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Cardarelli F, Drago S, Rizzi L, Bazzani M, Pesce P, Menini M, Migliorati M. Effects of Removable Functional Appliances on the Dentoalveolar Unit in Growing Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:746. [PMID: 38792929 PMCID: PMC11123302 DOI: 10.3390/medicina60050746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: The objective of this retrospective controlled study is to compare class II growing patients who underwent treatment with two different functional appliances: the Fraenkel regulator (FR-2), utilized as the control group, and the elastodontic device "Cranium Occluded Postural Multifunctional Harmonizers" (AMCOP), utilized as the test group. Materials and Methods: The study sample consisted of 52 patients with class II division I malocclusion (30 males, 22 females, mean age 8.6 ± 1.4 years) who were treated with the two different types of appliances: Group 1 (n = 27, mean age 8 [7.00, 9.00] years, 12 females, 15 males) received treatment with AMCOP, while Group 2 (n = 25, mean age 9.2 years [8.20, 10.00], 10 females, 15 males) received treatment with FR-2. The mean treatment duration for Group 1 was 28.00 [21.50, 38.00] months, while for Group 2 it was 23.70 [17.80, 27.40] months. Cephalometric analyses were performed on lateral cephalograms taken before treatment (T1) and after treatment (T2). Results: Significant intragroup differences were observed over time in Group 1 for 1^/PP. Similarly, significant intragroup differences were observed over time in Group 2 for SNB, ANB, and IMPA. Conclusions: Both treatment modalities resulted in the correction of class II malocclusion with dentoalveolar compensation, although the treatment duration with AMCOP tended to be longer on average.
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Affiliation(s)
- Filippo Cardarelli
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy;
| | - Sara Drago
- Department of Surgical Sciences and Integrated Diagnostics (DISC), Genova University, 16132 Genoa, Italy; (S.D.); (P.P.); (M.M.)
| | - Luigi Rizzi
- School of Dentistry, Genova University, 16126 Genoa, Italy; (L.R.); (M.B.)
| | - Martina Bazzani
- School of Dentistry, Genova University, 16126 Genoa, Italy; (L.R.); (M.B.)
| | - Paolo Pesce
- Department of Surgical Sciences and Integrated Diagnostics (DISC), Genova University, 16132 Genoa, Italy; (S.D.); (P.P.); (M.M.)
| | - Maria Menini
- Department of Surgical Sciences and Integrated Diagnostics (DISC), Genova University, 16132 Genoa, Italy; (S.D.); (P.P.); (M.M.)
| | - Marco Migliorati
- Department of Surgical Sciences and Integrated Diagnostics (DISC), Genova University, 16132 Genoa, Italy; (S.D.); (P.P.); (M.M.)
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Har Zion G, Katzhendler E, Bader Farraj A, Rabin M, Einy S. Evaluating the Effects of Carriere Motion Appliance and Twin Block Appliances in Class II Correction-A Retrospective Study. Dent J (Basel) 2024; 12:119. [PMID: 38786517 PMCID: PMC11119562 DOI: 10.3390/dj12050119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/28/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
This retrospective study compared Class II orthodontic non-extraction treatment using Carriere Motion Appliance (CMA) and Twin Block (TB) appliances. METHODS The treatment of 38 patients was assessed. Pre- and post-treatment cephalometric radiographs were analyzed to evaluate skeletal, dental, and soft tissue treatment outcomes and efficacy. RESULTS Both appliances effectively corrected the Class II molar relationship. When measured at the distal aspect of the first molar, TB achieved 4.22 mm, while CMA had a 2.55 mm correction. When measured in the mesial aspect, the CMA achieved a 3.9 mm correction. The changes in SNB and ANB were statistically significant only in the TB group. The CMA appliance demonstrated statistically significantly less protrusion of the mandibular incisors and less upper incisor retrusion without vertical changes compared to the TB appliance. The TB demonstrated statistically significant lower lip protrusion compared to the CMA. CONCLUSION The CMA corrects Class II malocclusions only by exerting a dentoalveolar influence and does not demonstrate the added effects associated with TB, such as elongation of lower facial height (LFH) and less loss of lower anchorage. Nonetheless, the correction in the TB group comprised both dentoalveolar and skeletal components. The CMA promotes a multidirectional upper and lower molar movement, and despite our 2D cephalometric analysis, we were able to estimate the extent of upper molar derotation.
