scholarly journals The Effects of Functional Appliances on Female Patients with Skeletal Class II Malocclusion 6 Months after Menarche

2016 ◽  
Vol 17 (4) ◽  
pp. 286-293
Author(s):  
Ali AM Jouybari ◽  
Valiallah Arash ◽  
Saeid Tavanafar ◽  
Soraya Khafri ◽  
Zahra Dehghan

ABSTRACT Aim To investigate the skeletal, dental, and soft tissue changes in girls with class II division 1 malocclusion after growth spurt peak under the effect of activator appliance. Materials and methods In this clinical trial study, 15 female patients, with skeletal class II and mandibular growth deficiency and at least 5 mm overjet, were randomly selected 6 months after their menarche. The mean of their ages at the beginning was 12.33 ± 0.81 years, and in the end it was 13.73 ± 0.79 years; the mean duration of treatment was 12.2 ± 3.18 months. Lateral, cephalometric radiographs were taken from all the patients before and after the treatment. Data were analyzed with Statistical Package for the Social Sciences (SPSS) 20 using paired t-test. Results On an average, the ANB angle, the angle of the upper incisors with the S-N, facial convexity, and overjet decreased by 2.6° ± 0.9, 5.4° ± 0.8, 3.8° ± 3.4, and 5.6 ± 1.8 mm respectively. The SNB angle, the angle of the lower incisors with the N-B, the labiomental angle, the total length of the mandible, the lower anterior facial height, the lower lip distance, the first molar of the mandible, and the soft tissue pogonion to the vertical line from the S point increased by 2.8° ± 1.8, 3.4° ± 3, 14.7 ± 15, 3.7 ± 2.6, 2.1 ± 1.6, 6.3 ± 2.5, 4.4 ± 2.4, and 6 ± 3.3 mm respectively. All these figures were statistically significant (p = 0.000). Conclusion The functional appliance improved the dental–skeletal relations and the soft tissue profile of patients after growth spurt peak of puberty in a group of Iranian girls, whereas dental changes were more than skeletal ones. Clinical significance Functional appliances can be used for correction of skeletal class II malocclusion 6 months after menarche in girls. How to cite this article Jouybari AAM, Arash V, Tavanafar S, Khafri S, Dehghan Z. The Effects of Functional Appliances on Female Patients with Skeletal Class II Malocclusion 6 Months after Menarche. J Contemp Dent Pract 2016;17(4):286-293.

Author(s):  
Fareena Ghaffar ◽  
Abdullah Jan ◽  
Obaid Akhtar ◽  
Alaina T. Mughal ◽  
Rooma Shahid ◽  
...  

Abstract Objective This study aimed to compare dentoskeletal changes in skeletal class-II malocclusion with removable twin block appliance and fixed AdvanSync2 appliance. Materials and Methods A prospective randomized clinical trial was conducted over a span of 1 year at AFID at Rawalpindi. Thirty patients with skeletal class-II malocclusion, 16 males (53.3%) and 14 females (46.6%), were randomly selected and divided in two equal groups (15 each) to be treated with either fixed functional appliances (FFAs) or with removable functional appliances (RFAs). Out of 30 patients, 15 between cervical vertebral maturation (CVM) stages of 2 and 3 were treated with RFA (twin block appliances) and remaining 15 between CVM stages of 4 and 5 were treated with FFA (AdvanSync2 appliances). Pretreatment (T1) and posttreatment (T2), angular variable, and linear variable were measured to compare the dentoskeletal effects between the two groups. Statitical Analysis Paired sample t-test was used to assess significant difference between variables at T1 (Pre-treatment) and T2 (Post-treatment) stage for both RFA and FFA group. Comparison among the RFA and FFA group was made using non-parametric Mann-Whitney U Test. IBM SPSS version 25.0 was used for evaluation. Results No significant difference was found in angular variables between the RFA and FFA groups (p > 0.05) with the exception of linear variables. Sella-posterior nasal spine (S-PNS) length significantly increased and Jarabak's ratio significantly decreased for FFA group (p = 0.010 and 0.045, respectively), when compared with RFA group. Conclusion Both the appliances, twin block (RFA) and AdvanSync2 (FFA), are effective for correction of skeletal class-II malocclusion. Both the appliances produced similar effects in the sagittal plane but for better vertical control twin block should be the appliance of choice. AdvanSync2 appliance could be preferred over twin block appliance when dentoalveolar and slight retrusive effect on the maxilla is desired especially for individuals in postpubertal growth spurt.


