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El-Fateh, Tarek, and Sabine Ruf. "Herbst treatment with mandibular cast splints—revisited." Angle Orthodontist 81, no. 5 (March 28, 2011): 820–27. http://dx.doi.org/10.2319/101010-591.1.
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Abstract Objective: The objective of this study was to reassess the dento-skeletal treatment effects and the amount of anchorage loss during reduced mandibular splint (RMS) Herbst treatment. Materials and Methods: One hundred consecutive Class II patients treated with a RMS-Herbst appliance were analyzed. The mean pretreatment age of the patients was 14.5 years, and the mean treatment time with the Herbst appliance was 8.1 months. Both before (T1) and after (T2) Herbst treatment a cephalometric measurement of lower incisor inclination, a sagittal occlusion analysis, and a dental cast analysis were performed. A comparison was performed with a historic Herbst control group treated with total mandibular cast splints (TMS). Results: During treatment the lower incisors proclined markedly (12.9° ± 4.6°). The amount of incisor proclination in the RMS group was, on average, 3.6° larger (P < .001) than in the TMS group. The lower incisor proclination increased from 11.9° (prepeak) to 14.3° (young adult). The level of professional experience of the practitioners performing the treatment did not influence the amount of incisor proclination significantly. The total available space in the lower arch increased by an average of 1.8 mm, and a space opened between the lower second premolars and lower permanent first molars in 62% of the present RMS-Herbst (average of 0.4 mm per side). Conclusions: Treatment with RMS-Herbst appliances leads to higher proclination of the lower incisors than does treatment with TMS-Herbst appliances; it also leads to an overall larger amount of anchorage loss.
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Oliveira, Márlio Vinícius de, Matheus Melo Pithon, Márcia Luzia Lacerda Xavier, Rodrigo Villamarim Soares, Martinho Campolina Rebello Horta, and Dauro Douglas Oliveira. "Incisor proclination and gingival recessions: is there a relationship?" Brazilian Journal of Oral Sciences 15, no. 2 (April 20, 2017): 180. http://dx.doi.org/10.20396/bjos.v15i2.8648780.
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Aim: To test the hypothesis that there is no relationship between the amount of vestibular inclination of mandibular incisors and the appearance of gingival recession in this region. Methods: This study included 20 patients selected in accordance with the following inclusion criteria: 1. adult patients without gingival recession in the mandibular incisors before treatment (T0), 2. no previous orthodontic treatment, 3. treated without tooth extraction in the mandibular arch, 4. bonded mandibular splinting from one canine to another after the active stage of orthodontic treatment (T1), 5. no visible wear of the incisal edge of the mandibular incisors, 6. Pre- and post-treatment teleradiography and plaster casts, and plaster casts 3 years post-treatment (T2). Depending on the amount of inclination of the mandibular incisors after treatment, the sample was divided into two groups: Group 1- 10 individuals (IMPA T1-T0 ≤ 5˚) and Group 2- 10 individuals (IMPA T1-T0 > 5˚). The measurement of length of the clinical crown (LCC) of the four mandibular incisors, distance between the incisal edge and vestibular marginal gingiva were made in plaster casts at T0, T1 and T2. Results: In spite of Group 1 presenting a reduction in LCC at T2, there was no statistically significant difference in LCC in the 3 time intervals evaluated in the two groups. Conclusions: The null hypothesis was accepted. The variation in the amount of vestibular inclination of the mandibular incisors during orthodontic treatment and 3 years after conclusion of treatment did not promote the appearance of gingival recessions in this group of patients.
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Yitschaky, Oded, Meital Segev Neuhof, Michael Yitschaky, and Avraham Zini. "Relationship between dental crowding and mandibular incisor proclination during orthodontic treatment without extraction of permanent mandibular teeth." Angle Orthodontist 86, no. 5 (March 18, 2015): 727–33. http://dx.doi.org/10.2319/080815-536.1.
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ABSTRACT Objective: To examine changes in mandibular incisor proclination and protrusion resulting from alleviation of crowding. Materials and Methods: Records of 96 patients from a private practice treated without extractions or interproximal enamel reduction in the mandibular arch were included. Pre- and post-treatment cephalograms and models were examined to determine changes in incisor proclination, protrusion and crowding. Results: For every millimeter of crowding alleviation, increases in incisor proclination (ΔIMPA) and protrusion (ΔL1 to A-Pog) of 0.5° and 0.2 mm, respectively, were found, on average. High variability was calculated for both linear variables (that can be reduced by incorporating other variables by multilinear regression). Conclusions: For every millimeter of crowding alleviated, 0.5° of proclination and 0.2 mm of protrusion are expected. Our results indicate that proclination is mulifactorial and cannot be explained solely by the amount of crowding alleviated during orthodontic treatment. These results may be a useful guiding principle rather than a prognostic tool.
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Choi, Yoon Jeong, Chooryung J. Chung, and Kyung-Ho Kim. "Periodontal consequences of mandibular incisor proclination during presurgical orthodontic treatment in Class III malocclusion patients." Angle Orthodontist 85, no. 3 (August 4, 2014): 427–33. http://dx.doi.org/10.2319/021414-110.1.
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ABSTRACT Objective: To test the hypothesis that periodontal changes are similar between proclined and minimal-changed mandibular incisor position groups during presurgical orthodontic treatment for Class III orthognathic surgery. Materials and Methods: The following measurements were performed before and after presurgical orthodontic treatment of 75 patients (proclination group, 39 subjects; minimal-change group, 36 subjects): clinical crown length, sulcus and bone probing depths, and width of attached gingiva from clinical examination; infradentale-to-MP (perpendicular distance of infradentale to mandibular plane) from examination of lateral cephalograms; and the distance between the cementoenamel junction and alveolar crest from examination of periapical radiographs. Data were compared between the two groups, and a regression analysis was performed to investigate factors affecting the periodontal changes. Results: In both groups, clinical crown length and bone probing depth increased during presurgical orthodontics (P < .05). Infradentale-to-MP and the width of attached gingiva decreased more in the proclination group than in the minimal-change group (P < .05). Proclination and protrusion of the mandibular incisors, and treatment duration affected the periodontal changes. Conclusions: The null hypothesis was rejected. Proclination of the mandibular incisors for decompensation in Class III surgery patients seems to result in labial alveolar bone recession and a decrease in width of attached gingiva. However, the amount of the periodontal recession appeared to be clinically insignificant.
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Elkordy, Sherif A., Amr M. Abouelezz, Mona M. S. Fayed, Mai H. Aboulfotouh, and Yehya A. Mostafa. "Evaluation of the miniplate-anchored Forsus Fatigue Resistant Device in skeletal Class II growing subjects: A randomized controlled trial." Angle Orthodontist 89, no. 3 (December 28, 2018): 391–403. http://dx.doi.org/10.2319/062018-468.1.
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ABSTRACT Objectives: To evaluate the use of direct miniplate anchorage in conjunction with the Forsus Fatigue Resistant Device (FFRD) in treatment of skeletal Class II malocclusion. Materials and Methods: Forty-eight females with skeletal Class II were randomly allocated to the Forsus plus miniplates (FMP) group (16 patients, age 12.5 ± 0.9 years), Forsus alone (FFRD; 16 patients, age 12.1 ± 0.9 years), or the untreated control group (16 subjects, age 12.1 ± 0.9 years). After leveling and alignment, miniplates were inserted in the mandibular symphysis in the FMP group. The FFRD was inserted directly on the miniplates in the FMP group and onto the mandibular archwires in the FFRD group. The appliances were removed after reaching an edge-to-edge incisor relationship. Results: Data from 46 subjects were analyzed. The effective mandibular length significantly increased in the FMP group only (4.05 ± 0.78). The mandibular incisors showed a significant proclination in the FFRD group (9.17 ± 2.42) and a nonsignificant retroclination in the FMP group (−1.49 ± 4.70). The failure rate of the miniplates was reported to be 13.3%. Conclusions: The use of miniplates with the FFRD was successful in increasing the effective mandibular length in Class II malocclusion subjects in the short term. The miniplate-anchored FFRD eliminated the unfavorable mandibular incisor proclination in contrast to the conventional FFRD.
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Kumar, G. Anil, and Amit Maheshwari. "A Retrospective Cephalometric Evaluation of Dental Changes with Activator and Activator Headgear Combination in the Treatment of Skeletal Class II Malocclusion." Journal of Contemporary Dental Practice 12, no. 1 (2011): 14–18. http://dx.doi.org/10.5005/jp-journals-10024-1003.
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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.
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Ferguson, Donald J., Urmi Mazumder, Laith Makki, M. Thomas Wilcko, and William M. Wilcko. "Mandibular Incisor Position Changes do not Explain Increase in Keratinized Gingiva Height after Periodontally Accelerated Osteogenic Orthodontics." APOS Trends in Orthodontics 7 (August 1, 2017): 168–74. http://dx.doi.org/10.4103/apos.apos_78_17.
