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AlMogbel A, Alshawy ES, Alhusainy A. Efficacy of clear aligner therapy over conventional fixed appliances in controlling orthodontic movement: A systematic review. J Orthod Sci 2024; 13:23. [PMID: 38784075 PMCID: PMC11114459 DOI: 10.4103/jos.jos_176_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/10/2023] [Accepted: 01/03/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The purpose of the current systematic review was to answer the clinical research question "Is Clear Aligner Therapy (CAT) effective in controlling the orthodontic movement?" by bringing together the most up-to-date information about the available evidence for CAT. METHODOLOGY On January 1, 2023, a search was conducted in PubMed, ERIC, Embase, and CINHAL for any research papers published in the previous 10 years that provided an overview of the PICO questions. Both the titles and abstracts of the selected studies were evaluated independently by two different authors, and if there was any disagreement between the two review authors, a third reviewer was brought in to settle it. RESULTS Among included studies, three were retrospective non-randomized and two studies were prospective randomized clinical trials. Various authors reported better outcome for fixed orthodontic appliances than for clear aligner treatment (CAT) in relation to mandibular incisor proclination. The mean objective grading system score was better for braces (17) than for CAT (12) with no clinically significant difference, while staging had a significant impact on treatment efficacy. CONCLUSION The results of this study suggest that clear aligners may be an effective alternative to traditional braces, but more research is needed to confirm these findings and determine the optimal size of future prospective studies evaluating this treatment.
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Affiliation(s)
- AbdulMajeed AlMogbel
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| | - Ebrahim S. Alshawy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| | - Abdulmageed Alhusainy
- Department of Conservative Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
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Balboni A, Cretella Lombardo E, Balboni G, Gazzani F. Vertical effects of distalization protocol with Clear aligners in Class II patients: a prospective study. Minerva Dent Oral Sci 2023; 72:291-297. [PMID: 37162331 DOI: 10.23736/s2724-6329.23.04783-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND The aim of the present prospective study was to detect the effects on vertical dentoskeletal dimension produced by molar distalization with Clear Aligners in a group of subjects with Class II malocclusion. METHODS The Clear Aligners Group (CAG) comprised 20 patients (13 females, seven males) with a mean age of 17.2±3.2 years. The same standardized protocol of sequential distalization was applied in all subjects. For each patient lateral cephalograms have been analyzed before treatment (T1) and at the end of the therapy (T2). RESULTS At the end of treatment, clear aligners were effective in the correction of Class II dental relationship with the correction of the overjet (-1.3 mm). The treated group showed statistically significant reduction in FMA angle (-1.3°) associated with a counterclockwise rotation of the occlusal plane (POccl^PF -3.1°; SN^POccl -4.2°) and a slight intrusion of maxillary first molars to palatal plane (-0.9 mm). Finally, statistically significant differences were detected in anterior facial height (N-Me) and in the ArGo^GoMe angle (-1.2 mm and -3.4°, respectively). CONCLUSIONS Upper molar distalization with clear aligners represents a valid alternative to non-extraction treatment of Class II malocclusion, reducing the extrusion of maxillary first molars and improving the control of the occlusal plane and of the vertical dimension.
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Affiliation(s)
- Alessia Balboni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy -
| | | | - Giulia Balboni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
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Lione R, Balboni A, Di Fazio V, Pavoni C, Cozza P. Effects of pendulum appliance versus clear aligners in the vertical dimension during Class II malocclusion treatment: a randomized prospective clinical trial. BMC Oral Health 2022; 22:441. [PMID: 36217134 PMCID: PMC9552402 DOI: 10.1186/s12903-022-02483-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/28/2022] [Indexed: 11/11/2022] Open
Abstract
Background The aim of the present study was to compare the effects on vertical dentoskeletal dimension produced by Pendulum appliance and Clear Aligners in patients with Class II malocclusion.
