Stability of skeletal changes induced by growth modulation procedures in the treatment of skeletal Class II malocclusion

Skeletal Class II malocclusion is attributed to maxillary prognathism, mandibular retrognathism or combination of both. In adolescent cases, the treatment includes growth modulation with headgear or myofunctional appliances. However in adults, optimum esthetic and functional efficacy can be achieved by orthodontic-surgical combination. This case report describes a 21 years old post-pubertal male with severe skeletal Class II discrepancy with normal maxilla and retrognathic mandible. The case was treated with bilateral sagittal split osteotomy (BSSO) with mandibular advancement approach. Straight profile, pleasing esthetics, bilateral Class I molar and canine relationship, normal overjet and overbite were achieved because of a combined ortho-surgical approach.

Download Full-text

Correlation Analysis between Three-Dimensional Changes in Pharyngeal Airway Space and Skeletal Changes in Patients with Skeletal Class II Malocclusion following Orthognathic Surgery

BioMed Research International ◽

10.1155/2022/3995690 ◽

2022 ◽

Vol 2022 ◽

pp. 1-15

Author(s):

Moonhwan Kim ◽

Chung-Ju Hwang ◽

Jung-Yul Cha ◽

Sang-Hwy Lee ◽

Young Joon Kim ◽

...

Keyword(s):

Orthognathic Surgery ◽

Three Dimensional ◽

Class Ii ◽

Class Ii Malocclusion ◽

Sectional Area ◽

Skeletal Class ◽

Pharyngeal Airway ◽

Skeletal Changes ◽

Skeletal Class Ii ◽

Anterior Posterior

Introduction. Studies on the pharyngeal airway space (PAS) changes using three-dimensional computed tomography (CT) have shed more light on patients with Class III than Class II malocclusion. This paper focuses on analyzing the long-term changes in the PAS and evaluating the postoperative association between these PAS and skeletal changes in patients with skeletal Class II malocclusion who have undergone orthognathic surgery. Methods. The records of 21 patients with skeletal Class II malocclusion who had undergone orthognathic surgery were included. The anatomical modifications in both jaws, changes in volume, sectional area (SA), minimum sectional area (MSA), and anterior-posterior (AP) and transverse (TV) width in the airway at one month before surgery ( T 0 ), and one month ( T 1 ) and one year ( T 2 ) after surgery were analyzed using CT images. The association between the skeletal and airway changes was evaluated between T 0 , T 1 , and T 2 . Results. After surgery, the ANS, A point, and PNS demonstrated significant posterior and superior movement. The B point and the pogonion exhibited substantial anterior and superior movement. The total and inferior oropharyngeal volumes (vol 3, vol 4) notably increased, while the nasopharyngeal volume (vol 1) decreased. The anterior-posterior movement at the ANS and PNS after surgery was significantly associated with the total volume, vol 2, vol 3, SA 1, MSA, and TV width 1, while substantial association with the total volume was found at the pogonion. Conclusion. Thus, an ideal treatment plan can be formulated for patients with skeletal Class II malocclusion by considering the postoperative PAS changes.

Download Full-text

Evaluation of the effects of skeletal anchoraged Forsus FRD using miniplates inserted on mandibular symphysis: A new approach for the treatment of Class II malocclusion

The Angle Orthodontist ◽

10.2319/051314-345.1 ◽

2014 ◽

Vol 85 (3) ◽

pp. 413-419 ◽

Cited By ~ 20

Author(s):

Tuba Unal ◽

Mevlut Celikoglu ◽

Celal Candirli

Keyword(s):

