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Mariscal JF, Ravelli DB, Dos Santos Pinto A, Dominguez GC, de Arruda Aidar LA, Jacob HB. Comparisons of soft tissue changes after Herbst appliance treatment in three different growth phases. J World Fed Orthod 2024; 13:78-85. [PMID: 38155063 DOI: 10.1016/j.ejwf.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/21/2023] [Accepted: 11/06/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND This study aimed to compare the soft tissue effects of Herbst appliance in Class II malocclusion patients treated in three different craniofacial growth phases: prepubertal (PRE), circumpubertal (CIR), and postpubertal (POS). METHODS In total, 95 patients with Class II Division 1 malocclusion previously treated with a Herbst appliance were analyzed. Through the cervical vertebral maturation stages method, patients were allocated into three groups depending on the growth craniofacial phase at the beginning of treatment: PRE, CIR, and POS. Seventeen cephalometric measures were evaluated from each lateral radiograph before and after Herbst therapy using the Radiocef 2 software (Radio Memory, Belo Horizonte). Intragroup and intergroup treatment changes were compared statistically using a paired t test and MANOVA test, respectively. RESULTS Soft tissue thickness changes were related only to mandible; all three mandibular measurements (L1_LL, B_B', and Pog_Pog') showed thickening for the PRE group ranging from 0.92 mm (Pog_Pog') to 2.02 mm (B_B'), and only lower lip thickened overtime for the POS group (L1_LL = 0.99 mm). Soft and hard tissue pogonion displaced anteriorly, but only the soft tissue showed differences among groups; PRE group presented more anterior displacement than POS group (3.61 mm and 1.39 mm, respectively). Hard and soft tissue facial convexity decreased more in the PRE and CIR groups than in the POS group. Mentolabial sulcus depth reduced more in the PRE (1.07 mm) and CIR (1.29 mm) groups than in the POS (0.55 mm) group. Horizontal movement of the skeletal and soft pogonion presented a moderate-high positive correlation (r = 0.783), and hard and soft facial convexity showed a moderate-low positive correlation (r = 0.403). CONCLUSIONS Herbst appliance therapy produces soft tissue improvements in the three phases of craniofacial growth, being greater in patients in the PRE and CIR phases.
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Affiliation(s)
- Juan Francisco Mariscal
- Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil.
| | - Dirceu Barnabé Ravelli
- Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Ary Dos Santos Pinto
- Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | | | | | - Helder B Jacob
- Department of Orthodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
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Hourfar J, Kinzinger GSM, Frye L, Lisson JA. Outcome differences after orthodontic camouflage treatment in hypo- and hyperdivergent patients - A retrospective cephalometric investigation. Clin Oral Investig 2023; 27:7307-7318. [PMID: 37953326 PMCID: PMC10713694 DOI: 10.1007/s00784-023-05321-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/10/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES To compare differences in outcome in skeletal and dental parameters in hypo- and hyperdivergent Class II patients after extraction of upper first premolars and comprehensive orthodontic treatment. MATERIALS AND METHODS 37 Class-II-patients with dental camouflage treatment were divided into a hypo- (n = 18) or a hyperdivergent (n = 19) group depending on the mandibular plane angle (hypo: < 34° or hyper: ≥ 34°). Lateral cephalograms were available before (T1) and after (T2) treatment and were analyzed with customized measurements. Data from a growth survey served as a control and were used to calculate the actual treatment effect. Data were analyzed by one-sample Student's t-tests and independent Student's t-tests. Statistical significance was set at p < 0.05. RESULTS The measurements showed similar changes in both groups. The effects were mainly dentoalveolar. Hypodivergent patients showed an almost equal increase in anterior and posterior facial height, while hyperdivergent patients only showed an increase in anterior facial height. CONCLUSIONS In hyperdivergent patients, the anterior facial height increases despite camouflage treatment. This indicates a tendency towards bite opening and backward rotation of the mandible. Hypodivergent patients do not experience deepening of the bite. CLINICAL RELEVANCE In hyperdivergent patients with upper first premolars extraction the anterior facial height increased differently than in hypodivergent patients. This should be considered if a bite opening is a possible contraindication to treatment.