2020 ◽  
Vol 14 (03) ◽  
pp. 429-434
Author(s):  
I. Gusti Aju Wahju Ardani ◽  
Floretta Charlene Dinata ◽  
Ari Triwardhani

Abstract Objectives Class II malocclusion is largely due to a retrognathic mandible. Mandibular rotation is closely related to changes in the occlusal plane during growth. The problems in the occlusal plane could cause disadvantages in the soft tissue profile in Class II malocclusion, presenting treatment challenges for an orthodontist. This study aimed to investigate the importance of the occlusal plane for a better soft tissue profile in Class II malocclusion for Javanese patients. Materials and Methods The total number of cephalogram softcopies of patients with skeletal Class II malocclusion were selected based on ANB values (> 4 degrees), no agenesis teeth except the third molar, and all permanent teeth. The cephalograms were calculated using digital tracing by Morpheus 3D imaging. The points and areas to be analyzed on the cephalogram were predetermined. The examination was performed in a span of 1 month and performed via a statistical test using Pearson’s test and multiple regression analysis (p < 0.05). Results There were significant correlation values between the angles produced by the occlusal plane to sella national, Frankfurt horizontal, mandibular plane, and Z-angle (p < 0.05). Conclusion Patients with skeletal Class II malocclusion have a significant correlation between the occlusal plane and the vertical plane, thereby affecting the shape of the soft tissue profile, which causes a facial imbalance. By improving mandibular movement, the soft tissue profile can also be corrected.


2015 ◽  
Vol 143 (1-2) ◽  
pp. 12-15 ◽  
Author(s):  
Zorana Stamenkovic ◽  
Vanja Raickovic ◽  
Vladimir Ristic

Introduction. The effects of orthodontic treatment are considered to be successful if the facial harmony is achieved, while the structures of soft tissue profile are in harmony with skeletal structures of neurocranium and viscerocranium. In patients with skeletal distal bite caused by mandibular retrognathism, facial esthetics is disturbed often, in terms of pronounced convexity of the profile and change in the position and relationship of the lips. Objective. The aim of this study was to determine the extent of soft tissue profile changes in patients with skeletal Class II malocclusion treated with three different orthodontic appliances: Fr?nkel functional regulator type I (FR-I), Balters? Bionator type I and Hotz appliance. Methods. The study included 60 patients diagnosed with skeletal Class II malocclusion caused by mandibular retrognathism, in the period of early mixed dentition. Each subgroup of 20 patients was treated with a variety of orthodontic appliances. On the lateral cephalogram, before and after treatment, the following parameters were analyzed: T angle, H angle, the height of the upper lip, the position of the upper and lower lip in relation to the esthetic line. Within the statistical analysis the mean, maximum, minimum, standard deviation, coefficient of variation, two-factor analysis of variance with repeated measures and the factor analysis of variance were calculated using ANOVA, Bonferroni test and Student?s t-test. Results. A significant decrease of angles T and H was noticed in the application of FR-I, from 21.60? to 17.15?, and from 16.45? to 13.40? (p<0.001). FR-I decreased the height of the upper lip from 26.15 mm to 25.85 mm, while Hotz appliance and Balters? Bionator type I increased the height of the upper lip, thereby deteriorating esthetics of the patient. Conclusion. All used orthodontic appliances lead to changes in soft tissue profile in terms of improving facial esthetics, with the most distinctive changes in the application of Fr?nkel?s functional regulator type I, which is the most successful appliance for achieving the overall facial harmony of the patient.


