scholarly journals Maxillary premolars extraction or molar distalization with or without TADs: cephalometric evaluation of soft tissue changes in Class II treatment

Author(s):  
Lorenz Moser ◽  
Enrica Di Lorenzo ◽  
Marco Serafin ◽  
Giuliano Maino ◽  
Ute Schneider-Moser ◽  
...  

Introduction: Problem solving in Class II malocclusion treatment performed with premolars extractions or distalizing techniques in relation to the profile modification. Aim: To cephalometrically compare soft tissue changes produced either by maxillary premolar extraction, tooth-borne Pendulum appliance or bone-borne MGBM appliance. Materials and Methods: Both pre- (T1) and post-treatment (T2) lateral cephalograms of 89 skeletal Class II patients (36 M, 53 F), treated during pubertal growth spurt, were retrospectively selected. Three groups were formed based on the therapy performed: 30 patients had been treated with maxillary first premolars extraction (U4), 31 patients with a conventional tooth-borne distalizing with Pendulum appliance (PA), and 28 patients with a skeletally anchored distalizing appliance (MGBM). Soft tissue was analyzed comparing upper (UL) and lower (LL) lip’s points with regard to True Vertical Line (TVL) and Esthetic plane (E-plane). Skeletal and dental values have been recorded in order to cephalometrically compare ΔT2-T1 changes among groups and to correlate dental and skeletal changes to profile modifications. One-way ANOVA was employed to compare groups at T1. Paired sample t-tests were employed to assess significant intra- and intergroup differences between T2 and T1. Significance level was set at 0.05 Results: UL and LL showed a slight but not significant retrusion relative to TVL in all three groups. UL and LL distances to E-plane were not statistically significant among U4, PA, and MGBM groups. Independently of the treatment, UL was tangent to TVL in all groups. No statistically significant differences have been shown in skeletal records. Significant differences were recorded in Overjet among U4 than PA and MGBM groups. Conclusions: Class II malocclusion treatment with maxillary first premolar extraction, conventional or skeletal distalization did not significantly affect the profile producing similar changes in the soft tissue.

2021 ◽  
pp. 030157422110572
Author(s):  
Ankit Kumar Shahi ◽  
Payal Sharma ◽  
Achint Juneja ◽  
Divya Shetty ◽  
Rishibha Bhardwaj ◽  
...  

Objectives: To evaluate the treatment outcomes between Twin Block and AdvanSync2® appliances by comparing the skeletal, dentoalveolar, and soft tissue changes. Materials and Methods: Radiographic data of 20 patients were retrospectively analyzed. Data were selected from patients in their skeletal growth spurt as evaluated by the cervical vertebral maturation method (CVMI 2, 3, and 4), with class II malocclusion characterized with retrognathic mandible (ANB > 4°, SNB < 77°, FMA = 25 ± 5°, overjet > 5 mm). There were 10 patients in each group that underwent orthodontic correction for class II malocclusion: either using Twin Block or AdvanSync2®. Independent t test and Paired t test and chi-square tests were used for the data analysis. The level of statistical significance was set at P value ≤.05. Results: The chronological and skeletal age were similar in both the groups. Records were taken for the functional treatment with mean treatment span of 8 ± 1 month. Changes in SNB (group I = 1.59°, group II = 3.11°) ( P < .01), Co-Gn (group I = 2.89 mm, group II = 5.34 mm), and U1-L1° (group I = −1.51°, group II = 2.97°) showed statistically different outcome between the groups, when the pre-post data were studied. Rest of the variables—cranial base, maxillary skeletal, mandibular skeletal, intermaxillary, vertical skeletal, maxillary dentoalveolar, mandibular dentoalveolar, and soft tissue—showed similar outcome ( P > .05). Conclusion: Both appliances lead to desirable outcomes in the correction of class II malocclusion. AdvanSync2® resulted in inducing more of changes in SNB and effective mandibular length as compared to Twin Block. Overjet and molar relation improved significantly with both the appliances. Both the appliances resulted in similar skeletal, dentoalveolar, and soft tissue changes.


2018 ◽  
Vol 23 (3) ◽  
pp. 63-72 ◽  
Author(s):  
Bruno D’Aurea Furquim ◽  
Guilherme Janson ◽  
Laura de Castro Cabrera Cope ◽  
Karina Maria Salvatore Freitas ◽  
José Fernando Castanha Henriques

