Dentoskeletal and Soft Tissue Effects in the Treatment of Class II Malocclusion with Klammt's Elastic Open Activator

2016 ◽  
Vol 17 (1) ◽  
pp. 63-69
Author(s):  
Sheila Marques Inamassu-Lemes ◽  
Acácio Fuziy ◽  
André Luiz Ferreira Costa ◽  
Paulo Eduardo Guedes Carvalho ◽  
Ana Carla Raphaelli Nahás-Scocate
Keyword(s):  
Soft Tissue ◽  
Conflicts Of Interest ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Lower Lip ◽  
Skeletal Changes ◽  
Tissue Effects ◽  
Age Range ◽  
Cephalometric Measurements ◽  
Lower Incisors

ABSTRACT Aim The purpose of this study was to evaluate the dentoskeletal and soft tissue effects resulting from treatment with Klammt's elastic open activator (EOA) functional orthopedic appliance in patients with Class II malocclusion characterized by mandibular deficiency. Materials and methods Teleradiographs were evaluated in the lateral aspect of the initial (T1) and final (T2) orthopedic phases for 16 patients with Class II, Division 1 malocclusion. The age range was from 9 to 11.2 years, with a mean age of 9.9 years. The cephalometric points were demarcated, and cephalometric measurements were obtained by the same investigator to avoid interobserver variability. Results The EOA promoted increased lower anterior facial height (LAFH), increased effective mandibular length, clockwise rotation of the mandible, retrusion and verticalization of the upper incisors, proclination and protrusion of the lower incisors, extrusion of the upper molars, mesial movement of the lower molars and anterior projection of the lower lip. Conclusion Skeletal changes characterized by an increase in mandibular length and dentoalveolar changes with an emphasis on the verticalization and retrusion of the upper incisors, proclination of the lower incisors and mesial positioning of the lower molars were key to improving the occlusal relationship and esthetic facial factors. Clinical significance The EOA is well indicated in patients with Class II malocclusion due to mandibular deficiency with increased overbite, proclined upper incisors and verticalized lower incisors. How to cite this article Inamassu-Lemes SM, Fuziy A, Costa ALF, Carvalho PEG, Nahás-Scocate ACR. Dentoskeletal and Soft Tissue Effects in the Treatment of Class II Malocclusion with Klammt's Elastic Open Activator. J Contemp Dent Pract 2016;17(1):63-69. Conflicts of Interest None declared

scholarly journals Comparison of Soft Tissue Changes Between Two Class II Malocclusion Treatment Protocols: with and without Extractions Associated to Intermaxillary Elastics

2020 ◽  
Vol 22 (4) ◽  
pp. 204-209
Author(s):  
Honório Tóttoli Segundo ◽  
Victor França Didier ◽  
Renata Rodrigues de Almeida-Pedrin ◽  
Ana Cláudia de Castro Ferreira Conti ◽  
Marcio Rodrigues de Almeida ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Treatment Time ◽  
Class Ii ◽  
Treatment Modalities ◽  
Class Ii Malocclusion ◽  
Lower Lip ◽  
Tissue Changes ◽  
Group 2 ◽  
Soft Tissue Changes ◽  
Group 1