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Purpose This study aimed to reexamine the relationship between mandibular incisor inclination, prominence and vertical changes in position, and keratinized gingival tissue (KT) height changes labial to the mandibular incisors after orthodontic treatment with and without augmented corticotomy (Cort). Materials and Methods Two orthodontically treated groups of 35 individuals each, with (Cort) and without (conventional [Conv]) alveolar decortication and augmentation bone grafting (periodontally accelerated osteogenic orthodontics [PAOO]), were matched for sample size, gender, mandibular premolar extractions, pretreatment age, posttreatment observation period, and pretreatment KT height in this case–controlled retrospective study. Pre- and post-treatment lateral cephalometric radiographs were evaluated for mandibular incisor vertical, inclination, and prominence changes. Results As reported previously (Wilcko 2015), KT height had significantly increased by 0.78 mm (P = 0.001) in the Cort group and decreased by 0.38 mm (P = 0.002) in Conv on an average of 1.5 years after completion of active orthodontic therapy. In this study, Cort mandibular incisors proclined and protruded significantly during therapy while Conv incisors did not. Changes in mandibular incisor inclination and prominence explained neither the decrease in keratinized gingiva height in Conv nor the KT height gain in Cort. Conclusions In spite of mandibular incisor proclination and protrusion, orthodontic therapy combined with alveolar decortication and augmentation bone grafting resulted in a clinically significant increase in keratinized gingiva height 1.5 years’ posttreatment.
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Pamukçu, Hande, and Ömür Polat Özsoy. "A comparison of treatment results of adult deep-bite cases treated with lingual and labial fixed appliances." Angle Orthodontist 91, no. 5 (April 22, 2021): 590–96. http://dx.doi.org/10.2319/011021-29.1.
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ABSTRACT Objectives To compare the cephalometric treatment results of adult deep-bite cases after labial and lingual fixed orthodontic treatment. Materials and Methods A total of 102 patients underwent lingual orthodontic treatment and complete records were evaluated. The following inclusion criteria were used: patients who had Angle Class I or mild Class II malocclusion; comprehensive orthodontic treatment that did not include intrusion mechanics or any extractions; patients with an initial overbite of more than 3.7 mm. Thirteen patients met the inclusion criteria. These cases were matched with the same number of patients according to age with a labial orthodontic treatment group. Pre- and post-treatment cephalometric radiographs were evaluated. Independent t test or Fisher exact tests were performed to assess the differences between the groups. Results Proclination of the upper incisors was higher in the labial group. Incisor mandibular plane angle (IMPA) showed an increase of 1.2° in the lingual group and 9.7° in the labial group. Lower incisor edge was approximately in a stable sagittal position in the lingual group but significant lower incisor proclination was seen in the labial group. The lower incisors were intruded (-1 mm) in the lingual group but lower incisors were minimally extruded (0.3 mm) in the labial group. No significant difference was found in the movements of upper and lower molars for both groups. Conclusions The nature of lower incisor movement involved less protrusion in lingual orthodontics than the labial treatment. Lingual orthodontic treatment is a better option in adult cases where intrusion of lower incisors without labial tipping is desired.
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Duncan, Laura O., Luis Piedade, Milos Lekic, Rodrigo S. Cunha, and William A. Wiltshire. "Changes in mandibular incisor position and arch form resulting from Invisalign correction of the crowded dentition treated nonextraction." Angle Orthodontist 86, no. 4 (December 4, 2015): 577–83. http://dx.doi.org/10.2319/042415-280.1.
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ABSTRACT Objective: To investigate changes in mandibular incisor position resulting from Invisalign correction of the crowded dentition without extraction. Materials and Methods: A retrospective chart review was completed on 61 adult White patients. Patients were categorized into three groups based on the value of pretreatment crowding of the lower dentition: 20 mild (2.0–3.9 mm), 22 moderate (4.0–5.9 mm), and 19 severe (>6.0 mm). Cephalometric radiographs were measured to determine lower incisor changes. Interproximal reduction and changes in arch width were also measured. Statistical evaluation of T0 and T1 values using paired t-tests and analysis of covariance were applied to evaluate mean value changes. Results: Lower incisor position and angulation changes were statistically significant in the severe crowding group. There were no statistically significant differences in lower incisor position between the mild and moderate crowding groups. There was a statistically significant increase in buccal expansion in each of the three groups. Conclusions: Invisalign® treatment can successfully resolve mandibular arch crowding using a combination of buccal arch expansion, interproximal reduction, and lower incisor proclination. When there is <6 mm of crowding, lower incisor position remained relatively stable. The lower incisors proclined and protruded in the more severely crowded dentitions (>6 mm).
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Kamak, Gulen, Hasan Kamak, Hakan Keklik, and Hakan Gurcan Gurel. "The Effect of Changes in Lower Incisor Inclination on Gingival Recession." Scientific World Journal 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/193206.
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Aim. Orthodontic treatment may promote development of recessions. The mechanism by which orthodontic treatment influences occurrence of recessions remains unclear. The aim of this study was to test the hypothesis that a change of mandibular incisor inclination promotes development of labial gingival recessions.Materials and Methods. The study sample comprised dental casts and lateral cephalograms obtained from 109 subjects before orthodontic treatment (Tb) and after orthodontic treatment (Ta). Depending on the change of lower incisor inclination during treatment, the subjects were divided into three groups: Retroclination (R), Stable Position (S), and Proclination (P). The presence of gingival recessions of mandibular incisors and clinical crown heights were assessed on plaster models.Results and Conclusions. From Tb to Ta, Inc_Incl showed a statistically significant change in the R, P, and S groups (p<0.05). Increase of clinical crown heights of the lower incisors (42, 4, and 31) was not statistically significant in any group. The only statistically significant intergroup difference was the greater increase of the clinical crown height of tooth number 32 in the P group in comparison with the R group (p=0.049). The change of lower incisor inclination during treatment did not lead to development of labial gingival recessions in the study sample.
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Daokar, Suchita, and Mitali Sharma. "A Systematic Review of Skeletal, Dental and Soft Tissue Treatment Effects of Twin Block Appliance." Orthodontic Journal of Nepal 10, no. 1 (September 4, 2020): 65–72. http://dx.doi.org/10.3126/ojn.v10i1.31007.
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This systematic review aims to assess skeletal, dental and soft tissue treatment effects of the conventional Twin-block appliance compared to control in Class II malocclusion till date. The electronic databases of Medline, PubMed and Cochrane library were systematically searched until September 2019. The human studies that had used the conventional Twin block appliance with a control group evaluated by a Lateral Cephalogram were included. A total of 321 articles were examined. 10 articles were selected. Majority studies reported a significant improvement in the mandible and in the vertical height, maxillary restrictive effect was less consistently reported. A restrictive maxillary molar effect and an advancement in the mandibular molar has been suggested. Retroclination of the maxillary incisors and proclination of mandibular incisor inclination has been reported. There is some evidence to suggest a retrusive upper lip effect and a protrusive lower lip effect. Increase in Nasolabial angle and some decrease in the mentolabial sulcus to be expected. In conclusion the conventional Twin Block appliance have shown desirable skeletal, dental and soft tissue effects. However certain inevitable side effects are also seen mainly its effect on lower anterior proclination.
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Eissa, Osama, Mahmoud El-Shennawy, Safaa Gaballah, Ghada El-Meehy, and Tarek El Bialy. "Treatment outcomes of Class II malocclusion cases treated with miniscrew-anchored Forsus Fatigue Resistant Device: A randomized controlled trial." Angle Orthodontist 87, no. 6 (September 8, 2017): 824–33. http://dx.doi.org/10.2319/032717-214.1.
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ABSTRACT Objective: To evaluate the skeletal, dental, and soft tissue effects of the Forsus Fatigue Resistant Device (FRD) used with miniscrew anchorage and compare them with those of the conventional Forsus FRD. Materials and Methods: This study was carried out on 38 patients. These patients were randomly allocated into three groups. The 14 patients in group 1 (aged 12.76 ± 1.0 years) were treated with the FRD appliance. In group 2, the 15 patients (aged 12.52 ± 1.12 years) received treatment with FRD using miniscrew anchorage, and the 9 patients in group 3 (aged 12.82 ± 0.9 years) received no treatment as a control group. Linear and angular measurements were made on lateral cephalograms before and immediately after Forsus treatment. Data were analyzed statistically using paired t-, ANOVA, and Tukey tests. Results: Class I molar relationship and overjet correction were achieved in both treatment groups. Although mandibular growth was statistically nonsignificant, there was a significant headgear effect on the maxilla. Mandibular incisor proclination, maxillary incisor retroclination, and distalization of maxillary molars were significant in both treatment groups. However, no significant differences were found between the treatment groups. Conclusions: Class II correction was mainly dentoalveolar in both treatment groups. Use of miniscrews with Forsus did not enhance mandibular forward growth nor prevent labial tipping of the mandibular incisors.