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Affiliation(s)
- Jan Hourfar
- Department of Orthodontics, Saarland University, 66424, Homburg, Saar, Germany
| | | | - Linda Frye
- Department of Orthodontics, Saarland University, 66424, Homburg, Saar, Germany
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Hourfar J, Kinzinger GSM, Frye L, Lisson JA. Effects of fixed functional orthodontic treatment in hypodivergent and hyperdivergent class II patients-a retrospective cephalometric investigation. Clin Oral Investig 2023; 27:4773-4784. [PMID: 37351654 PMCID: PMC10415434 DOI: 10.1007/s00784-023-05105-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/05/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To compare skeletal and dentoalveolar changes after orthodontic treatment of class II malocclusion in patients with hypodivergent and hyperdivergent growth patterns through cast splint fixed functional appliances (FFA). MATERIALS AND METHODS N = 42 out of n = 47 patients with mandibular plane angles < 34° or ≥ 34° were divided into a hypodivergent (n = 24) and a hyperdivergent (n = 18) group. All patients received a single-step mandibular advancement protocol through an FFA. Lateral cephalograms were analyzed after initial leveling and alignment (T1) and immediately after FFA removal (T2). The therapeutic effect was calculated through comparison with age-matched controls from a growth survey. Statistical significance was set at p < 0.05. RESULTS Hypodivergent and hyperdivergent patients showed different treatment outcomes, but significant differences existed only for overbite and interincisal angle. Nearly all measurements suggested similar treatment-related changes for both groups with exception for dentoalveolar parameters. CONCLUSION Treatment with FFA causes similar skeletal and dentoalveolar effects in hypodivergent and in hyperdivergent patients. The correction of overjet and molar relationship is mainly caused by dentoalveolar changes. CLINICAL RELEVANCE Hyperdivergent patients do not respond unfavorably to FFA treatment compared to hypodivergent patients. Lower incisor protrusion occurs more pronounced in hypodivergent patients. The growth pattern ought to be considered when choosing FFA for class II treatment.
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Affiliation(s)
- Jan Hourfar
- Department of Orthodontics, Saarland University, 66424, Homburg, Saar, Germany
| | | | - Linda Frye
- Department of Orthodontics, Saarland University, 66424, Homburg, Saar, Germany
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Santori F, Masedu F, Ciavarella D, Staderini E, Chimenti C, Tepedino M. Effect of Class II functional treatment on facial attractiveness, as perceived by professionals and laypeople. Sci Rep 2021; 11:13989. [PMID: 34234201 PMCID: PMC8263773 DOI: 10.1038/s41598-021-93343-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/14/2021] [Indexed: 11/23/2022] Open
Abstract
The literature offers different perspectives for and against two-phase treatment of skeletal Class II malocclusion. Facial attractiveness is an important aspect to take into account, given that children with skeletal Class II are often bullied by their peers and have low self-esteem and a lower social perception. The aim of the present study was to evaluate the aesthetic perception of facial profiles by a large number of observers, before and after treatment with a functional appliance, compared to untreated controls. The pre- and post-treatment cephalograms of 20 Class II subjects treated with Sander’s bite-jumping appliance and 20 untreated historical controls were collected and transformed into black and white silhouettes depicting only the lower third of the face. An online questionnaire comprising the silhouettes of the two groups, three “calibration” profiles and an “ideal” profile was submitted to dentists, orthodontists, undergraduates and laypeople, asking them to rate the profile’s attractiveness using a Visual Analogue Scale (VAS). The effect of treatment, and observers’ age, expertise and gender were analysed. The calibration images and the ideal profiles were used to evaluate the coherence of each observer’s judgement. The protocol was approved by the local Ethics Committee. Nine-hundred and ten questionnaires were collected. Treated subjects showed a larger improvement of facial attractiveness compared to controls. A significant effect of gender on the observer’s ratings was observed. Some observers showed incoherent judgement, which had a significant effect on the regression model. In conclusion, early treatment with functional appliances seems to improve patients’ facial aesthetics. This improvement is perceived equally by dental professionals and laypeople.
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Affiliation(s)
- Federica Santori
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, V.Le San Salvatore, Edificio Delta 6, 67100, L'Aquila, Italy
| | - Francesco Masedu
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, V.Le San Salvatore, Edificio Delta 6, 67100, L'Aquila, Italy
| | - Domenico Ciavarella
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
| | - Edoardo Staderini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Istituto di Clinica Odontoiatrica e Chirurgia Maxillo-Facciale, Rome, Italy
| | - Claudio Chimenti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, V.Le San Salvatore, Edificio Delta 6, 67100, L'Aquila, Italy
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, V.Le San Salvatore, Edificio Delta 6, 67100, L'Aquila, Italy
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Gazzani F, Franchi L, Lione R, Cozza P, Pavoni C. Soft tissue evaluation of functional therapy in growing patients with Class II malocclusion: a long-term study. Eur J Orthod 2021; 44:37-42. [PMID: 33740061 DOI: 10.1093/ejo/cjab008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of this study was to analyse the soft tissue changes produced by the functional treatment of mandibular advancement in growing Class II patients. MATERIALS The treated group consisted of 25 Caucasian patients (12 females and 13 males) with dento-skeletal Class II malocclusion treated with functional therapy (Activator). All patients were evaluated before treatment (T1; mean age, 9.9 years), at the end of functional treatment phase (T2; mean age, 11.9 years), and at a post-pubertal follow-up observation (T3; mean age, 18.5 years). The treated group was compared with a matched control group of 25 untreated subjects (13 females, 12 males) with untreated Class II division 1 malocclusion. Statistical comparisons between the two groups were performed with independent samples t-tests (P < 0.05). RESULTS Significant improvements were found during the long-term interval for mandibular sulcus (9.9°) and the profile facial angle (9.8°) in the treated group. No significant effects were found in terms of lower face percentage between the two groups. CONCLUSION Removable functional appliances induced positive effects on the soft tissue profile in Class II growing subjects with good stability in the long-term.