2011 ◽  
Vol 12 (1) ◽  
pp. 14-18 ◽  
Author(s):  
G Anil Kumar ◽  
Amit Maheshwari

ABSTRACT Aim The aims of this study were to evaluate the dental changes brought about by activator and activator headgear combination (ACHG) and to determine whether we can achieve control over the lower incisor proclination which is a side effect of using functional appliances; or not, while treating cases of skeletal class II malocclusions. Methods Lateral cephalograms of 45 skeletal class II division 1 patients were selected for the study. Fifteen of them were successfully treated with an Andresen activator and the other 15 with an activator headgear combination. Fifteen class II subjects who had declined treatment served as the control group. Cephalometric landmarks were marked by one author to avoid interobserver variability. Results The results revealed that both the activator and the activator headgear combination significantly (p < 0.001) affected dental variables measured. The mandibular incisor proclination was effectively controlled in the activator headgear combination group. Conclusion An activator headgear combination would offer itself as a better option compared with activator alone in the treatment of skeletal class II malocclusions especially in cases with proclined mandibular incisors. Clinical significance When one of the treatment goals is to achieve a greater control over mandibular incisor proclination in the treatment of Skeletal Class II malocclusions, employing a combination of activator and headgear may substantially improve clinical outcomes. How to cite this article Lall R, Kumar GA, Maheshwari A Kumar M. A Retrospective Cephalometric Evaluation of Dental Changes with Activator and Activator Headgear Combination in the Treatment of Skeletal Class II Malocclusion. J Contemp Dent Pract 2011;12(1):14-18.


2019 ◽  
Vol 12 (1) ◽  
pp. 233-238
Author(s):  
E. Deena Nancy ◽  
A. Arif Yezdani ◽  
M. S. Kannan ◽  
S. Kishore Kumar ◽  
Kesavaram Padmavathy

Orthodontic treatment planning decisions are dependent on the assessment of growth status. Skeletal maturity could be assessed with various radiologic and non-radiologic biologic markers.The purpose of our study was to investigate the reliability of serum Insulin like Growth Factor – 1(IGF-1) as a skeletal maturity indicator in comparison to the stages in cervical vertebral maturation (CVM). Twenty five subjects with skeletal class II malocclusion in the age range of 11-19 years were recruited for the study. The cervical vertebrae staging was assessed by lateral cephalograms. Blood was collected aseptically and serum was separated. The serum levels of IGF- 1 were quantitatively assessed using a commercial ELISA kit, IGF-1 600 ELISA (DRG Instruments GmbH, Germany). There was a significant decline in the mean IGF-1 levels with increase in age in both the sexes. Statistically significant difference was observed in the concentration of IGF-1 among the different age groups. There was a significant decline in the mean IGF-1 levels with increase in CVM staging from stage 2 to stage 4. IGF-1 could be a more reliable biologic skeletal maturity indicator in comparison to cervical vertebral maturity indicator and thus could predict more accurately the growth status of the mandible to facilitate correction of skeletal class II jaw discrepancies.


2019 ◽  
Vol 2019 ◽  
pp. 1-16
Author(s):  
Giuseppe Perinetti

A deficient mandibular growth on the sagittal plane is the most frequent diagnostic finding in dentoskeletal Class II malocclusion. Evidence indicated that functional treatment for such malocclusion is efficient only if performed during the pubertal growth spurt, as identified through radiographical growth indicators. With the aim of reducing the radiation to the patients and to follow longitudinally individual growth phases, the use of the sole third finger middle phalanx maturation (MPM), as a 5-stage method, has been proposed. Herein, three clinical cases of skeletal Class II malocclusion in growing patients treated by removable functional appliances (with or without full-fixed appliance treatment) are reported. Timing of intervention was strictly planned according to the MPM method, and skeletal effects have been recorded up to 21 months of follow-up. In all the cases, noteworthy skeletal effects have been achieved in terms of mandibular elongation, with relevant occlusal and aesthetic outcomes. It has also been showed that results are stable or slightly improved after functional treatment. These results would be achieved irrespective of the appliance used and support the use of the MPM method in everyday clinical practice.


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