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Arya, Siddarth, Shashikumar HC, Shwetha GS, Spoorthy Mallikarjuna, and Suma T. "Effects of Enlarged Adenoids on Craniofacial Growth in Bangalore Population – A Cross-Sectional Cephalometric Study." RGUHS Journal of Dental Sciences 13, no. 3 (2021): 211–19. http://dx.doi.org/10.26715/rjds.13_3_10.
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Background and Objectives: The purpose of the present cross-sectional study was to determine the effects of enlarged adenoids on the growth pattern of maxilla and mandible and to evaluate the relationship between airway size and lip strain. Methods: Pre-treatment lateral cephalograms of twenty-five children (10 boys, 15 girls) were taken. The children selected for the study were in the age group of 5 – 13 years (mean age of 10 years) during the year 2008- 11. All the tracings were made on 75µm lacquered polyester acetate tracing papers using a 0.05” lead pencil. This study assessed the associations of upper lip strain and upper pharynx size with selected cephalometric measures. The data was analyzed using SPSS (Statistical Package for Social Science, Ver.10.0.5) package. Results: The increased upper lip strain was associated with a forwardly placed maxilla, increased mandibular plane angle and upper pharynx size was associated with decrease in mandibular size (mandibular corpus size), increase in gonial angle (Ar-Go-Gn), decrease in middle third of face (N- ANS) and increase in lower jaw anterior face height (ANS- Me). Also, the dental effect of increase in the degree of mandibular incisor proclination relative to mandibular plane was observed. Conclusion: With an increase in upper-lip strain and decreased upper pharynx size, forward maxillary placement, retrognathic mandible, downward and backward rotation of the mandible, decreased middle third of face, increase in lower anterior face height and increase in degree of mandibular incisor proclination relative to mandibular plane were observed. It was inferred from the present study that a decreased upper airway affects the craniofacial skeletal growth pattern in children.
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Ankita Agrawal, Narendra Sharma, Ranjit Kamble, Sunita Shrivastav, Shriya Prakash Murarka, and Akanksha Kumar. "Comparative evaluation of Skeletal, Dental, and Soft Tissue Changes in Class II Division 1 Malocclusion Cases Treated with Twin Block and innovative Clear Block Appliance - A Prospective Interventional Study." International Journal of Research in Pharmaceutical Sciences 12, no. 2 (April 7, 2021): 1238–46. http://dx.doi.org/10.26452/ijrps.v12i2.4666.
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The present study was undertaken to evaluate and compare the skeletal, dental, and soft tissue changes in skeletal Class II division 1 cases treated with Twin Block and Clear Block appliances using a cephalogram. A total of 40 patients of age between 12-14 years were randomly divided into two equal groups. Group 1: treated with Twin Block appliance and Group 2: treated with Clear Block appliance. The pre-treatment lateral cephalogram was taken and skeletal, dental, and soft tissue parameters were evaluated and the appliance was delivered. After 8 months, another lateral cephalogram of all the cases was taken and analyzed. The pre and post-treatment values were compared between the two groups. The pre-treatment cases were almost comparable in skeletal, dental, and soft tissue features in both groups. There was a significant change in mandibular growth by SNB angle. The retrusion and extrusion of maxillary incisors as well as a proclination and extrusion of mandibular incisors were seen in group 1 while no change was observed in group 2. Treatment with Clear Block appliances has shown significant and favorable Skeletal, Dental and Soft tissue changes which are similar to already proven by the Twin Block appliance. Clear Block provides an esthetic and less bulky option for growth modification with similar results as compared to conventional Twin Block with the additional benefit of preventing lower incisor proclination.
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Brunharo, Ione Helena Vieira Portella. "Surgical treatment of dental and skeletal Class III malocclusion." Dental Press Journal of Orthodontics 18, no. 1 (February 2013): 143–49. http://dx.doi.org/10.1590/s2176-94512013000100026.
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Orthodontic preparation for surgical treatment of skeletal Class III malocclusion involves joint planning with an oral and maxillofacial surgeon to address the functional and esthetic needs of the patient. In order to allow surgical manipulation of the jaws in the preoperative phase, the need to achieve a negative overjet through incisor decompensation often leads the orthodontist to extract the upper first premolars. This report illustrates an orthodontic preparation case where due to specific factors inherent in the patient's psychological makeup retroclination of the upper incisors and proclination of the mandibular incisors was achieved without removing any teeth. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) in partial fulfillment of the requirements for obtaining the BBO Diploma.
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Manni, Antonio, Marco Pasini, Laura Mazzotta, Sabrina Mutinelli, Claudio Nuzzo, Felice Roberto Grassi, and Mauro Cozzani. "Comparison between an Acrylic Splint Herbst and an Acrylic Splint Miniscrew-Herbst for Mandibular Incisors Proclination Control." International Journal of Dentistry 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/173187.
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Aim. The aim of this study is to compare dental and skeletal effects produced by an acrylic splint Herbst with and without skeletal anchorage for correction of dental class II malocclusion.Methods. The test group was formed by 14 patients that were treated with an acrylic splint miniscrew-Herbst; miniscrews were placed between mandibular second premolars and first molars; controls also consisted of 14 subjects that were treated with an acrylic splint Herbst and no miniscrews. Cephalometric measurements before and after Herbst treatment were compared. The value ofαfor significance was set at 0.05.Results. All subjects from both groups were successfully treated to a bilateral Class I relationship; mean treatment time was 8,1 months in the test group and 7.8 in the controls. Several variables did not have a statistical significant difference between the two groups. Some of the variables, instead, presented a significant difference such as incisor flaring, mandibular bone base position, and skeletal discrepancy.Conclusions. This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater mandibular skeletal effect.
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Hamdan, Ahmad M., Shannon M. Lewis, Kevin E. Kelleher, Sherif N. Elhady, and Steven J. Lindauer. "Does overbite reduction affect smile esthetics?" Angle Orthodontist 89, no. 6 (July 15, 2019): 847–54. http://dx.doi.org/10.2319/030819-177.1.
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ABSTRACT Objectives: To compare the effects of two common methods of overbite reduction on smile esthetics. Materials and Methods: A prospective clinical trial was conducted with 32 patients in whom overbite reduction was achieved using a maxillary incisor intrusion arch (18 patients) or flat anterior bite plate (14 patients). Clinical and cephalometric records were compared pretreatment (T1), after overbite reduction (T2), and posttreatment (T3). Results: Both treatment groups experienced a reduction in overbite and maxillary and mandibular incisor proclination during treatment (T1–T3). The center of resistance of the maxillary incisor and the incisal edge was significantly intruded in the intrusion arch group during overbite reduction (T1–T2). However, most of the intrusion of the center of resistance was lost by the end of treatment (T2–T3). Both treatment groups experienced a reduction in maxillary incisor display and flattening of the smile arc during overbite reduction. Conclusions: Both overbite reduction methods caused a decrease in incisor display and flattening of the smile arc. Smiles were improved in some patients by the end of treatment. However, reduction in incisor display persisted. Clinicians should take precautions to prevent negative effects of overbite reduction.
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Gupta, Ankita, and Trilok Shrivastava. "TADs assisted Camouflage Orthodontic Treatment of Class II Division 1 Malocclusion in a Non Growing Patient: A case report." Orthodontic Journal of Nepal 8, no. 2 (December 31, 2018): 55–59. http://dx.doi.org/10.3126/ojn.v8i2.23073.
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Class II, Division I malocclusion has been described as the most frequent treatment problem in orthodontic practice. Aim & objectives of the present case report was to evaluate the management of skeletal Class II division 1 malocclusion in non growing patient with extraction of upper first premolars. Clinical and cephalometric evaluation revealed skeletal Class II with Angles Class II division 1 malocclusion with mild mandibular anterior crowding and increased overjet, severe maxillary incisor proclination, mild mandibular crowding, exaggerated curve of spee, convex profile, incompetent lips, increased overjet and overbite. Maxillary first premolars were extracted followed by en-masse retraction of anteriors with the help of temporary anchorage devices (TADs) to avoid anchorage loss. Mandibular incisor was extracted to correct curve of spee. Following treatment marked improvement in patient’s smile, facial profile and lip competence were achieved and there was a remarkable increase in the patient’s confidence and quality of life.