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Affiliation(s)
- Francesca Gazzani
- Department of System Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Lorenzo Franchi
- Department of Orthodontics, University of Florence, Italy. Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, USA
| | - Roberta Lione
- Department of System Medicine, University of Rome 'Tor Vergata', Rome, Department of Dentistry UNSBC, Tirana, Italy
| | - Paola Cozza
- University of Rome 'Tor Vergata', Department of Dentistry UNSBC, Tirana. Rome, Italy
| | - Chiara Pavoni
- Department of Clinical Sciences and Translational Medicine, University of Rome 'Tor Vergata', Department of Dentistry UNSBC, Tirana, Rome, Italy
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Evaluation of the Nasolabial Angle in Orthodontic Diagnosis: A Systematic Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11062531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: This study is a systematic literature review aiming at identifying the variation of the average nasolabial angle (NLA) in various orthodontic situations. The NLA is one of the key factors to be studied in an orthodontic diagnosis for the aesthetics of the nose and facial profile. Methods: Out of 3118 articles resulting from four search engines (PubMed, Cochrane Library, Turning Research Into Practice (TRIP) and SciELO), the final study allowed the analysis and comparison of only 26 studies. These included studies have considered the NLA in the following cases: teeth extraction, class II malocclusion, class III malocclusion, rapid palatal expansion (RPE), orthognathic surgery, and non-surgical rhinoplasty with a hyaluronic acid filler. Results: The results indicate that teeth extraction and the use of hyaluronic acid fillers significantly affect the NLA. Conclusions: This systematic review shows that a statistically significant change in NLA values occurs in: extractive treatments of all four of the first or second premolars in class I patients; in class II patients with upper maxillary protrusion; in patients with maxillary biprotrusion, except for cases of severe crowding; and in patients undergoing non-surgical rhinoplasty with a hyaluronic acid filler. Trial registration number: PROSPERO CRD42020185166
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Distalization in Orthodontics: A Review and Case Series. Case Rep Dent 2021; 2021:8843959. [PMID: 33542843 PMCID: PMC7843187 DOI: 10.1155/2021/8843959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 11/17/2022] Open
Abstract
Distalization is a conservative method that is utilized in orthodontics to gain space by moving posterior teeth distally. It may be combined with other space gaining strategies, such as expansion, or can be used alone. Many methods have been used for distalization. These methods differ significantly in their place, whether to be extraoral or intraoral, site of action in upper and/or lower arch, and cooperation needed by the patient if it is removable or fixed. This review illustrates some of the most commonly used methods for distalization with a brief presentation of three cases that incorporated successful distalization techniques.