Trial design This is a prospective two-arm parallel group randomized clinical trial with 1:1 allocation ratio. Methods The Pendulum Group (PG) consisted of 20 patients (15F, 5 M) with a mean age of 17.2 ± 4.3 years. The Clear Aligners Group (CAG) comprised 20 patients (13F, 7 M) with a mean age of 17.2 ± 3.2 years. Distalization’s protocol in PG involved the activation of TMA wires till the achievement of Class I molar relationship. A protocol of sequential distalization was applied in the CAG. For each subject lateral cephalograms have been analyzed before treatment (T1) and at the end of the therapy (T2). Descriptive statistics and statistical between-group comparisons (PG vs CAG) were calculated for the craniofacial starting forms at T1 and for the T2–T1 changes. Statistical between-group comparisons for the T2–T1 changes were performed with independent samples t-tests (P < 0.05).
Results The PG showed significantly greater increases in SN^GoGn° when compared with CAG (+ 2.1 and − 0.3 degrees, respectively). Clockwise rotation of the occlusal plane with significantly greater increase of SN^POccl angle was observed in PG (+ 2.8 degrees) when compared with CAG (− 4.2 degrees). The PG revealed a significant increase in the N-Me variable with a mean change of + 4.4 mm compared to the CAG with mean values of − 1.2 mm. The PG showed an increase in the ArGo^GoMe angle (+ 0.7° degrees) compared to the CAG (− 3.4° degrees). The PG showed significantly greater increases in both maxillary and mandibular first molar to palatal plane (+ 1.3 and + 2.1 mm, respectively) when compared with CAG (− 0.9 and − 0.2 mm, respectively).
Conclusions Upper molar distalization with clear aligners represents a valid alternative to non-extraction treatment of Class II malocclusion, reducing the extrusion of maxillary first molars and improving the management of the occlusal plane and vertical dimension. Trial registration: ClinicalTrials.gov, NCT05298280. Registered 28 March 2022—Retrospectively registered, https://clinicaltrials.gov.
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Affiliation(s)
- Roberta Lione
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy. .,Department of Dentistry, UNSBC, Tirana, Albania. .,Department of Faculty of Medicine and Surgery, UniCamillus International Medical University, Rome, Italy.
| | - Alessia Balboni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy
| | - Valentina Di Fazio
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy
| | - Chiara Pavoni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy.,Department of Dentistry, UNSBC, Tirana, Albania
| | - Paola Cozza
- Department of Dentistry, UNSBC, Tirana, Albania.,Department of Faculty of Medicine and Surgery, UniCamillus International Medical University, Rome, Italy
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Verma P, George AM. Efficacy of clear aligners in producing molar distalization: Systematic review. APOS TRENDS IN ORTHODONTICS 2022. [DOI: 10.25259/apos_37_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
The aim of this review is to systematically analyze the efficacy of molar distalization using clear aligners in non-growing Class II patients.
Materials and Methods:
A complete search across the electronic database through PubMed, Cochrane, Google scholar, LILACS, and manual search of orthodontic journals were done till 2019. Studies were selected on the basis of PRISMA guidelines.
Results:
A total of four articles were included in this review. The amount of molar distalization reported was 2–3 mm.
Conclusion:
Out of the four studies included. In all the studies a significant amount of distalization was reported. Three retrospective studies concluded that distalization with aligners is the most effective of all tooth movements. One study concluded that aligners effectively achieved distalization with an efficacy of 87%, other two studies concluded that aligners effectively distalized the molars with good control over vertical dimension and mesiodistal tipping.