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Elkordy, Sherif A., Ramy Abdeldayem, Mona M. S. Fayed, Ibrahim Negm, Dina El Ghoul, and Amr M. Abouelezz. "Evaluation of the splint-supported Forsus Fatigue Resistant Device in skeletal Class II growing subjects." Angle Orthodontist 91, no. 1 (October 12, 2020): 9–21. http://dx.doi.org/10.2319/040320-250.1.
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ABSTRACT Objectives To evaluate the use of the Forsus Fatigue Resistant Device (FFRD), supported with bimaxillary splints, in treatment of skeletal Class II malocclusion. Materials and Methods Data from 46 skeletal Class II females who received either conventional Forsus alone (FFRD group) (15 patients, 12.54 ± 0.90 years), FFRD and bimaxillary splints (splint-FFRD group) (15 patients, 12.29 ± 0.82 years), or were untreated controls (16 subjects, 12.1 ± 0.9 years) were retrieved from previous clinical trials. FFRD was inserted onto the mandibular archwire in the FFRD group after leveling and alignment with multibracket appliances. In the splint-FFRD group, Forsus was inserted between fixed maxillary and mandibular splints. Treatment continued until reaching an edge-to-edge incisor relationship. Results Both treatment groups failed to induce significant mandibular skeletal effects compared to the normal growth exhibited by untreated controls. The splint-FFRD group showed significant reduction of SNA (−0.88° ± 0.51°) and ANB (−1.36° ± 0.87°). The mandibular incisors showed significant proclination in the FFRD (9.17° ± 2.42°) and splint-FFRD groups (7.06° ± 3.34°). Conclusions The newly proposed splint-supported FFRD was equally effective as the conventional FFRD in treatment of Class II malocclusion with dento-alveolar changes and additional maxillary restricting effect. It has an additional advantage of immediate initiation of the Class II correction.
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Bittencourt, Marcos Alan Vieira, Arthur Costa Rodrigues Farias, and Marcelo de Castellucci e. Barbosa. "Conservative treatment of a Class I malocclusion with 12 mm overjet, overbite and severe mandibular crowding." Dental Press Journal of Orthodontics 17, no. 5 (October 2012): 43–52. http://dx.doi.org/10.1590/s2176-94512012000500007.
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INTRODUCTION: A female patient aged 12 years and 2 months had molars and canines in Class II relationship, severe overjet (12 mm), deep overbite (100%), excessive retroclination and extrusion of the lower incisors, upper incisor proclination, with mild midline diastema. Both dental arches appeared constricted and a lower arch discrepancy of less than -6.5 mm. Facially, she had a significant upper incisors display at rest, interposition and eversion of the lower lip, acute nasolabial angle and convex profile. OBJECTIVE: To report a clinical case consisting of Angle Class I malocclusion with deep overbite and overjet in addition to severe crowding treated with a conservative approach. METHODS: Treatment consisted of slight retraction of the upper incisors and intrusion and protrusion of the lower incisors until all crowding was eliminated. RESULTS: Adequate overbite and overjet were achieved while maintaining the Angle Class I canine and molar relationships and coincident midlines. The facial features were improved, with the emergence of a slightly convex profile and lip competence, achieved through a slight retraction of the upper lip and protrusion of the lower lip, while improving the nasolabial and mentolabial sulcus. CONCLUSIONS: This conservative approach with no extractions proved effective and resulted in a significant improvement of the occlusal relationship as well as in the patient's dental and facial aesthetics.
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Yamada, Kazuyo, Shingo Kuroda, Toru Deguchi, Teruko Takano-Yamamoto, and Takashi Yamashiro. "Distal Movement of Maxillary Molars Using Miniscrew Anchorage in the Buccal Interradicular Region." Angle Orthodontist 79, no. 1 (January 1, 2009): 78–84. http://dx.doi.org/10.2319/020408-68.1.
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Abstract Objective: To quantify the treatment effects of interradicular miniscrew anchorage and to confirm the validity of the clinical usage of interradicular miniscrews in the distal movement of maxillary molars in nonextraction treatment. Materials and Methods: Twenty-four maxillary molars were moved to the distal using miniscrews placed in the interradicular space between the second premolar and the first molar at an oblique angle of 20 to 30 degrees to the long axis of the proximal tooth. The teeth were evaluated as to how the molars were moved to the distal with the use of lateral cephalograms and dental casts. Results: Maxillary molars were moved to the distal by 2.8 mm with distal tipping of 4.8 degrees and intruded by 0.6 mm. Maxillary incisors were moved to the distal by 2.7 mm with palatal tipping of 4.3 degrees. Molar extrusion and/or consequent mandibular rotation was not observed in any patient. Conclusion: Miniscrews placed in the maxillary interradicular space provide successful molar distal movement of 2.8 mm without patient compliance and with no undesirable side effects such as incisor proclination, clockwise mandibular rotation, or root resorption.
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Neves, Leniana Santos, Luiz Filiphe Gonçalves Canuto, Rodrigo Hermont Cançado, Guilherme Janson, Alexandre Fortes Drummond, and José Fernando Castanha Henriques. "Influence of fixed appliances on two-phase orthopedic-orthodontic treatment." Brazilian Journal of Oral Sciences 17 (December 6, 2018): e18922. http://dx.doi.org/10.20396/bjos.v17i0.8654174.
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Aim: The purpose of this retrospective study was to investigate the effects of phase 2 with fixed appliances, after phase 1 Bionator treatment of Class II division 1 malocclusion, as compared to a matching control group. Methods: The experimental group consisted of 20 patients who were evaluated after orthodontic treatment with fixed appliances subsequently to functional therapy with the Bionator in phase 1. A control group consisting of 20 Class II, division 1 individuals. Results: During phase 1 there was significant forward growth restriction in the maxillary complex, improvement of the maxillomandibular relationship and decrease in facial convexity. There was also significant reduction of the maxillary incisor proclination and protrusion, protrusion of the mandibular incisors, and vertical development of the mandibular molars. The overjet was significantly reduced and the molar relationship was significantly improved. Treatment during phase 2, with fixed appliances, resulted in significant maxillary forward growth restriction and facial convexity reduction. Conclusion: Major Class II skeletal and dentoalveolar anteroposterior correction was obtained during phase 1, with the Bionator. Phase 2, with fixed appliances only produced a significant maxillary forward growth restriction and facial convexity reduction, without any significant dentoalveolar change.
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Oztoprak, Mehmet Oguz, Didem Nalbantgil, Ayhan Uyanlar, and Tulin Arun. "A cephalometric comparative study of class II correction with Sabbagh Universal Spring (SUS²) and Forsus FRD appliances." European Journal of Dentistry 06, no. 03 (July 2012): 302–10. http://dx.doi.org/10.1055/s-0039-1698965.
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ABSTRACTObjectives:The purpose of this clinical prospective study was to compare the dentofacial changes produced by the Sabbagh Universal Spring (SUS²) and Forsus FRD appliances in late adolescent patients with Class II malocclusion, and quantify them in comparison with an untreated group.Methods: The study was carried out on 59 patients with skeletal and dental Class II malocclusion due to retrognatic mandible. Among these, 20 were treated with SUS², 20 were treated with FRD, and no treatment was done to 19 subjects as the control group. 36 cephalometric landmarks were identified on each lateral cephalometric radiograph.Results:The effects of both appliances were dentoalveolar and no significant vertical and sagittal skeletal effect on maxilla and mandible was achieved. The retrusion and extrusion of the maxillary incisors as well as the protrusion and intrusion of mandibular incisors were found to be statistically significant in both treatment groups. Soft tissue profile improvement was limited in both treatment groups.Conclusions: Both appliances corrected Class II discrepancies through dentoalveolar changes; however lower incisor proclination was more prominent with the Forsus FRD. (Eur J Dent 2012;6:302- 310)
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Furquim, Bruno D’Aurea, Guilherme Janson, Laura de Castro Cabrera Cope, Karina Maria Salvatore Freitas, and José Fernando Castanha Henriques. "Comparative effects of the Mandibular Protraction Appliance in adolescents and adults." Dental Press Journal of Orthodontics 23, no. 3 (June 2018): 63–72. http://dx.doi.org/10.1590/2177-6709.23.3.063-072.oar.
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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.
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Hennessy, Joe, Thérèse Garvey, and Ebrahim A. Al-Awadhi. "A randomized clinical trial comparing mandibular incisor proclination produced by fixed labial appliances and clear aligners." Angle Orthodontist 86, no. 5 (September 2016): 706–12. http://dx.doi.org/10.2319/101415-686.1.
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Matsumoto, Kensuke, Scott Sherrill-Mix, Normand Boucher, and Nipul Tanna. "A cone-beam computed tomographic evaluation of alveolar bone dimensional changes and the periodontal limits of mandibular incisor advancement in skeletal Class II patients." Angle Orthodontist 90, no. 3 (February 19, 2020): 330–38. http://dx.doi.org/10.2319/080219-510.1.