AbstractThe literature is scarce on the intermaxillary elastics impacts on soft tissue during the treatment of Class II malocclusion The purpose of the present study was to compare the soft tissue changes after the treatment of Class II malocclusion using intermaxillary elastics with and without the premolars extraction. The sample consisted of 41 patients Class II Division 1 malocclusion with bilateral molar relationship of at least ½ cusp, divided into two groups. Group 1: 21 patients (mean age 18.97 years) treated for a mean period of 3.15 years with intermaxillary elastics without dental extractions. Group 2: 20 patients (mean age,17.40 years) treated for a mean period of 3.07 years with intermaxillary elastics and extraction of two maxillary premolars. Lateral cephalometric radiographs were used to measure the soft tissue and incisor variations before and after orthodontic treatment. Dolphin Imaging Premium software was used for radiographic analysis. Groups 1 and 2 were highly similar concerning age, initial overjet, molar relationship, treatment time, and initial cephalometric measurements. Statistically significant differences between both groups were observed (P<0.05) related to the anteroposterior position of the lower lip in Group 2 and facial convexity angle in Group 1. Conclusions: Both treatment modalities promoted similar effects on the facial profile, except for the greater retrusion of the lower lip in the protocol with extractions and decrease in the facial convexity in the protocol without extractions. Keywords: Malocclusion. Angle Class II. Orthodontics. Orthodontic Anchorage Procedures. Tooth Extractions ResumoA literatura é escassa quanto ao impacto dos elásticos intermaxilares nos tecidos moles durante o tratamento da má oclusão de classe II. O objetivo deste trabalho foi comparar as alterações tegumentares do tratamento da má oclusão de Classe II com elásticos intermaxilares sem extração e com extrações de pré-molares. A amostra retrospectiva foi de 41 indivíduos que apresentavam no início do tratamento relação molar de no mínimo 1/2 Classe II bilateral e foram divididos em dois grupos. Grupo 1: 21 pacientes (média de idade inicial de 18,97 anos), tratados por um período médio de 3,15 anos, sem extrações e com uso elásticos intermaxilares; Grupo 2: 20 pacientes (média de idade de 17,40 anos), tratados por um período médio de 3,07 anos, com extrações de dois pré-molares superiores e elásticos. As telerradiografias foram usadas para aferir as medidas tegumentares e a variação dos incisivos antes e depois do tratamento ortodôntico através do software Dolphin Imaging Premium 11.7. Ambos os grupos mostraram alto grau de compatibilidade nos quesitos idade, overjet inicial, relação molar, tempo de tratamento e medidas cefalométricas iniciais. Os resultados ao final do tratamento mostraram diferença estatisticamente significante entre os grupos (p<0,05) na posição anteroposterior do lábio inferior (Grupo 2) e no ângulo de convexidade facial (Grupo 1). Conclusões: As duas modalidades de tratamento promovem efeitos semelhantes no perfil facial, exceto pela maior retrusão do lábio inferior no protocolo com extrações e diminuição da convexidade facial no protocolo sem extrações. Palavras-chave: Má Oclusão de angle classe II. Ortodontia. Procedimentos de Ancoragem em Orthodontia. Extração Dentária.

scholarly journals Dental, skeletal and soft tissue effects of the Distal Jet appliance: A prospective clinical study

2019 ◽  
Vol 24 (6) ◽  
pp. 56-64 ◽  
Author(s):  
Rachelle Simões Reis ◽  
José F. C. Henriques ◽  
Guilherme Janson ◽  
Karina Maria Salvatore Freitas ◽  
Wilana Moura
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Plane Angle ◽  
Tissue Effects ◽  
Mandibular Plane ◽  
Maxillary Incisors ◽  
Distal Jet ◽  
Mandibular Plane Angle

ABSTRACT Objective: This study evaluated the dental, skeletal and soft tissue effects in Class II malocclusion patients treated with Distal Jet appliance, compared to an untreated control group. Methods: 44 patients with Class II malocclusion were divided into two groups: Group 1 (experimental) - 22 patients, mean age of 12.7 years, treated with the Distal Jet appliance for a mean period of 1.2 years; Group 2 (control) - 22 untreated patients, mean age of 12.2 years, followed by a mean period of 1.2 years. Lateral cephalograms were obtained before treatment (T0) and at the end of the distalization (T1).Independent t test was used to identify intergroup differences. Results: When compared to control group, the Distal Jet produced a significant increase in mandibular plane angle (0.7 ± 2.0o). The maxillary second molars presented distal inclination (6.6 ± 3.8o), distalization (1.1 ± 1.1 mm) and extrusion (1.3 ± 2.1 mm). The maxillary first molars distalized by 1.2 ± 1.4 mm. The maxillary first premolars mesialized by 3.4 ± 1.1 mm. The maxillary incisors showed slight labial tipping of 4.3 ± 4.7o and were protruded by 2.4 ± 1.7 mm. There were no significant changes in the facial profile. The overjet increased 1.5 ± 1.1 mm and overbite had no significant changes. Conclusion: The Distal Jet appliance is effective to distalize the maxillary first molars, but promotes increase in mandibular plane angle, distal inclination, extrusion and distalization of maxillary second molars, mesialization of maxillary first premolars, proclination and protrusion of maxillary incisors, and increase in overjet, when compared to a control group.

scholarly journals Treatment effects of skeletally anchored Forsus FRD EZ and Herbst appliances: A retrospective clinical study

2015 ◽  
Vol 86 (2) ◽  
pp. 306-314 ◽  
Author(s):  
Mevlut Celikoglu ◽  
Suleyman Kutalmis Buyuk ◽  
Abdullah Ekizer ◽  
Tuba Unal
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Herbst Appliance ◽  
Mandibular Incisor ◽  
Skeletal Class ◽  
Tissue Effects ◽  
Skeletal Class Ii ◽  
Group I ◽  
Retrospective Clinical Study