ABSTRACT Objective: The aim of this study was to compare the skeletal, dental, and soft tissue effects of the Mandibular Protraction Appliance (MPA) application in adolescent and adult Class II malocclusion patients. Methods: The sample comprised the pretreatment and posttreatment lateral cephalograms of 39 subjects presenting Class II malocclusion treated with the MPA and fixed appliances. Sample was divided into two groups: Group 1 comprised 23 subjects (10 male; 13 female), at a mean pretreatment age of 11.75 years, with a mean treatment time of 3.32 years; Group 2 included 16 subjects (7 male; 9 female), at a mean pretreatment age of 22.41 years, with a mean treatment time of 4.24 years. Intergroup comparison of the initial and final stages and treatment changes between the groups was performed with t tests, at p< 0.05. Results: The adults showed less significant amounts of skeletal, dentoalveolar and soft tissue changes than the adolescents. There was significantly greater palatal tipping of the maxillary incisors and retrusion of the upper lip in the adolescents. The adult group showed greater mandibular incisor proclination in the posttreatment stage. Conclusion: Adult patients treated with MPA showed less significant amounts of skeletal, dentoalveolar and soft tissue changes than adolescents.


2019 ◽  
Vol 68 (3) ◽  
Author(s):  
Michele Tepedino ◽  
Maria V. Della Noce ◽  
Domenico Ciavarella ◽  
Patrizia Gallenzi ◽  
Massimo Cordaro ◽  
...  

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 ◽  
...  

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.


2020 ◽  
Vol 18 (3) ◽  
pp. 424-435
Author(s):  
Fernanda Pinelli Henriques Fontes ◽  
Silvio Augusto Bellini-Pereira ◽  
Aron Aliaga-Del-Castillo ◽  
Mayara Paim Patel ◽  
Marcos Roberto de Freitas ◽  
...  

2020 ◽  
Vol 18 (2) ◽  
pp. 286-296
Author(s):  
Fernanda Pinelli Henriques Fontes ◽  
Cristina Bastiani ◽  
Silvio Augusto Bellini-Pereira ◽  
Aron Aliaga-Del Castillo ◽  
José Fernando Castanha Henriques ◽  
...  

2007 ◽  
Vol 77 (5) ◽  
pp. 808-816 ◽  
Author(s):  
Nevenka Tadic ◽  
Michael G. Woods

Abstract Objective: This retrospective study was designed to show likely upper incisal and soft tissue lip changes accompanying Class II fixed appliance treatment with only two upper premolar extractions and to assess whether the lips, especially, are predictably and directly affected with such treatment. Materials and Methods: Pretreatment and posttreatment lateral cephalograms and study casts from 61 growing Class II patients (aged 11 to 18 years; 39 division 1 and 22 division 2) were assessed. Upper and lower lip curve depths, nasolabial angle, and upper incisal position and angulation were all assessed and compared with changes in other cephalometric variables. Results: A wide range of individual response in both lip and upper incisor behavior were noted. The observed soft tissue lip changes were most likely to be related to the preexisting morphology of the lips themselves, while upper incisal changes were mainly related to their own pretreatment positions and changes occurring with treatment in the underlying bony structures. Conclusion: Orthodontic treatment involving the extractions of only two upper premolars is likely to result in a wide range of variation in lip and upper incisor behavior. The preexisting soft tissue morphology is likely to be the greatest determinant of lip behavior.


Author(s):  
Prajwal Shetty ◽  
Mukul Shetty ◽  
Maitreyi Chalapati ◽  
Chaitra Kori ◽  
Crystal Runa Soans ◽  
...  

Abstract Introduction The purpose of this study was to evaluate and compare the skeletal, dentoalveolar and soft-tissue effects of 2 fixed functional appliance; Forsus Fatigue Resistance Device (FFRD) and PowerScope appliance in treating patients with skeletal class II division 1 malocclusion. Materials and Methods This comparative prospective two-group study included 20 patients with a mean age of 11.2 ± 1.6 years with skeletal class II malocclusion with retrognathic mandible. One group was treated with FFRD, and second group was treated with PowerScope appliance. Lateral cephalograms were evaluated at T1 (pre-functional appliance treatment)) and at T2 (postappliance treatment). Cephalometric values were calculated and assessed to evaluate skeletal, dentoalveolar and soft-tissue changes. Results Sagittal correction of class II malocclusion appeared to be mainly achieved by dentoalveolar changes in the PowerScope group. The FFRD was able to induce both skeletal and dentoalveolar changes. A favorable influence on facial convexity was achieved by both groups. A significant increase in upper pharynx and lower pharynx dimension was seen in the PowerScope group. A statistically significant decrease in upper lip protrusion, increase in lower lip protrusion, increased nasolabial angle, and decrease in inferior labial sulcus were noted in both the groups. Lower incisors proclined more in the PowerScope group. Conclusion Both appliances were effective in correcting class II malocclusion. Forsus had more skeletal effects on the mandible, whereas PowerScope had less skeletal effects on the mandible and more dentoalveolar effects, contributing to class II correction. Both groups showed a significant improvement in soft-tissue profile. PowerScope group showed a significant increase in airway dimensions


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