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ABSTRACT Objectives To evaluate the presence of dehiscences and changes in alveolar bone height and width in the area of the mandibular central incisors pre- and post-orthodontic treatment. Materials and Methods In 60 skeletal Class II patients, cone-beam computed tomographic (CBCT) images were obtained and the patients were divided into four groups based on the presence of dehiscences at pre- and post-orthodontic treatment. The alveolar bone height and width were measured on CBCT in cross section along the long axis of the teeth. Lateral cephalograms were analyzed. Results The changes in L1-NB and IMPA appeared to be correlated with vertical bone loss and dehiscence. Alveolar bone height appeared to follow a segmented relationship with these two variables, with changes below a threshold (L1-NB = 0.71 mm, IMPA = 3.02°) having relatively minimal or no effect on bone loss but with changes beyond the threshold correlated with extensive bone loss. Similarly, increases in L1-NB or IMPA correlated with decreases in alveolar bone width (L1-NB: −0.25 mm/mm, IMPA: −0.07 mm/°) and increased the probability of developing dehiscences, with an estimated 50% probability of vertical bone loss at a L1-NB change of 2.00 mm or, equivalently, an IMPA change of 8.02° was estimated. Conclusions When treating skeletal Class II patients, the limits of incisor proclination/protraction are less than previously thought. To prevent undesired periodontal outcomes, careful three-dimensional diagnosis is advisable. Furthermore, when excessive protrusion and/or proclination is planned, additional treatment modalities, including orthognathic surgery, tooth extraction, and corticotomy with bone graft, should be considered.
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Ehsani, Sayeh, Brian Nebbe, David Normando, Manuel O. Lagravere, and Carlos Flores-Mir. "Dental and skeletal changes in mild to moderate Class II malocclusions treated by either a Twin-block or Xbow appliance followed by full fixed orthodontic treatment." Angle Orthodontist 85, no. 6 (January 21, 2015): 997–1002. http://dx.doi.org/10.2319/092814-696.1.
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ABSTRACT Objective: To compare the short-term skeletal and dental effects of two-phase orthodontic treatment including either a Twin-block or an XBow appliance. Materials and Methods: This was a retrospective clinical trial of 50 consecutive Class II cases treated in a private practice with either a Twin-block (25) or XBow (25) appliance followed by full fixed orthodontic treatment. To factor out growth, an untreated Class II control group (25) was considered. Results: A MANOVA of treatment/observation changes followed by univariate pairwise comparisons showed that the maxilla moved forward less in the treatment groups than in the control group. As for mandibular changes, the corpus length increase was larger in the Twin-block group by 3.9 mm. Dentally, mesial movement of mandibular molars was greater in both treatment groups. Although no distalization of maxillary molars was found in either treatment group, restriction of mesial movement of these teeth was seen in both treatment groups. Both treatment groups demonstrated increased mandibular incisor proclination with larger increases for the XBow group by 3.3°. The Wits value was decreased by 1.6 mm more in the Twin-block group. No sex-related differences were observed. Conclusions: Class II correction using an XBow or Twin-block followed by fixed appliances occurs through a relatively similar combination of dental and skeletal effects. An increase in mandibular incisor inclination for the XBow group and an increased corpus length for the Twin-block group were notable exceptions. No overall treatment length differences were seen.
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Eissa, Osama, Mahmoud ElShennawy, Safaa Gaballah, Ghada ElMehy, and Tarek El-Bialy. "Treatment of Class III malocclusion using miniscrew-anchored inverted Forsus FRD: Controlled clinical trial." Angle Orthodontist 88, no. 6 (June 18, 2018): 692–701. http://dx.doi.org/10.2319/110717-760.1.
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ABSTRACT Objectives: To evaluate the skeletal, dental, and soft tissue changes after the use of miniscrew-anchored inverted Forsus fatigue-resistant device (FRD) in treatment of Class III malocclusion. Materials and Methods: In this controlled clinical trial, 16 patients (9 girls and 7 boys; age 12.45 ± 0.87 years) were consecutively treated with miniscrew-anchored inverted Forsus FRD. This group was compared with a matched control group of 16 untreated patients (8 girls and 8 boys; age 11.95 ± 1.04 years). Miniscrews were inserted bilaterally between the maxillary canine and first premolar. Forsus FRD was selected and inserted in an inverted manner mesial to the mandibular headgear tube and distal to the maxillary canine bracket. Results: Class I molar and canine relationships with positive overjet were achieved in an average period of 6.4 ± 1.46 months. Maxillary forward growth showed a statistically significant increase (SNA°: 1.73 ± 0.53, P < .5), maxillary incisor proclination was statistically significant (U1 to NA°: −0.39 ± 0.33, P > .5), and the lower incisors exhibited significant retroclination (L1 to NB°: 1.65 ± 0.83, P < .5). Significant lower lip retrusion and upper lip protrusion were obvious treatment outcomes (P < .5). Conclusions: The use of miniscrew-anchored inverted FRD could effectively increase maxillary forward growth, but it did not prevent mesial movement of the maxillary dentition. Significant lower incisor retroclination was observed. Significant esthetic improvement of the facial profile was achieved primarily because of lower lip retrusion and upper lip protrusion.
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Vijayalakshmi, Devaki, Reshme Radha Divakar, Ratna Parameswaran, and Janani Jayapal. "“Surgery-first Orthognathic Approach” for Correction of Skeletal Class III with Open Bite." Journal of Contemporary Dentistry 9, no. 3 (2019): 144–49. http://dx.doi.org/10.5005/jp-journals-10031-1266.
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ABSTRACT Introduction This case report illustrates the treatment of a skeletal class III patient with the surgery-first orthognathic approach (SFOA) protocol. Background “Surgery-first orthognathic approach” is a growing trend that provides an immediate facial change. The SFOA protocol utilizes dentoalveolar compensation as the key advantage to effect immediate facial change, which in conjunction with the rapid acceleratory phenomenon (RAP) augments the intended tooth movement, thereby reducing the total treatment duration. Case description A 24-year-old male presented with forwardly placed lower jaw with associated difficulty during eating. Clinical examination revealed severe lip incompetency, mandibular excess, class III skeletal malocclusion, severe bimaxillary incisor proclination, posterior crossbite, and lower midline shift toward right on an average mandibular plane angle. Conclusion The SFOA protocol involving bilateral sagittal split osteotomy (BSSO) mandibular setback along with the correction of the pitch and yaw was performed and the orthodontic phase was followed. Clinical significance The total treatment time was 5 months and 15 days, following which excellent facial transformation and stable occlusion was achieved. How to cite this article Divakar RR, Parameswaran R, Jayapal J, et al. “Surgery-first Orthognathic Approach” for Correction of Skeletal Class III with Open Bite. J Contemp Dent 2019;9(3):144–149.
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Jones, Graham, Peter H. Buschang, Ki Beom Kim, and Donald R. Oliver. "Class II Non-Extraction Patients Treated with the Forsus Fatigue Resistant Device Versus Intermaxillary Elastics." Angle Orthodontist 78, no. 2 (March 1, 2008): 332–38. http://dx.doi.org/10.2319/030607-115.1.
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Abstract Objective: To evaluate the Forsus Fatigue Resistant Device (FRD) as a compliance-free alternative to Class II elastics. Materials and Methods: A sample of 34 (14 female, 20 male) consecutively treated nonextraction FRD patients (12.6 years of age) were matched with a sample of 34 (14 female, 20 male) consecutively treated nonextraction Class II elastics patients (12.2 years of age) based on four pretreatment variables (ANB, L1-GoMe, SN-GoMe, and treatment duration). Pretreatment and posttreatment cephalometric radiographs were traced and analyzed using the pitchfork analysis and a vertical cephalometric analysis. t-Tests were used to evaluate group differences. Group differences were evaluated using t-tests. Results: No statistically significant differences were found in the treatment changes between the groups. There was a general trend for mesial movement of the maxilla, mandible, and dentition during treatment for both groups. The mandibular skeletal advancement and dental movements were greater than those in the maxilla, which accounted for the Class II correction. Lower incisor proclination was evident in both groups. Vertically, the maxillary and mandibular molars erupted during treatment in both groups, while lower incisors proclined. With the exception of lower molar mesial movements and total molar correction, which were significantly (P < .05) greater in the Forsus group, there were no statistically significant group differences in the treatment changes. Conclusions: The Forsus FRD is an acceptable substitute for Class II elastics for noncompliant patients.
