 ◽

Cited By ~ 1

Author(s):

Fernando Antonio Gonçalves ◽

Vânia Célia Vieira de Siqueira

Keyword(s):

Muscle Adaptation ◽

Class Iii ◽

Class Iii Malocclusion ◽

Mandibular Setback ◽

Skeletal Malocclusion ◽

Lateral Cephalograms ◽

Maxillary Surgery ◽

Bimaxillary Surgery ◽

Student’S T ◽

The Stability

OBJECTIVE: To evaluate the stability of bimaxillary surgery in patients with skeletal malocclusion, with the use of rigid internal fixation. METHODS: Lateral cephalograms from 20 patients, 11 males and 9 females, mean age of 26 years and 1 month, were evaluated before surgery, immediately post-operative and at least 6 months after surgery. Nineteen cephalometric measurements were evaluated, and the results were statistically analyzed by means of the Student's t test and the Kruskal-Wallis test. RESULTS: The Le Fort I maxillary advancement surgery showed almost no relapse. There was lack of stability of mandibular setback, with relapse of 37.33% on point B, due to counterclockwise rotation of the mandible between post-operative periods, occurred by better intercuspation after surgery and muscle adaptation. The results showed the same tendencies for both genders. CONCLUSION: It was concluded that on the bimaxillary surgery treatment of Class III malocclusion, the maxillary surgery was very stable, but the mandibular setback recurred. No statistical differences were found in surgical stability between genders.

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Maxillary Protraction in an Adolescent Female Patient: A Case Report

Dental Journal of Advance Studies ◽

10.1055/s-0038-1675250 ◽

2018 ◽

Vol 6 (02/03) ◽

pp. 118-121

Author(s):

Suruchi Jatol-Tekade ◽

Satyajit Tekade ◽

Sachin Sarode ◽

Vishal Patni ◽

Vihang Naphde

Keyword(s):

Case Report ◽

Female Patient ◽

Treatment Options ◽

Forward Direction ◽

Face Mask ◽

Treatment Modalities ◽

Class Iii ◽

Class Iii Malocclusion ◽

Growth Modulation ◽

Skeletal Class

AbstractTandem appliance is preferred over face mask mainly because of compliance reasons. In the given case report, clinicians have used tandem appliance for correcting skeletal class III malocclusion patient in later stage of growth. Operators utilized residual growth. Facial harmony was achieved by gaining positive overjet. Adolescent class III malocclusion is challenging to treat. Occurrence of class III malocclusion is just 5% in India. If patient reports in growing stage, clinicians get many relevant treatment options. Lack of knowledge about growth modulation therapy causes loss of growing stage of patients. This situation reduces available treatment modalities. Here is a case of female patient with class III malocclusion who is near completion of her growth; maxillary growth was stimulated in forward direction taking anchorage from overgrown mandible with the help of tandem appliance.

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Comparison of skeletal anchorage and tooth-borne maxillary protraction followed by fixed appliance in Class III malocclusion

European Journal of Orthodontics ◽

10.1093/ejo/cjz086 ◽

2019 ◽

Vol 42 (2) ◽

pp. 193-199 ◽

Cited By ~ 1

Author(s):

Sang-Hoon Lee ◽

Sang-Duck Koh ◽

Dong-Hwa Chung ◽

Jin-Woo Lee ◽

Sang-Min Lee

Keyword(s):

Phase Ii ◽

Class I ◽

Skeletal Anchorage ◽

Class Iii ◽

Class Iii Malocclusion ◽

Fixed Appliance ◽

Skeletal Class ◽

Maxillary Protraction ◽

Lateral Cephalograms ◽

Residual Growth

Summary Objectives The purpose of this study was to compare the results of skeletal anchorage (SAMP) and tooth- borne (TBMP) maxillary protraction followed by fixed appliance in growing skeletal Class III patients. Materials and methods Patients treated with maxillary protraction were selected and classified into two groups (SAMP: n = 19, mean age = 11.19 years; TBMP: n = 27, mean age = 11.21 years). Lateral cephalograms taken before treatment (T0), after the maxillary protraction (T1), and after the fixed appliance treatment (T2) were analysed and all variables were statistically tested to find difference between the two groups. Results Compared to the TBMP, the SAMP showed significant forward growth of maxilla (Co-A point and SN-Orbitale) and improvement in intermaxillary relationship (ANB, AB to mandible plane, and APDI) after the overall treatment (T0–T2), with no significant sagittal changes in maxilla or mandible throughout the fixed appliance treatment (T1–T2). Limitations In maxillary protraction, effects of skeletal anchorage were retrospectively compared with those of dental anchorage, not with Class I or III control. Conclusions and implications After maxillary protraction, skeletal and tooth-borne anchorage did not cause significant differences in the residual growth of maxilla throughout the phase II treatment. Orthopaedic effects with skeletal anchorage showed appropriate stability in maxilla and intermaxillary relationship even after fixed appliance treatment.