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Hourfar J, Lisson JA, Kinzinger GSM. Changes of epiglottis and hyoid bone position after orthodontic treatment with cast splint fixed functional appliances. Clin Oral Investig 2021; 25:1525-1534. [PMID: 33409688 DOI: 10.1007/s00784-020-03460-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/10/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Angle Class II malocclusions including a retrognathic mandible are the most frequent orthodontic problems. Both removable and fixed functional appliances can be used for mandibular advancement. Mandibular advancement after treatment with any fixed functional appliance has numerous therapeutic effects, such as stretching of masticatory muscles, ligaments, membranes and surrounding soft tissues, thus causing positional changes of the hyoid bone and epiglottis. This retrospective study investigates and compares treatment effects upon epiglottis- and hyoid bone position and posterior airway space in class II patients who received mandibular advancement through two different cast splint fixed functional appliances. MATERIAL AND METHODS Two groups of 21 patients each ('Functional Mandibular Advancer' (FMA) and Herbst appliance) were investigated. The same experienced orthodontist performed the treatment in all patients, employing a single-step advancement protocol. The mandible always received initial protrusion into an edge-to-edge position. Conventional lateral cephalograms were available pre-treatment (T1) and immediately after appliance removal (T2) for all patients. The measurements comprised (I) hyoid bone, (II) epiglottis or (III) posterior airway space. Treatment-related changes were analysed with one-sample Student's t tests for intragroup comparisons and independent Student's t tests for intergroup comparisons. Statistical significance was set at p < 0.05. RESULTS Measurements of the hyoid bone showed mostly increases for both appliances after treatment. Intergroup comparisons were not significant for FMA patients but significant for selected measurements in Herbst appliance patients. Intergroup comparisons showed insignificant changes. The posterior airway space was always insignificantly increased after treatment. The greatest increase was found caudally. Intergroup comparisons showed insignificant changes. CONCLUSIONS Both fixed functional appliances cause an anterior and caudal displacement of epiglottis and hyoid bone and enlarge the posterior airway space. The therapeutic effects of the Herbst appliance are slightly larger, although not significantly. CLINICAL RELEVANCE Treatment with either Herbst appliance of FMA alters the hyoid bone position and enlarges the posterior airway space. Still, long-term data are as yet unavailable; it remains unknown if the effects upon posterior airway space remain stable, and if a resulting posterior airway space enlargement may have clinical influence upon obstructive sleep apnoea syndrome.
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Affiliation(s)
- Jan Hourfar
- Department of Orthodontics, Saarland University, Homburg/Saar, Germany.
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Güler ÖÇ, Malkoç S. Comparison of facial soft tissue changes after treatment with 3 different functional appliances. Am J Orthod Dentofacial Orthop 2020; 158:518-526. [PMID: 32988567 DOI: 10.1016/j.ajodo.2019.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to evaluate the effects of 3 different fixed or removable functional appliances on the soft tissue changes in patients with Class II Division 1 malocclusion using 3-dimensional images. METHODS A total of 60 patients with Class II Division 1 malocclusion (38 girls and 22 boys; mean age, 12.35 ± 1.01 years) were treated with 3 different functional appliances, namely, Twin-block (TB) (group TB, n = 20), mono-block (MB) (group MB, n = 20), or Herbst (H) (group H, n = 20) for 9.55 ± 1.46 months. Three-dimensional photographs of each patient were taken at the baseline and the end of the therapy with a 3dMD Face system (3dMD, Atlanta, Ga). Statistical analyses were performed using the dependent samples t test, 1-way analysis of variance, Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed rank tests. RESULTS No statistically significant differences were detected for soft tissue changes except for the lower facial width found, at least in group H (P <0.05). Volumetric differences in the mandible were similar between the groups (P >0.05). A statistically significant decrease in total facial height and an increase in convexity angle and facial depth were detected in all groups after treatment compared with the baseline (P <0.05). The upper and lower facial height, lower lip height, and nasal width were statistically significantly increased in the TB and MB groups after treatment compared with the baseline (P <0.05) and similar to those in group H (P >0.05). CONCLUSIONS TB, MB, and H appliances may promote the facial soft tissue profile, including volumetric improvement, in the mandibular region.
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Affiliation(s)
- Özge Çelik Güler
- Department of Orthodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
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Martina S, Di Stefano ML, Paduano FP, Aiello D, Valletta R, Paduano S. Evaluation of Profile Changes in Class II Individuals Treated by Means of Herbst Miniscope Appliance. Dent J (Basel) 2020; 8:dj8010027. [PMID: 32244893 PMCID: PMC7175301 DOI: 10.3390/dj8010027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 11/16/2022] Open
Abstract
Background: To evaluate the profile changes following orthopedic/orthodontic treatment with the Herbst Miniscope® appliance in subjects affected with Class II malocclusion with mandibular retrusion. Methods: A total of 44 patients presenting a skeletal Angle Class II malocclusion (ANB > 4°) due to mandibular retrusion and a cervical maturation stage between CS2 and CS3 were included in the study. Of these 44 patients, 22 (mean age 11.9 ± 1.3, HBT group) were treated using the Herbst appliance, while 22 (mean age 10.6 ± 1.3, CTR group) were followed for a 12-month observational period. A cephalometric tracing was performed at the beginning of treatment (T0) and after 12 months (T1). Results: In both groups there was a significant advancement of soft tissue pogonion (HBT = 3.5 ± 3.0 mm, p < 0.001; CTR = 2.2 ± 2.9 mm, p < 0.001), but the difference between the two groups was not significant (p = 0.172). On the contrary, both groups had a significant advancement of the mandibular sulcus (HBT = 3.7 ± 2.8 mm, p < 0.001; CTR = 1.2 ± 2.2 mm, p < 0.001) and a lower lip protrusion (HBT = 3.45 ± 2.51 mm, p < 0.001; CTR = 1.7 ± 2.7 mm, p = 0.008), but in both cases the HBT group showed a statistically significant greater increase in sulcus protrusion (p = 0.002) and lower lip protrusion (p = 0.029) than controls. There were no statistically significant effects on the upper jaw. Conclusions: The Herbst appliance advanced the lower jaw soft tissues.