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Sultana, Naznin, Md Nazmul Hasan, Gazi Shamim Hassan, Mir Abu Naim, and Nasrin Akther. "Orthodontic camouflage management of a class II malocclusion with excessive overjet- A case report." Update Dental College Journal 3, no. 1 (February 17, 2014): 41–45. http://dx.doi.org/10.3329/updcj.v3i1.17984.
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In orthodontic practice various treatment modalities have been presented for the treatment for the class II, div 1malocclusions. Recently a large number of young adults have been seeking shorter, cost effective and a non surgical correction of Class II malocclusions and they accept dental camouflage as a treatment option to mask the skeletal discrepancy .This case report presents one such case, a 15years old growing male who has Class II div I malocclusion with sever maxillary incisor proclination, convex profile ,high mandibular plane angle, incompetent lips, increased overjet& overbite, over retained upper left deciduous canine ,impacted upper left canine and a supernumerary tooth in canine region. We considered the camouflage treatment by extracting the upper right first premolar, left impacted canine, deciduous canine and supernumerary tooth. Following the treatment, a satisfactory result was achieved with an ideal, static and a functional occlusion, facial profile, acceptable smile, competent lip and stable treatment results. DOI: http://dx.doi.org/10.3329/updcj.v3i1.17984 Update Dent. Coll. j: 2013; 3 (1): 41-45
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Ali, MW, and MZ Hossain. "Successful orthodontic treatment of Class II division 1 malocclusion in a non growing patient : A case report." Bangladesh Journal of Orthodontics and Dentofacial Orthopedics 2, no. 2 (August 13, 2013): 41–45. http://dx.doi.org/10.3329/bjodfo.v2i2.16165.
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Aim & objectives of the present case report was to evaluate the management of skeletal Class II division 1 malocclusion in non growing patient with extraction of upper first premolars. Clinical and cephalometric evaluation revealed skeletal Class II division 1 malocclusion with severe maxillary incisor proclination, convex profile, average mandibular plane angle, incompetent lips, increased overjet and overbite. After extraction of upper 1st premolars, canine retraction was done which was followed by retraction of severely proclined upper anterior teeth by judicious control of third order bend in rectangular stainless steel arch wire with V loop . For anchorage management, intra oral anchorage with tip back & toe in bends in stainless steel arch wire was satisfactory. Following treatment marked improvement in patients smile, facial profile and lip competence were achieved and there was a remarkable increase in the patients confidence and quality of life. DOI: http://dx.doi.org/10.3329/bjodfo.v2i2.16165 Ban J Orthod & Dentofac Orthop, April 2012; Vol-2, No.2, 41-45
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Govinakovi, Prashantha S., Ibrahim Al-Busaidi, and Viswapurna Senguttuvan. "Cephalometric Norms in an Omani Adult Population of Arab Descent." Sultan Qaboos University Medical Journal [SQUMJ] 18, no. 2 (September 9, 2018): 182. http://dx.doi.org/10.18295/squmj.2018.18.02.010.
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Objectives: This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for Caucasians. Methods: This cross-sectional studywas conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and October 2016. A total of 150 Omani patients between 20–29 years old seeking orthodontic treatment were included. All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal overjet/overbite (<3 mm) and mild spacing/crowding of the teeth (≤3 mm). Lateral cephalography was performed in centric occlusion with the lips relaxed and the head in a natural position. Cephalometric measurements were then compared with Eastman Standard norms. Results: The Omani subjects were found to have a slightly retrusive maxilla, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more protrusive and the nasolabial angle was more obtuse. Conclusion: In the Omani sample, increased proclination of the incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent.Keywords: Cephalometry, standards; Population Characteristics; Ethnic Groups; Arabs; Orthodontics; Oman.
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Nayak, Sunil S., C. Pushpalatha, Vinny S. Bhasin, Praveen Tammannavar, and Vinod Viswanathan. "A Cephalometric Evaluation of Pretreatment and Post-treatment Outcome using Tetragon Analysis: A Retrospective Study." Journal of Contemporary Dental Practice 14, no. 2 (2013): 238–43. http://dx.doi.org/10.5005/jp-journals-10024-1306.
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ABSTRACT Statement of problem Few cephalometric analyses have been put forward to assess the treatment outcome after orthodontic treatment. However, these analyses are somewhat complicated and time consuming. The Tetragon analysis is introduced with measurement of treatment outcome as one of its objectives. Purpose of study The study was undertaken to evaluate the treatment outcome by checking the skeletal and dental changes using pretreatment and post-treatment radiographs and to evaluate the efficiency of treatment in the Department of Orthodontics, College of Dental Sciences, Davangere, using the Tetragon analysis. Materials and methods Records of 35 finished patients with fixed orthodontic therapy using preadjusted edgewise appliance were selected. The samples were analyzed separately for the skeletal parameters consisting of skeletal class I, II and III using Tetragon analysis. Results The post-treatment reduction of upper incisor palatal plane angle was found to be statistically significant in skeletal class I (p < 0.01) and skeletal class II patients (p < 0.05). The post-treatment increase in interincisal angle was found to be statistically significant in skeletal class I (p < 0.01) class II patients (p < 0.05). Conclusion Fixed appliance therapy reduced the proclination of upper incisors and increased the interincisal angle in skeletal class I and II cases but not in skeletal class III cases. The lower incisal angulation and the maxilla-mandibular plane angle did change significantly and so were the angles of the Trigon. The Tetragon analysis proved easy to measure the treatment outcome. How to cite this article Bhasin VS, Tammannavar P, Pushpalatha C, Nayak SS, Viswanathan V. A Cephalometric Evaluation of Pretreatment and Post-treatment Outcome using Tetragon Analysis: A Retrospective Study. J Contemp Dent Pract 2013;14(2):238-243.
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Seehra, J., P. S. Fleming, N. Mandall, and A. T. DiBiase. "A comparison of two different techniques for early correction of Class III malocclusion." Angle Orthodontist 82, no. 1 (August 1, 2011): 96–101. http://dx.doi.org/10.2319/032011-197.1.
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Abstract Objective: To compare the effectiveness of Reverse Twin-Block therapy (RTB) and protraction face mask treatment (PFM) with respect to an untreated control in the correction of developing Class III malocclusion. Materials and Methods: A retrospective comparative study of subjects treated cases with either PFM (n = 9) or RTB (n = 13) and untreated matched controls (n = 10) was performed. Both the PFM and control group samples were derived from a previously conducted clinical trial, and the RTB group was formed of consecutively treated cases. The main outcome variables assessed were skeletal and dental changes. Lateral cephalograms were taken at the start and end of treatment or during the observation period. Analysis of variance was used to compare changes in cephalometric variables arising during the study period in the lateral group. Linear regression analysis and an unpaired t-test were used to determine the impacts of treatment duration and gender, respectively. Results: Significantly greater skeletal changes arose with PFM therapy than with RTB therapy or in the control group (SNA, SNB, and ANB; P < .001). The dentoalveolar effects of RTB therapy exceeded those of PFM treatment, with significantly more maxillary incisor proclination (P < .001) and mandibular incisor retroclination (P < .006) arising with treatment. Conclusions: Both appliances are capable of correction of Class III dental relationships; however, the relative skeletal and dental contributions differ. Skeletal effects, chiefly anterior maxillary translation, predominated with PFM therapy. The RTB appliance induced Class III correction, primarily as a result of dentoalveolar effects.
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Raucci, Gaetana, Camila Pachêco-Pereira, Maryam Elyasi, Fabrizia d'Apuzzo, Carlos Flores-Mir, and Letizia Perillo. "Predictors of postretention stability of mandibular dental arch dimensions in patients treated with a lip bumper during mixed dentition followed by fixed appliances." Angle Orthodontist 87, no. 2 (September 21, 2016): 209–14. http://dx.doi.org/10.2319/051216-379.1.
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ABSTRACT Objective: To identify which dental and/or cephalometric variables were predictors of postretention mandibular dental arch stability in patients who underwent treatment with transpalatal arch and lip bumper during mixed dentition followed by full fixed appliances in the permanent dentition. Materials and Methods: Thirty-one patients were divided into stable and relapse groups based on the postretention presence or absence of relapse. Intercuspid, interpremolar, and intermolar widths; arch length and perimeter; crowding; and lower incisor proclination were evaluated before treatment (T0), after lip bumper treatment (T1), after fixed appliance treatment (T2), and a minimum of 3 years after removal of the full fixed appliance (T3). Logistic regression analyses were performed to evaluate the effect of changes between T0 and T1, as predictive variables, on the occurrence of relapse at T3. Results: The model explained 53.5 % of the variance in treatment stability and correctly classified 80.6 % of the sample. Of the seven prediction variables, intermolar and interpremolar changes between T0 and T1 (P = .024 and P = .034, respectively) were statistically significant. For every millimeter of increase in intermolar and interpremolar widths there was a 1.52 and 2.70 times increase, respectively, in the odds of having stability. There was also weak evidence for the effect of sex (P = .047). Conclusions: The best predictors of an average 4-year postretention mandibular dental arch stability after treatment with a lip bumper followed by full fixed appliances were intermolar and interpremolar width increases during lip bumper therapy. The amount of relapse in this crowding could be considered clinically irrelevant.