ABSTRACT Objective:  To evaluate the skeletal, dentoalveolar, and soft tissue effects of the Forsus FRD appliance with miniplate anchorage inserted in the mandibular symphyses and to compare the findings with a well-matched control group treated with a Herbst appliance for the correction of a skeletal Class II malocclusion due to mandibular retrusion. Materials and Methods:  The sample consisted of 32 Class II subjects divided into two groups. Group I consisted of 16 patients (10 females and 6 males; mean age, 13.20 ± 1.33 years) treated using the Forsus FRD EZ appliance with miniplate anchorage inserted in the mandibular symphyses. Group II consisted of 16 patients (9 females and 7 males; mean age, 13.56 ± 1.27 years) treated using the Herbst appliance. Seventeen linear and 10 angular measurements were performed to evaluate and compare the skeletal, dentoalveolar, and soft tissue effects of the appliances using paired and Student's t-tests. Results:  Both appliances were effective in correcting skeletal class II malocclusion and showed similar skeletal and soft tissue changes. The maxillary incisor was statistically significantly more retruded in the skeletally anchored Forsus FRD group (P &lt; .01). The mandibular incisor was retruded in the skeletally anchored Forsus FRD group (−4.09° ± 5.12°), while it was protruded in the Herbst group (7.50° ± 3.98°) (P &lt; .001). Conclusion:  Although both appliances were successful in correcting the skeletal Class II malocclusion, the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors.

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.

Soft-tissue changes after Class II malocclusion treatment using the Sander bite-jumping appliance: a retrospective study

2019 ◽  
Vol 68 (3) ◽  
Author(s):  
Michele Tepedino ◽  
Maria V. Della Noce ◽  
Domenico Ciavarella ◽  
Patrizia Gallenzi ◽  
Massimo Cordaro ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Soft Tissue ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Tissue Changes ◽  
Soft Tissue Changes

scholarly journals Dentoskeletal Effects and “Effective” Temporomandibular Joint, Maxilla and Chin Changes in Good and Bad Responders to van Beek Activator Treatment

2007 ◽  
Vol 77 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Sabine Ruf ◽  
Margareta Bendeus ◽  
Hans Pancherz ◽  
Urban Hägg
Keyword(s):  
Temporomandibular Joint ◽  
Class Ii ◽  
Good Responder ◽  
Skeletal Changes ◽  
Maxillary Molars ◽  
Division 1 ◽  
The Subject ◽  
Subject Material ◽  
Lateral Head ◽  
Lower Incisors

Abstract Objective: To assess possible differences in dentoskeletal effects and “effective” temporomandibular joint, maxilla, and chin changes between good and bad responders to van Beek activator treatment. Materials and Methods: The subject material consisted of 20 consecutive normodivergent male Class II division 1 patients treated with a van Beek activator. Because of insufficient cooperation, four patients were excluded. Lateral head films were taken 6 months before treatment, at start of treatment, and after 12 months of treatment. The patients were placed into a good responder group (successful, n = 8) and a bad responder group (unsuccessful, n = 8). An overjet reduction ≥4 mm was considered successful. Results: During the van Beek treatment period, the good responders showed a significantly larger improvement in overjet and molar relationship than did the bad responders. The good responders exhibited a significant posterior development of condylion, less anterior mandibular autorotation, retrusion of upper incisors, protrusion of lower incisors, distalization of maxillary molars, and a mesial movement of mandibular molars. No significant dental movements were seen in the bad responders. Conclusions: Although van Beek activator treatment affected the direction of condylar growth, as well as the direction of maxilla and chin changes, it can be concluded that skeletal changes did not contribute to the Class II correction. Instead, overjet reduction during van Beek activator treatment was found to be due to a favorable dental reaction.

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

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.