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Affiliation(s)
- Gilad Har Zion
- Private Practice of Orthodontics, Alfasi 19 St., Jerusalem 9230209, Israel;
| | - Eyal Katzhendler
- Department of Orthodontics, Faculty of Dental Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem 91120, Israel;
| | - Amal Bader Farraj
- Galilee College of Dental Sciences, Department of Orthodontics, Galilee Medical Center, Nahariya 2210001, Israel; (A.B.F.); (M.R.)
| | - Miryam Rabin
- Galilee College of Dental Sciences, Department of Orthodontics, Galilee Medical Center, Nahariya 2210001, Israel; (A.B.F.); (M.R.)
| | - Shmuel Einy
- Galilee College of Dental Sciences, Department of Orthodontics, Galilee Medical Center, Nahariya 2210001, Israel; (A.B.F.); (M.R.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 5290002, Israel
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Feng Q, Jiang F, Wang H, Shen G, Zhao Z, Jiang L, Jiang C, Fan Q, Zhu J, Pan P, Huang W, Li J. Evaluation of modified clear Twin Block aligner in treating adolescents with skeletal class II malocclusion: A two-centre cephalometric study. Orthod Craniofac Res 2024. [PMID: 38558502 DOI: 10.1111/ocr.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/24/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION The purpose of this study was to evaluate the therapeutic effect of modified clear Twin Block (CTB) aligner and traditional twin block (TB) appliance from skeletal, dentoalveolar and soft tissue changes in adolescents with skeletal class II malocclusion. METHODS A total of 80 adolescents, included in this study from two medical centres, were distributed into CTB group, TB group and control group based on the treatment they received. Lateral cephalograms at pre-treatment (T1) and post-treatment (T2) were measured by modified Pancherz's cephalometric analysis, and dentoskeletal and soft tissue changes were analysed by independent-sample t-test, paired-sample t-test, ANOVA test and Scheffe's Post Hoc test. RESULTS Seventy-five adolescents completed the study, including 32 in the CTB group, 32 in the TB group and 11 in the control group. Both CTB and TB treatment showed significant differences in most dentoskeletal and soft tissue measurements. Compared with the control group, improvements were observed in class II molar relationship through significant different in S Vert/Ms-S Vert/Mi in the CTB group (P < .01) and the TB group (P < .001), as well as deep overjet through significant different in S Vert/Is-S Vert/Ii in the CTB group (P < .001) and the TB group (P < .001). Besides, the CTB group also showed less protrusion of lower incisors and resulted in a more significant improvement in profile with fewer adverse effects on speaking, eating and social activities. CONCLUSIONS For adolescents with skeletal class II malocclusion, CTB appliance was as effective as TB on improving dentoskeletal and soft tissue measurements, featuring more reliable teeth control and patient acceptance.