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Vilanova, Lorena, José Fernando Castanha Henriques, Guilherme Janson, Mayara Paim Patel, Rachelle Simões Reis, and Aron Aliaga-Del Castillo. "Class II malocclusion treatment effects with Jones Jig and Distal Jet followed by fixed appliances." Angle Orthodontist 88, no. 1 (October 5, 2017): 10–19. http://dx.doi.org/10.2319/022517-142.1.
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ABSTRACT Objectives: To compare the skeletal, dentoalveolar, and soft tissue changes in Class II malocclusion patients treated with Jones Jig and Distal Jet distalizers followed by fixed appliances. Materials and Methods: The experimental groups comprised 45 Class II malocclusion subjects divided into two groups. Group 1 consisted of 25 patients treated with the Jones Jig, and group 2 consisted of 20 patients treated with the Distal Jet. Group 3 comprised 19 untreated Class II subjects. Cephalograms were analyzed before and after orthodontic treatment. For intergroup comparisons, one-way analysis of variance and post hoc Tukey tests were performed. Results: During treatment, the experimental groups exhibited significant increases in occlusal plane inclination and maxillary second molar mesial tipping. Additionally, the molar relationship improved and overjet decreased significantly in the experimental groups. The Jones Jig group showed greater mandibular incisor proclination and greater overbite reduction than the control group. No significant intergroup differences in nasolabial angle changes were found. Conclusions: Treatment protocols using the Jones Jig and Distal Jet followed by fixed appliances were effective in correcting Class II malocclusion by means of dentoalveolar changes without significant skeletal and soft tissue changes. The experimental groups showed occlusal plane clockwise rotation and greater mesial tipping of maxillary second molars when compared to the untreated group.
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Raucci, Gaetana, Camila Pachêco-Pereira, Maryam Elyasi, Fabrizia d’Apuzzo, Carlos Flores-Mir, and Letizia Perillo. "Short- and long-term evaluation of mandibular dental arch dimensional changes in patients treated with a lip bumper during mixed dentition followed by fixed appliances." Angle Orthodontist 86, no. 5 (January 15, 2016): 753–60. http://dx.doi.org/10.2319/073015-519.1.
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ABSTRACT Objective: To evaluate short- and long-term mandibular dental arch changes in patients treated with a lip bumper during the mixed dentition followed by fixed appliances, compared with a matched control sample. Materials and Methods: Dental casts and lateral cephalograms obtained from 31 consecutively treated patients before (T0) and after (T1) lip bumper, after fixed appliances (T2), and a minimum of 3 years after fixed appliances (T3) were analyzed. The control group was matched as closely as possible. Arch width, arch perimeter, arch length, and incisor proclination were evaluated. Repeated measures ANOVA was used to analyze changes in measurements over all four time points between treatment and control groups. Results: Arch widths and crowding were always significantly different except at T2−T1. At T1−T0, only crowding decreased 3.2 mm while intercanine, interpremolar, and intermolar widths increased by 3.8, 3.3, and 3.9 mm, respectively. Changes at T3−T2 showed a significant decrease of 2.1 mm for crowding and an increase of 3.5, 2.9, 2.7, and 0.8 mm for intercanine, interpremolar, and intermolar widths and arch perimeter, respectively. Finally, at T3−T0, the reduction in crowding of 5.03 mm was significant and clinically important in the treated group. The differences between intercanine, interpremolar, and intermolar widths were also significant (2.1, 3.8, and 3.6 mm, respectively). All those differences favored the treated group. Conclusions: Mandibular dental arch dimensions were significantly changed after lip bumper treatment. At follow-up, all arch widths were slightly decreased, generating an increase of 0.4 mm in crowding, considered clinically irrelevant. Overall changes remained stable after an average 6.3-year follow-up.
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Inamassu-Lemes, Sheila Marques, Acácio Fuziy, André Luiz Ferreira Costa, Paulo Eduardo Guedes Carvalho, and Ana Carla Raphaelli Nahás-Scocate. "Dentoskeletal and Soft Tissue Effects in the Treatment of Class II Malocclusion with Klammt's Elastic Open Activator." Journal of Contemporary Dental Practice 17, no. 1 (January 2016): 63–69. http://dx.doi.org/10.5005/jp-journals-10024-1804.
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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
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Elkordy, Sherif A., Amr M. Abouelezz, Mona M. Salah Fayed, Khaled H. Attia, Ramy Abdul Rahman Ishaq, and Yehya A. Mostafa. "Three-dimensional effects of the mini-implant–anchored Forsus Fatigue Resistant Device: A randomized controlled trial." Angle Orthodontist 86, no. 2 (May 19, 2015): 292–305. http://dx.doi.org/10.2319/012515-55.1.
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ABSTRACT Objective: To detect three-dimensionally the effects of using mini-implant anchorage with the Forsus Fatigue Resistant Device (FFRD). Materials and Methods: The sample comprised 43 skeletal Class II females with deficient mandibles. They were randomly allocated into three groups: 16 patients (13.25 ± 1.12 years) received FFRD alone (Forsus group), 15 subjects (13.07 ± 1.41 years) received FFRD and mini-implants (FMI group), and 12 subjects (12.71 ± 1.44 years) were in the untreated control group. Three-dimensional analyses of cone beam computed tomographic images were completed, and the data were statistically analyzed. Results: Class I relationship and overjet correction were achieved in 88% of the cases. None of the two treatment groups showed significant mandibular skeletal effects. In the FMI group, significant headgear effect, decrease in maxillary width, and increase in the lower facial height were noted. In the FMI group, retroclination of maxillary incisors and distalization of maxillary molars were significantly higher. Proclination and intrusion of mandibular incisors were significantly greater in the Forsus group. Conclusions: FFRD resulted in Class II correction mainly through dentoalveolar effects and with minimal skeletal effects. Utilization of mini-implant anchorage effectively reduced the unfavorable proclination and intrusion of mandibular incisors but did not produce additional skeletal effects.
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Renkema, Anne-Marie, Zuzanna Navratilova, Katerina Mazurova, Christos Katsaros, and Piotr S. Fudalej. "Gingival labial recessions and the post-treatment proclination of mandibular incisors." European Journal of Orthodontics 37, no. 5 (December 5, 2014): 508–13. http://dx.doi.org/10.1093/ejo/cju073.
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Yared, Karen Ferreira Gazel, Elton Gonçalves Zenobio, and Wellington Pacheco. "Periodontal status of mandibular central incisors after orthodontic proclination in adults." American Journal of Orthodontics and Dentofacial Orthopedics 130, no. 1 (July 2006): 6.e1–6.e8. http://dx.doi.org/10.1016/j.ajodo.2006.01.015.
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Cattaneo, Paolo M., Raaid A. Salih, and Birte Melsen. "Labio-lingual root control of lower anterior teeth and canines obtained by active and passive self-ligating brackets." Angle Orthodontist 83, no. 4 (December 18, 2012): 691–97. http://dx.doi.org/10.2319/071212-575.1.
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ABSTRACT Objective: To investigate the torque capabilities of passive and active self-ligating (SL) brackets on mandibular incisors and canines using three-dimensional (3D) imaging analysis. Materials and Methods: Two types of SL bracket systems were analyzed: a passive and an active. Both brackets had a 0.022 × 0.028-inch slot size. Treatment protocol and wire sequences were followed as recommended by the manufacturers. Twenty-six patients were included in the passive group and 20 were included in the active group; all received pretreatment and posttreatment cone-beam computed tomography (CBCT) scanning. Based on the CBCT scans, a customized 3D analysis was developed to assess labiolingual inclination of the roots of mandibular canines and incisors with respect to the occlusal plane before and after treatment. Results: Following treatment, a statistically significant labiolingual proclination of the teeth was seen in both groups. Moreover, in both SL systems the roots exhibited a large variation in labiolingual inclination between adjacent teeth even after treatment. Conclusions: A significant proclination was seen for the mandibular front teeth; the claimed third-order torque control of SL systems could not be demonstrated. Therefore, a considerable play between the wire and the brackets could be hypothesized, even more in relation to the passive than the active SL brackets.
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Giuntini, Veronica, Andrea Vangelisti, Caterina Masucci, Efisio Defraia, James A. McNamara Jr, and Lorenzo Franchi. "Treatment effects produced by the Twin-block appliance vs the Forsus Fatigue Resistant Device in growing Class II patients." Angle Orthodontist 85, no. 5 (March 18, 2015): 784–89. http://dx.doi.org/10.2319/090514-624.1.