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

2016 ◽  
Vol 50 (1) ◽  
pp. 31-41
Author(s):  
Prashantha Govinakovi Shivamurthy ◽  
Alireza Jafari ◽  
Ashutosh Shetty ◽  
Sadashiva Shetty Kandavara
Keyword(s):  
Class Ii ◽  
Class Ii Malocclusion ◽  
Growth Modulation ◽  
Skeletal Class ◽  
Skeletal Changes ◽  
Skeletal Class Ii

scholarly journals Long-term evaluation of Class II subdivision treatment with unilateral maxillary first molar extraction

2014 ◽  
Vol 85 (5) ◽  
pp. 757-763 ◽  
Author(s):  
Christos Livas ◽  
Nikolaos Pandis ◽  
Johan Willem Booij ◽  
Christos Katsaros ◽  
Yijin Ren
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Long Term Effects ◽  
Similar Time ◽  
Lower Lip ◽  
Soft Tissue Profile ◽  
The Face ◽  
Molar Extraction

ABSTRACT Objective:  To evaluate the long-term effects of asymmetrical maxillary first molar (M1) extraction in Class II subdivision treatment. Materials and Methods:  Records of 20 Class II subdivision whites (7 boys, 13 girls; mean age, 13.0 years; SD, 1.7 years) consecutively treated with the Begg technique and M1 extraction, and 15 untreated asymmetrical Class II adolescents (4 boys, 11 girls; mean age, 12.2 years; SD, 1.3 years) were examined in this study. Cephalometric analysis and PAR assessment were carried out before treatment (T1), after treatment (T2), and on average 2.5 years posttreatment (T3) for the treatment group, and at similar time points and average follow-up of 1.8 years for the controls. Results:  The adjusted analysis indicated that the maxillary incisors were 2.3 mm more retracted in relation to A-Pog between T1 and T3 (β  =  2.31; 95% CI; 0.76, 3.87), whereas the mandibular incisors were 1.3 mm more protracted (β  =  1.34; 95% CI; 0.09, 2.59), and 5.9° more proclined to the mandibular plane (β  =  5.92; 95% CI; 1.43, 10.41) compared with controls. The lower lip appeared 1.4 mm more protrusive relative to the subnasale-soft tissue-Pog line throughout the observation period in the treated adolescents (β  =  1.43; 95% CI; 0.18, 2.67). There was a significant PAR score reduction over the entire follow-up period in the molar extraction group (β  =  −6.73; 95% CI; −10.7, −2.7). At T2, 65% of the subjects had maxillary midlines perfectly aligned with the face. Conclusions:  Unilateral M1 extraction in asymmetrical Class II cases may lead to favorable occlusal outcomes in the long term without harming the midline esthetics and soft tissue profile.

scholarly journals Skeletal Class II Malocclusion Treatment with Combined Twin Block and Lip Bumper Appliances: A Case Report

2021 ◽  
Vol 16 (Supp. 1) ◽  
pp. 87-94
Author(s):  
Hilda Fitria Lubis ◽  
Nurhayati Harahap ◽  
Ananda Permata Sari
Keyword(s):  
Class Ii ◽  
Class Ii Malocclusion ◽  
Condylar Cartilage ◽  
Lower Lip ◽  
Mandibular Growth ◽  
Twin Block ◽  
Skeletal Class ◽  
Anterior Teeth ◽  
Skeletal Class Ii ◽  
Lip Bumper

Functional appliances have been used over a century in clinical orthodontic treatments for skeletal Class II malocclusion patients. Its popularity is attributed to its high patient adaptability and ability to produce rapid treatment changes. The twin block and lip bumper can be combined depending on the patient’s cases. The purpose of therapy with twin block is effective in mandibular growth deficiencies to induce supplementary lengthening of mandibular by stimulating increased growth at the condylar cartilage. The patient was a ten-year-old male patient with skeletal Class II malocclusion. He had a convex facial profile, SNA (sella, nasion, A point) angle of 77.5°, SNB (sella, nasion, B point) angle of 73.0°, ANB (A point, nasion, B point) angle of 4.5°, overjet of 6.5 mm, overbite of 11/41 = 5.0 mm, 21/31 = 4.5 mm, abnormal upper labial frenulum, crossbite in the second left premolar of maxilla, crowded anterior teeth of mandibular, deficiency of mandibular growth, lower lip sucking habit, anterior teeth of maxilla with diastema and proclination. Orthodontic treatment for patient is a combination of twin block and lip bumper appliances. After seven months, frenectomy is used to eliminate and correct the spacing in the frenulum. After 10 months, the patient’s skeletal and profile had improved to skeletal Class I malocclusion, SNA angle of 78.0°, SNB angle of 75.0°, ANB angle of 3.0°, overbite and overjet of 4.0 mm, and the lower lip sucking habit had stopped. Twin block and lip bumper appliances are particularly good alternative treatment in managing selected cases of skeletal Class II malocclusion.

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