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Affiliation(s)
- Purva Verma
- Department of Orthodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India,
| | - Ashwin Mathew George
- Department of Orthodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India,
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Turner S, Harrison JE, Sharif FN, Owens D, Millett DT. Orthodontic treatment for crowded teeth in children. Cochrane Database Syst Rev 2021; 12:CD003453. [PMID: 34970995 PMCID: PMC8786262 DOI: 10.1002/14651858.cd003453.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Crowded teeth develop when there is not enough space in the jaws into which the teeth can erupt. Crowding can affect baby teeth (deciduous dentititon), adult teeth (permanent dentition), or both, and is a common reason for referral to an orthodontist. Crowded teeth can affect a child's self-esteem and quality of life. Early loss of baby teeth as a result of tooth decay or trauma, can lead to crowded permanent teeth. Crowding tends to increase with age, especially in the lower jaw. OBJECTIVES To assess the effects of orthodontic intervention for preventing or correcting crowded teeth in children. To test the null hypothesis that there are no differences in outcomes between different orthodontic interventions for preventing or correcting crowded teeth in children. SEARCH METHODS Cochrane Oral Health's Information Specialist searched four bibliographic databases up to 11 January 2021 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated any active interventions to prevent or correct dental crowding in children and adolescents, such as orthodontic braces or extractions, compared to no or delayed treatment, placebo treatment or another active intervention. The studies had to include at least 80% of participants aged 16 years and under. DATA COLLECTION AND ANALYSIS Two review authors, independently and in duplicate, extracted information regarding methods, participants, interventions, outcomes, harms and results. We resolved any disagreements by liaising with a third review author. We used the Cochrane risk of bias tool to assess the risk of bias in the studies. We calculated mean differences (MDs) with 95% confidence intervals (CI) for continuous data and odds ratios (ORs) with 95% CIs for dichotomous data. We undertook meta-analysis when studies of similar comparisons reported comparable outcome measures, using the random-effects model. We used the I2 statistic as a measure of statistical heterogeneity. MAIN RESULTS Our search identified 24 RCTs that included 1512 participants, 1314 of whom were included in analyses. We assessed 23 studies as being at high risk of bias and one as unclear. The studies investigated 17 comparisons. Twenty studies evaluated fixed appliances and auxiliaries (lower lingual arch, lower lip bumper, brackets, archwires, lacebacks, headgear and adjunctive vibrational appliances); two studies evaluated removable appliances and auxiliaries (Schwarz appliance, eruption guidance appliance); and two studies evaluated dental extractions (lower deciduous canines or third molars). The evidence should be interpreted cautiously as it is of very low certainty. Most interventions were evaluated by a single study. Fixed appliances and auxiliaries One study found that use of a lip bumper may reduce crowding in the early permanent dentition (MD -4.39 mm, 95% CI -5.07 to -3.71; 34 participants). One study evaluated lower lingual arch but did not measure amount of crowding. One study concluded that coaxial nickel-titanium (NiTi) archwires may cause more tooth movement in the lower arch than single-stranded NiTi archwires (MD 6.77 mm, 95% CI 5.55 to 7.99; 24 participants). Another study, comparing copper NiTi versus NiTi archwires, found NiTi to be more effective for reducing crowding (MD 0.49 mm, 95% CI 0.35 to 0.63, 66 participants). Single studies did not show evidence of one type of archwire being better than another for Titinol versus Nitinol; nickel-titanium versus stainless steel or multistrand stainless steel; and multistranded stainless steel versus stainless steel. Nor did single studies find evidence of a difference in amount of crowding between self-ligating and conventional brackets, active and passive self-ligating brackets, lacebacks added to fixed appliances versus fixed appliances alone, or cervical pull headgear versus minor interceptive procedures. Meta-analysis of two studies showed no evidence that adding vibrational appliances to fixed appliances reduces crowding at 8 to 10 weeks (MD 0.24 mm, 95% CI -0.81 to 1.30; 119 participants). Removable appliances and auxiliaries One study found use of the Schwarz appliance may be effective at treating dental crowding in the lower arch (MD -2.14 mm, 95% CI -2.79 to -1.49; 28 participants). Another study found an eruption guidance appliance may reduce the number of children with crowded teeth after one year of treatment (OR 0.19, 95% CI 0.05 to 0.68; 46 participants); however, this may have been due to an increase in lower incisor proclination in the treated group. Whether these gains were maintained in the longer term was not assessed. Dental extractions One study found that extracting children's lower deciduous canines had more effect on crowding after one year than no treatment (MD -4.76 mm, 95 CI -6.24 to -3.28; 83 participants), but this was alongside a reduction in arch length. One study found that extracting wisdom teeth did not seem to reduce crowding any more than leaving them in the mouth (MD -0.30 mm, 95% CI -1.30 to 0.70; 77 participants). AUTHORS' CONCLUSIONS Most interventions were assessed by single, small studies. We found very low-certainty evidence that lip bumper, used in the mixed dentition, may be effective for preventing crowding in the early permanent dentition, and a Schwarz appliance may reduce crowding in the lower arch. We also found very low-certainty evidence that coaxial NiTi may be better at reducing crowding than single-stranded NiTi, and that NiTi may be better than copper NiTi. As the current evidence is of very low certainty, our findings may change with future research.