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ABSTRACT Objective: To compare the dentoskeletal changes produced by the Twin-block appliance (TB) followed by fixed appliances vs the Forsus Fatigue Resistant Device (FRD) in combination with fixed appliances in growing patients having Class II division 1 malocclusion. Materials and Methods: Twenty-eight Class II patients (19 females and 9 males; mean age, 12.4 years) treated consecutively with the TB followed by fixed appliances were compared with a group of 36 patients (16 females and 20 males; mean age, 12.3 years) treated consecutively with the FRD in combination with fixed appliances and with a sample of 27 subjects having untreated Class II malocclusion (13 females and 14 males; mean age, 12.2 years). Mean observation interval was 2.3 years in all groups. Cephalometric changes were compared among the three groups by means of ANOVA and Tukey's post hoc tests. Results: The FRD produced a significant restraint of the maxilla compared with the TB and control samples (SNA, −1.1° and −1.8°, respectively). The TB sample exhibited significantly greater mandibular advancement and greater increments in total mandibular length than either the FRD or control groups (SNB, 1.9° and 1.5°, respectively; and Co-Gn, 2.0 mm and 3.4 mm, respectively). The FRD produced a significantly greater amount of proclination of the mandibular incisors than what occurred with the TB or the control samples (2.9° and 5.6°, respectively). Conclusion: The TB appliance produced greater skeletal effects in terms of mandibular advancement and growth stimulation while the Forsus caused significant proclination of the mandibular incisors.
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Årtun, Jon, and Olaf Krogstad. "Periodontal status of mandibular incisors following excessive proclination A study in adults with surgically treated mandibular prognathism." American Journal of Orthodontics and Dentofacial Orthopedics 91, no. 3 (March 1987): 225–32. http://dx.doi.org/10.1016/0889-5406(87)90450-1.
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Jiang, Ting, Jian Kai Wang, Yang Yang Jiang, Zheng Hu, and Guo Hua Tang. "How well do integrated 3D models predict alveolar defects after treatment with clear aligners?" Angle Orthodontist 91, no. 3 (January 25, 2021): 313–19. http://dx.doi.org/10.2319/042220-342.1.
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ABSTRACT Objectives To evaluate the accuracy of integrated models (IMs) constructed by pretreatment cone-beam computed tomography (pre-CBCT) in diagnosing alveolar defects after treatment with clear aligners. Materials and Methods Pre-CBCT and posttreatment cone-beam computed tomography (CBCT) scans from 69 patients who completed nonextraction treatment with clear aligners were collected. The IMs comprised anterior teeth in predicted positions and alveolar bone from pre-CBCT scans. The accuracy of the IMs for identifying dehiscences or fenestrations was evaluated by comparing the means of the defect volumes, absolute mean differences, and Pearson correlation coefficients with those measured from post-CBCT scans. Defect prediction accuracy was assessed by sensitivity, specificity, positive predictive values, and negative predictive values. Factors possibly affecting changes in mandibular alveolar defects were analyzed using a mixed linear model. Results The IM measurements showed mean deviations of 2.82 ± 9.99 mm3 for fenestrations and 3.67 ± 9.93 mm3 for dehiscences. The absolute mean differences were 4.50 ± 9.35 mm3 for fenestrations and 5.17 ± 9.24 mm3 for dehiscences. The specificities of the IMs were higher than 0.8, whereas the sensitivities were both lower (fenestration = 0.41; dehiscence = 0.53). The positive predictive values were unacceptable (fenestration = 0.52; dehiscence = 0.62), and the overall reliability was low (<0.80). Molar distalization and proclination were positively correlated with significant increases in alveolar defects at the mandibular incisors after treatment. Conclusions Alveolar defects after clear aligner treatment cannot be simulated accurately by IMs constructed from pre-CBCT. Caution should be taken in the treatment of crowding with proclination and molar distalization for the safety of alveolar bone at the mandibular incisors.
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Paduano, Sergio, Gianrico Spagnuolo, Giuseppe di Biase, and Iacopo Cioffi. "Treatment of a Class II Division 2 Patient with Severe Skeletal Discrepancy by Using a Custom Made TPA Proclination Spring." Open Dentistry Journal 7, no. 1 (September 20, 2013): 109–17. http://dx.doi.org/10.2174/1874210620130807002.
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This case report describes the orthodontic treatment of a boy, aged 15.3 years, with permanent dentition, mesofacial typology, affected with a severe sagittal skeletal Class II division 2 malocclusion, due to a mandibular retrusion. His chief compliant was the position of the maxillary incisors, displaced too palatally, and an impaired facial profile. Herbst and multi-bracket straightwire fixed appliances, together with a custom made modified transpalatal arch (i.e. TPA proclination spring), were used to correct the sagittal discrepancy and to improve the attractiveness of the impaired facial profile.
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Mani, Shubhangi Amit, Nilesh Mote, Kunal Dilip Pawar, Prashantkumar Mishra, Richa Anil Mishra, and Rajlaxmi Rajaram Rai. "Treatment of class II and class III maloccolusion by using churro jumper: an efficient, inexpensive and uncomplicated fixed flexible functional technique." Journal of Research in Dentistry 4, no. 1 (July 24, 2016): 9. http://dx.doi.org/10.19177/jrd.v4e120169-12.
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Functional orthopedic treatment seeks to improve skeletal and dental relationship of the jaws. The challenging task is to correctly position jaws antero-posteriorly and vertically with correct overbite, overjet and Centric relation. The Churro Jumper is an efficient, inexpensive and uncomplicated fixed flexible functional appliance. It is used to evaluate the efficacy of the Churro Jumper appliance in treatment of skeletal Class II malocclusion with retrognathic mandible. Churro Jumper contributes in correction of Class II molar relationship by dento-alveolar effects on both jaws. There was up-righting of maxillary incisors and proclination of mandibular incisors. Churro Jumper is clinically efficient as well as effective appliance to correct skeletal class II malocclusion. The only problem with this appliance is its frequent breakage and oral hygiene maintenance causing inconvenience to both patient as well as operator.
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Alogaibi, Yahya A., Fahad F. Alsulaimani, Basem Jamal, and Rania Mitwally. "Combined Orthodontic and Surgical Management for Treatment of Severe Class III Malocclusion with Anterior and Posterior Crossbites." Case Reports in Dentistry 2021 (June 25, 2021): 1–6. http://dx.doi.org/10.1155/2021/5579077.
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Severe class III malocclusion can be a great challenge, especially in adult patients. This case report describes an adult patient with severe skeletal class III malocclusion and with an obvious maxillary deficiency and mandibular excess causing both anterior and posterior crossbites in addition to a shift in the upper and lower midlines to the left concerning the facial midline. This was complicated by compensatory mechanisms such as the proclination of upper incisors and retroclination of lower incisors. Decompensation of the upper and lower arches was performed combined with upper arch expansion to relieve crowding in the upper arch and correct the posterior crossbite. This was followed by double jaw surgeries, including Le Fort I osteotomy in the maxilla and bilateral sagittal split osteotomy (BSSO) in the mandible. Orthodontic finishing procedures were then used to correct any other dental discrepancies. Remarkable esthetic and functional results were achieved with high patient satisfaction.
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Spalj, Stjepan, Kate Mroz Tranesen, Kari Birkeland, Visnja Katic, Andrej Pavlic, and Vaska Vandevska-Radunovic. "Comparison of Activator-Headgear and Twin Block Treatment Approaches in Class II Division 1 Malocclusion." BioMed Research International 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/4861924.
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The purpose was to compare the treatment effects of functional appliances activator-headgear (AH) and Twin Block (TB) on skeletal, dental, and soft-tissue structures in class II division 1 malocclusion with normal growth changes in untreated subjects. The sample included 50 subjects (56% females) aged 8–13 years with class II division 1 malocclusion treated with either AH (n=25) or TB (n=25) appliances. Pre- and posttreatment lateral cephalograms were evaluated and compared to 50 untreated class II division 1 cases matched by age, gender, ANB angle, and skeletal maturity. A paired sample, independent samples tests and discriminant analysis were performed for intra- and intergroup analysis. Treatment with both appliances resulted in significant reduction of skeletal and soft-tissue facial convexity, the overjet, and the prominence of the upper lip in comparison to untreated individuals (p<0.001). Retroclination of maxillary incisors and proclination of mandibular incisors were seen, the latter being significantly more evident in the TB group (p<0.05). Increase of effective mandibular length was more pronounced in the TB group. In conclusion, both AH and TB appliances contributed successfully to the correction of class II division 1 malocclusion when compared to the untreated subjects with predominantly dentoalveolar changes.