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Affiliation(s)
- Qingchen Feng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fulin Jiang
- Chongqing University Three Gorges Hospital, Chongqing, China
| | - Huixia Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Gang Shen
- Taikang Bybo Dental Hospital, Shanghai, China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lingyong Jiang
- Center of Craniofacial Orthodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Jiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qi Fan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jinyi Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peiyue Pan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenlong Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Juan Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Gómez-Gómez SL, Sánchez-Uribe LA, Villarraga-Ossa JA, Llano-Posada MC, Guzmán-Velásquez Y, Arango-Hincapie CA, Ardila CM. A finite element study comparing Advansync® and Twin Block in mandibular anterior repositioning. Orthod Craniofac Res 2024. [PMID: 38247223 DOI: 10.1111/ocr.12758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
OBJECTIVE This study aims to utilize the finite element method (FEM) to compare the dentoalveolar and mandibular effects associated with anterior mandibular repositioning using AdvanSync® (ADV) and Twin Block (TB). METHODS A patient with Class II skeletal malocclusion and mandibular retrognathism was selected. A TB appliance was subsequently applied. Computed Tomography (CT) scans were acquired at the beginning of treatment (T1) and 8 months later (T2). Concurrently, a numerical TB model was validated through FEM simulations, which were compared with the T2 results. The ADV appliance was virtually simulated to evaluate stress and deformation on the condyle, symphysis, first lower molar and lower central incisors. RESULTS Both simulations demonstrated significant mandibular advancement. However, ADV led to less incisor proclination and more molar intrusion compared to TB. ADV exhibited increased stress in the lower molar area, while TB had higher stress in the lower incisor region. Stress and deformations in the condyle and mandibular symphysis were similar in both simulations, with the highest stress observed at the condylar neck and the lowest at the upper pole of the condylar head. CONCLUSIONS Both appliances achieved similar levels of mandibular advancement, with greater proclination of the lower central incisors and more widespread distribution of stress and molar intrusion when using ADV compared to TB.
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Affiliation(s)
| | | | | | | | - Yeison Guzmán-Velásquez
- Department of Orthodontics, School of Dentistry, University of Antioquia, Medellín, Colombia
| | | | - Carlos M Ardila
- Biomedical Stomatology Research Group, School of Dentistry, University of Antioquia, Medellín, Colombia
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Liu A, Zhang W, Zhang W, Shi S, Chen Z, Liu Y, Lu Y. Efficacy of a modified twin block appliance compared with the traditional twin block appliance in children with hyperdivergent mandibular retrognathia: protocol for a single-centre, single-blind, randomised controlled trial. BMJ Open 2023; 13:e071959. [PMID: 38011986 PMCID: PMC10685957 DOI: 10.1136/bmjopen-2023-071959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Compensatory mouth breathing, caused by nasopharyngeal obstructive diseases, is the main cause of hyperdivergent mandibular retrognathia in children. Such deformities require effective growth guidance before pubertal growth peaks. The traditional mandibular advancement device, twin block (TB), can guide the forward development of the mandible. However, the side effect of increasing the vertical dimension of the lower facial third, worsens the facial profile of children with divergent growth trends. To solve this problem, a modified TB (LLTB) appliance was designed to control the vertical dimension by intruding incisors and inhibiting the elongation of posterior teeth during the advancement of the mandible, which could avoid the side effects of traditional appliances and effectively guide the growth of the mandible in a normal direction. METHODS AND ANALYSIS The study was designed as a single-centre, single-blind, randomised, parallel controlled trial. We aim to enrol 60 children aged 9-14 years with hyperdivergent skeletal class II malocclusion, using a 1:1 allocation ratio. The participants were will be randomly assigned to receive either the TB or LLTB treatment. The primary outcome will be a change in the angle of the mandibular plane relative to the anterior cranial base. The secondary outcomes will include changes in the sagittal maxillomandibular relation, occlusal plane, facial height, morphology of the mandible and upper airway width. Safety endpoints will also be evaluated. ETHICS AND DISSEMINATION Ethical approval was obtained from the ethics committee of Shanghai Stomatological Hospital. Both participants and their guardians will be fully informed of the study and sign an informed consent form before participating in the trial. The results will be publicly available in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER ChiCTR2000035882.
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Affiliation(s)
- Anqi Liu
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai, China
| | - Wei Zhang
- Biomedical Informatics & Statistics Center, School of Public Health, Fudan University, Shanghai, China
| | - Weihua Zhang
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai, China
| | - Shuangshuang Shi
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai, China
| | - Zhuoyue Chen
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai, China
| | - Yuehua Liu
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai, China
| | - Yun Lu
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai, China
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