Class Ii ◽

Prospective Clinical Study ◽

Class Ii Malocclusion ◽

New Approach ◽

Mandibular Symphysis ◽

Skeletal Class ◽

Skeletal Changes ◽

Skeletal Class Ii ◽

Student’S T ◽

Mandibular Retrusion

ABSTRACT Objective: To evaluate the skeletal, dentoalveolar, and soft tissue effects of the Forsus Fatigue Resistant Device (FRD) appliance with miniplate anchorage for the treatment of skeletal Class II malocclusion. Material and Methods: The prospective clinical study group included 17 patients (11 girls and 6 boys; mean age 12.96 ± 1.23 years) with Class II malocclusion due to mandibular retrusion and treated with skeletal anchoraged Forsus FRD. After 0.019 × 0.025-inch stainless steel archwire was inserted and cinched back in the maxillary arch, two miniplates were placed bilaterally on the mandibular symphysis. Then, the Forsus FRD EZ2 appliance was adjusted to the miniplates without leveling the mandibular arch. The changes in the leveling and skeletal anchoraged Forsus FRD phases were evaluated by means of the Paired and Student's t-tests using the cephalometric lateral films. Results: The success rate of the miniplates was found to be 91.5% (38 of 42 miniplates). The mandible significantly moved forward (P < .001) and caused a significant restraint in the sagittal position of the maxilla (P < .001). The overjet correction (−5.11 mm) was found to be mainly by skeletal changes (A-VRL, −1.16 mm and Pog-VRL, 2.62 mm; approximately 74%); the remaining changes were due to the dentoalveolar contributions. The maxillary and mandibular incisors were significantly retruded (P < .001). Conclusion: This new approach was an effective method for treating skeletal Class II malocclusion due to the mandibular retrusion via a combination of skeletal and dentoalveolar changes.

Download Full-text

Uso de propulsor mandibular fixo Flex Developer como recurso no tratamento da Classe II em paciente não colaborador

Orthodontic Science and Practice ◽

10.24077/2020;1352-4051 ◽

2020 ◽

Vol 13 (52) ◽

pp. 40-51

Author(s):

Renato Barcellos Rédua

Keyword(s):

Upper Airway ◽

Class Ii ◽

Class Ii Malocclusion ◽

Skeletal Class ◽

Advantages And Disadvantages ◽

Skeletal Class Ii ◽

High Incidence ◽

Therapeutic Alternatives ◽

Smile Aesthetics ◽

Treatment Alternatives

Class II malocclusion has a high incidence in the population, which may compromise smile aesthetics, occlusion function and stability. Skeletal Class II may affect facial aesthetics and upper airway volume. Class II malocclusion is routinely associated with skeletal Class II condition, having as treatment alternatives the use of Extra Buccal Appliance (EBA) or removable or fixed propulsor appliance. This article describes a case of a patient who did not accept the use of EBA and so it was fitted a Flex Developer propulsor for Class II correction and discussed the advantages and disadvantages of therapeutic alternatives for Class II correction.

Download Full-text

Evaluation of 3D Printed Modified Twin Block for Correction of Skeletal Class II Malocclusion in Growing Females

Case Medical Research ◽

10.31525/ct1-nct04028661 ◽

2019 ◽

Author(s):

Keyword(s):

Class Ii ◽

Class Ii Malocclusion ◽

Twin Block ◽

Skeletal Class ◽

Skeletal Class Ii ◽

3D Printed

Download Full-text

A Comparison of Five Different Methods for Describing Sagittal Jaw Relationship

British Journal of Orthodontics ◽

10.1179/bjo.20.1.13 ◽

1993 ◽

Vol 20 (1) ◽

pp. 13-17 ◽

Cited By ~ 4

Author(s):

Johannes Kirchner ◽

Stephen Williams

Keyword(s):

Correlation Analysis ◽

Treatment Planning ◽

Class Ii ◽

Diagnosis And Treatment ◽

Class Ii Malocclusion ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Accurate Picture

Analysis of sagittal jaw relationship is important in orthodontic diagnosis and treatment planning, and can be investigated by angular or linear parameters. In the present study an analysis was performed using profile cephalograms of 40 children with skeletal Class II malocclusion. A correlation analysis is presented, involving five different methods of expressing sagittal jaw relationships. Whilst some degree of agreement could be noted, it was not possible to suggest a pair of measurements, which in combination, could give a more accurate picture of sagittal jaw relationships.