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The duration of pubertal growth peak among three skeletal classes

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.21.5.067-074.oar ◽

2016 ◽

Vol 21 (5) ◽

pp. 67-74 ◽

Cited By ~ 3

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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Expansion/Facemask Treatment of an Adult Class III Malocclusion

Case Reports in Dentistry ◽

10.1155/2014/270257 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6

Author(s):

Gregory W. Jackson ◽

Neal D. Kravitz

Keyword(s):

Face Mask ◽

Class Iii ◽

Class Iii Malocclusion ◽

Older Children ◽

Maxillary Expansion ◽

Viable Option ◽

Maxillary Protraction ◽

Skeletal Pattern ◽

Maxillary Deficiency ◽

The Ideal

The orthodontic treatment of class III malocclusion with a maxillary deficiency is often treated with maxillary protraction with or without expansion. Skeletal and dental changes have been documented which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Concerning the ideal time to treat a developing class III malocclusion, studies have reported that, although early treatment may be the most effective, face mask therapy can provide a viable option for older children as well. But what about young adults? Can the skeletal and dental changes seen in expansion/facemask therapy in children and adolescents be demonstrated in this age group as well, possibly eliminating the need for orthodontic dental camouflage treatment or orthognathic surgery? A case report is presented of an adult class III malocclusion with a Class III skeletal pattern and maxillary retrusion. Treatment was with nonextraction, comprehensive edgewise mechanics with slow maxillary expansion with a bonded expander and protraction facemask.

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Prognosis Prediction for Class III Malocclusion Treatment by Feature Wrapping Method

The Angle Orthodontist ◽

10.2319/071508-371.1 ◽

2009 ◽

Vol 79 (4) ◽

pp. 683-691 ◽

Cited By ~ 7

Author(s):

Bo-Mi Kim ◽

Bo-Yeong Kang ◽

Hong-Gee Kim ◽

Seung-Hak Baek

Keyword(s):

Statistical Methods ◽

Classification Accuracy ◽

Prediction Accuracy ◽

Support Vector ◽

Second Phase ◽

Class Iii ◽

Class Iii Malocclusion ◽

Prognosis Prediction ◽

Lateral Cephalograms ◽

Sequential Forward Search

Abstract Objective: To use the feature wrapping (FW) method to identify which cephalometric markers show the highest classification accuracy in prognosis prediction for Class III malocclusion and to compare the prediction accuracy between the FW method and conventional statistical methods such as discriminant analysis (DA). Materials and Methods: The sample set consisted of 38 patients (15 boys and 23 girls, mean age 8.53 ± 1.36 years) who were diagnosed with Class III malocclusion and received both first-phase (orthopedic) and second-phase (fixed orthodontic) treatments. Lateral cephalograms were taken before (T0) and after first-phase treatment (T1) and after second-phase treatment and retention (T2). Based on the measurements taken at the T2 stage, the patients were allocated into good (n = 20) or poor (n = 18) prognosis groups. Forty-six cephalometric variables on T0 lateral cephalograms were analyzed by the FW method to identify key determinants for discriminating between the two groups. Sequential forward search (SFS) algorism and support vector machine (SVM) were used in conjunction with the FW method to improve classification accuracy. To compare the prediction accuracy of the FW method with conventional statistical methods, DA was performed for the same data set. Results: AB to mandibular plane angle (°) and A to N-perpendicular (mm) were selected as the most accurate cephalometric predictors by both the FW and DA methods. However, classification accuracy was higher with the FW method (97.2%) compared with DA (92.1%), because the FW method with SFS and SVM has a more precise classification algorithm. Conclusions: The FW method, which uses a learning algorithm, might be an effective alternative to DA for prognosis prediction.

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Assessment of Temporary Crown Extensions to Correct Linguoverted Mandibular Canine Teeth in 72 Client-Owned Dogs (2012-2016)

Journal of Veterinary Dentistry ◽

10.1177/0898756418774886 ◽

2018 ◽

Vol 35 (2) ◽

pp. 103-113 ◽

Cited By ~ 1

Author(s):

Sigbjørn H. Storli ◽

Robert A. Menzies ◽

Alexander M. Reiter

Keyword(s):

Original Position ◽

Treatment Modalities ◽

Class Iii ◽

Class Iii Malocclusion ◽

Canine Tooth ◽

Investigation Period ◽

Mandibular Canine ◽

Dental Records ◽

Viable Treatment

A search of the medical and dental records at Evidensia Lørenskog Dyreklinikk, in Lørenskog, Norway, was conducted to identify dogs that received temporary crown extensions (TCEs) to correct linguoverted mandibular canine (LMC) teeth over a 54-month investigation period (2012-2016). Criteria for inclusion into the study were the presence of complete medical and dental records, pre- and postoperative clinical photographs and intraoral radiographs of the affected canine teeth, adequate information pertaining to the procedures performed, and at least 1 follow-up >3 months after appliance removal. Seventy-two dogs with LMC teeth were treated with TCE. Thirty-nine breeds were represented in this study. Mean age at the time of appliance installation was 6.4 (range, 4.7-13.4 months [median, 5.9 months] months). Fifty-three (73.6%) dogs presented with class I malocclusion, 14 (19.5%) dogs with class II malocclusion, and 5 (6.9%) dogs with class III malocclusion. Twenty-five (34.7%) dogs were considered to have mild, 32 (44.4%) dogs to have moderate, and 15 (20.8%) dogs to have severe mandibular canine malocclusion. The TCE was combined with other treatment modalities (active orthodontics, extraction of nonstrategic teeth, gingivectomy, and inclined bite plane and ball therapy) to correct mandibular canine tooth malocclusions in 19 (26.4%) dogs. Fractured or detached crown extensions were seen in 9 (12.5%) dogs. Soft tissue ulceration or inflammation was seen in 7 (9.7%) dogs. The mandibular canine teeth occlusion resolved completely with self-retaining, functional, nontraumatic occlusion in 56 (77.8%) dogs. Fifteen dogs (20.8%) resolved with functional, nontraumatic occlusion, but the mandibular canine teeth were too short to be perfectly self-retained, thus left with 1- to 2-mm crown extensions for permanent retention. In 1 (1.4%) dog, both mandibular canine teeth relapsed almost back to original position. The results show that TCE is a viable treatment option to correct LMC teeth in young dogs.

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