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Affiliation(s)
- Stefano Martina
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi SA, Italy;
| | - Maria Luisa Di Stefano
- Department of Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro CZ, Italy; (M.L.D.S.); (S.P.)
| | | | - Domenico Aiello
- Department of Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro CZ, Italy; (M.L.D.S.); (S.P.)
- Correspondence:
| | - Rosa Valletta
- Discipline of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences University of Naples “Federico II”, 80131 Napoli NA, Italy;
| | - Sergio Paduano
- Department of Health, University “Magna Graecia” of Catanzaro, 88100 Catanzaro CZ, Italy; (M.L.D.S.); (S.P.)
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Treatment compliance of adolescent orthodontic patients with headgear activator and twin-block appliance assessed prospectively using microelectronic wear-time documentation. Eur J Orthod 2020; 42:180-186. [DOI: 10.1093/ejo/cjaa001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Summary
Background
Success of orthodontic removable appliance treatment relies on patient compliance. The aim of this quantitative and qualitative study was to explore the compliance and self-reported experience of adolescents in orthodontic treatment with headgear activator (HGA) or twin-block (TB) appliance.
Materials/methods
The study group comprised 52 adolescents with a mean age of 12.6 (±1.3) years at the start of the treatment. The patients were treated at a free-of-charge public dental clinic. Participants were randomly allocated to two equal groups to be treated with either HGA or TB. Patient compliance was evaluated as appliance wear time and subjective experience. Appliance wear time was recorded with Theramon® microchip, and the self-reported subjective experience using a questionnaire.
Results
In total, 30 patients completed the treatment during the follow-up period. HGA was worn on average 7 hours per day and TB 9 hours per day by those patients, who successfully completed the treatment. During a mean observation period of 13 months (range 7–23 months), the mean actual wear time was 43 per cent less than the advised 12 or 18 hours per day in the whole patient group, and 55 per cent in those patients, who completed the treatment. Compliance level was unrelated to the appliance type.
Limitations
Study assessed a relatively small number of patients.
Conclusions/implications
Adolescent patients wear HGA and TB less than advised. Individual variation in treatment adherence is considerable. Thereby, microelectronic wear-time documentation can be a cost-effective mean of identifying non-compliance.
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Tepedino M, Della Noce MV, Ciavarella D, Gallenzi P, Cordaro M, Chimenti C. Soft-tissue changes after Class II malocclusion treatment using the Sander bite-jumping appliance: a retrospective study. ACTA ACUST UNITED AC 2019; 68:118-125. [PMID: 31014061 DOI: 10.23736/s0026-4970.19.04197-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The soft tissue profile outcome after functional treatment of Class II malocclusion is important for a patient's aesthetic and psychosocial results. The soft tissue effects of the Sander bite-jumping appliance (BJA), which is the device that produces the greatest mandibular advancement according to a systematic review, have never been investigated. The aim of the present study was to assess the soft tissue effects of the BJA in comparison to matched untreated controls. METHODS A total of 19 patients treated with BJA during puberty were retrospectively recruited, and 15 untreated controls were retrieved from a previous growth study to match the treated group. Lateral cephalograms were used to evaluate the pre- and post-treatment differences in the ANB angle, the inclination of the upper and lower incisors, facial convexity, the nasolabial angle and the sagittal position of the skeletal and soft tissue at points A and B. Independent t-tests or Mann-Whitney U tests were used to detect differences between the two groups. RESULTS Statistically significant differences were found for the ANB angle, the inclination of the upper incisors and facial convexity. CONCLUSIONS Functional treatment of Class II patients with the Sander BJA during puberty was effective at improving the profile and reducing the facial convexity angle in the short term.
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Affiliation(s)
- Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy -
| | - Maria V Della Noce
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Domenico Ciavarella
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Patrizia Gallenzi
- Institute of Dental Clinic and Maxillofacial Surgery, A. Gemelli University Policlinic IRCCS Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Massimo Cordaro
- Institute of Dental Clinic and Maxillofacial Surgery, A. Gemelli University Policlinic IRCCS Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Claudio Chimenti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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