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Affiliation(s)
- Sarah Turner
- Orthodontic Department, Liverpool University Dental Hospital, Liverpool, UK
| | - Jayne E Harrison
- Orthodontic Department, Liverpool University Dental Hospital, Liverpool, UK
| | | | - Darren Owens
- Orthodontic Department, Liverpool University Dental Hospital, Liverpool, UK
| | - Declan T Millett
- Oral Health and Development, Cork University Dental School and Hospital, Cork, Ireland
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Freitas KMS, Massaro C, Miranda F, de Freitas MR, Janson G, Garib D. Occlusal changes in orthodontically treated subjects 40 years after treatment and comparison with untreated control subjects. Am J Orthod Dentofacial Orthop 2021; 160:671-685. [PMID: 34493418 DOI: 10.1016/j.ajodo.2020.05.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The objective of this study was to compare the aging changes of the dental arches in orthodontically treated and untreated subjects after a 4-decade follow-up period. METHODS This retrospective study analyzed 2 groups. The treated group comprised 29 patients (11 male, 18 female) presenting with Class I or Class II malocclusions orthodontically treated with extractions of 4 first premolars. Dental models taken at pretreatment (12.84 years), posttreatment (14.95 years), and long-term posttreatment (51.37 years) were evaluated. The untreated (control) group consisted of 22 untreated patients with dental models taken at 13.32, 17.82, and 60.95 years of age. The dental models were digitized, and the following variables were evaluated: Little irregularity index, intercanine, interpremolar and intermolar widths, arch length, arch perimeter, overjet, and overbite. Interphase comparison of the treated group was performed with repeated measures analysis of variance and Tukey tests. Intergroup comparisons were performed using t tests (P <0.05). RESULTS Crowding was corrected with treatment but relapsed significantly in the long term. Intercanine width increased with treatment and decreased in the long term. Interpremolar and intermolar widths, arch perimeter, and length decreased with treatment and continued to decrease long-term posttreatment. Overjet and overbite were corrected with treatment and remained stable in the long term. From posttreatment to long-term posttreatment, a greater crowding increase was observed in the treated group than in the untreated group. The treated group demonstrated a greater decrease in mandibular intercanine and maxillary and mandibular interpremolar widths than the untreated sample. Overbite increased in the treated group and decreased in the untreated group. The multiple regression analysis showed that previous 4-premolar extractions orthodontic treatment is significantly associated with anterior crowding in the long term. CONCLUSIONS In the long-term, the treated patients showed relapse of crowding and a decrease in arch form. Long-term changes of treated patients were different from untreated subjects. Relapse might have contributed to greater changes in incisor crowding and arch widths observed in the treated patients.