Download Full-text

Abordagem precoce da má oclusão de Classe II esquelética com atresia maxilar e mordida aberta anterior e o uso de alinhadores ClearCorrect – relato de caso

Orthodontic Science and Practice ◽

10.24077/2021;1453-97106 ◽

2021 ◽

Vol 14 (53) ◽

pp. 97-106

Author(s):

Roberto Hideo Shimizu ◽

Isabela Almeida Shimizu ◽

Ana Cláudia M. Melo Toyoffuku ◽

Rebecca Marquesini ◽

Tatiane Travizan Lima ◽

...

Keyword(s):

Treatment Time ◽

Low Complexity ◽

Class Ii ◽

Open Bite ◽

Class Ii Malocclusion ◽

Anterior Open Bite ◽

Skeletal Class ◽

Posterior Crossbite ◽

Skeletal Class Ii ◽

High Predictability

Adequate planning and early treatment of Angle Class II malocclusion with maxillary atresia and anterior open bite provides harmonization of maxillomandibular bone bases in the three planes of space. Orthodontic aligners have emerged as an alternative treatment having the following advantages: being more aesthetic and more comfortable for the patient, less treatment time when they are correctly indicated, less chairside time, less complications, possibility of remote monitoring, easier feeding, and dental hygiene. On the other hand, they offer difficulties to treat adults with severe skeletal Class II malocclusions, posterior crossbite and anterior open bite. Therefore, the objective of this clinical case report is to early correct skeletal Class II malocclusion with maxillary atresia through the use of mechanical orthopedics and devices that help eliminate habits and close the anterior open bite, and later the use of orthodontic aligners to finish the treatment. It was concluded that the early interceptive treatment of malocclusion was efficient to harmonize the bone bases in the anteroposterior, vertical, and transversal directions, changing this malocclusion from high to low complexity and, consequently, highly predictable and with an excellent prognosis for treatment with orthodontic aligners. The treatment with ClearCorrect aligners corrected the occlusion in a shorter period of time when compared to corrective orthodontics and with a high predictability in relation to the virtual setup.

Download Full-text

Comparative Study on the Efficiency of Intermaxillary Elastic Polymers used in the Treatment of Skeletal Class II Malocclusions in Growing Patients

Materiale Plastice ◽

10.37358/mp.19.2.5183 ◽

2019 ◽

Vol 56 (2) ◽

pp. 341-345 ◽

Cited By ~ 1

Author(s):

Luminita Ligia Vaida ◽

Raluca Dima ◽

Emilia Albinita Cuc ◽

Bianca Maria Negrutiu ◽

Abel Emanuel Moca ◽

...

Keyword(s):

Class Ii ◽

Class Ii Malocclusion ◽

Therapeutic Approaches ◽

Mandibular Growth ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Orthodontic Patients ◽

Group 2 ◽

Class Ii Elastics ◽

Group 1

The aim of this study was to evaluate the efficiency in using intermaxillary elastics to stimulate mandibular growth and advancement in orthodontic patients diagnosed with skeletal Class II malocclusion as well as to compare the use of these Class II elastics in two different therapeutic approaches. The sample consisted of 60 orthodontic patients aged 10-15 years, 34 girls and 26 boys. The sample was divided into two equal groups (each consisting of 30 patients). Patients belonging to the first group (Group 1) were subjected to 1/4�� - 6.0 oz elastics and were advised to change the elastic every 24 hours. Patients belonging to the second group (Group 2) were subjected to 1/4�- 4.5 oz elastics but with a recommendation to change the elastics every 12 hours. In order to evaluate the effectiveness of these two types of Class II elastics on mandibular growth and advancement, the value of the SNB angle at the beginning of the treatment (T1) was compared with the value of the SNB angle after 5 months of wearing intermaxillary elastics (T2). All patients showed statistically significant increased values of the SNB angle during the orthodontic treatment (p[0.001). Patients in Group 2 showed a significantly higher statistical increase (p[0.05) than patients in Group 1.

Download Full-text