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Affiliation(s)
- Karina Maria Salvatore Freitas
- Department of Orthodontics, Uningá University Center, Maringá, Paraná, Brazil; Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Felicia Miranda
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Daniela Garib
- Department of Orthodontics, Bauru Dental School, and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
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Talvitie T, Helminen M, Karsila S, Pirttiniemi P, Signorelli L, Varho R, Peltomäki T. Effects of force magnitude on dental arches in cervical headgear therapy. Eur J Orthod 2021; 44:146-154. [PMID: 34369566 PMCID: PMC10084716 DOI: 10.1093/ejo/cjab051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To study the influence of different force magnitudes on dental arches in cervical headgear (CHG) treatment. MATERIAL AND METHODS In this controlled clinical trial, patients (n = 40) were treated with CHG with light (L, 300 g, n = 22) or heavy force (H, 500 g, n = 18) magnitude. Subjects were asked to use CHG for 10 hours a day for 10 months. The outer bow of the CHG facebow was raised 10-20 degrees and the inner bow expanded 3-4 mm. Adherence to instructions and force magnitude were monitored with an electronic module (Smartgear, Swissorthodontics, Switzerland). Impressions for study models were taken before (T1) and after (T2) treatment and the study models were scanned into digital form (3Shape, R700 Scanner, Denmark). Measurements were made using the digital models (Planmeca Romexis, Model analyser, Finland). RESULTS During the treatment (T1-T2) the upper inter-canine distance increased by 2.83 mm (P = 0.000) and 2.60 mm (P = 0.000) in the L and H force magnitude groups, respectively. Upper inter-molar width increased by 3.16 mm (P = 0.000) and 2.50 mm (P = 0.000) in the L and H groups, respectively. Maxillary total arch perimeter increased by 6.39 mm (P = 0.001) and 6.68 mm (P = 0.001) in the L and H groups, respectively. In the amount of change over time, T1-T2, in the upper arch measurements, no significant difference was found between the groups. Lower inter-canine width increased by 0.94 mm (P = 0.005) and 1.16 mm (P = 0.000) in the L and H groups, respectively; no difference between the groups. Lower inter-molar distance increased by 2.17 mm (P = 0.000) and 1.11 mm (P = 0.008) in the L and H groups, respectively. At the end of the study, upper and lower inter-molar width was larger in the L group than in the H group (P = 0.039 and P = 0.022, respectively). CONCLUSION CHG therapy is an effective method for expanding and releasing moderate crowding of the upper dental arch. The lower arch spontaneously follows the upper arch in widening effects, and minor expansion can also be seen on the lower arch. In the L group, larger inter-molar width was achieved on the upper and lower arch; probably due to better adherence to instructions. Light force is recommended for use in CHG therapy.
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Affiliation(s)
- Tuula Talvitie
- Vaasa Social Services and Health Care Division, Dental Service, Vaasa, Finland.,Faculty of Health Sciences, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Mika Helminen
- Tays Research Services, Tampere University Hospital, Finland.,Faculty of Social Sciences, Health Sciences, Tampere University, Finland
| | - Susanna Karsila
- Turku Municipal Health Care Services, Dental Teaching Unit, Turku, Finland
| | - Pertti Pirttiniemi
- Department of Oral Development and Orthodontics, Research Unit of Oral Health Sciences, University of Oulu, Finland.,Medical Research Center, Oulu University Hospital, Finland
| | | | - Reeta Varho
- Turku Municipal Health Care Services, Dental Teaching Unit, Turku, Finland
| | - Timo Peltomäki
- Faculty of Health Sciences, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Faculty of Medicine and Health Technology, Tampere University, Finland
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Pupulim DC, Henriques JFC, Freitas KMS, Fontes FPH, Fernandes TMF. Class ii treatment effects with fixed functional appliances: jasper jumper vs. forsus fatigue resistant device. Orthod Craniofac Res 2021; 25:134-141. [PMID: 34219381 DOI: 10.1111/ocr.12515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/28/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to compare cephalometric changes of Class II malocclusion patients treated with Jasper Jumper and Forsus, associated with fixed appliances. METHODS The sample consisted of 62 individuals divided into 3 groups: group 1 included 22 subjects with a mean initial age of 12.39 years, treated with Jasper Jumper associated with fixed appliances for a mean period of 2.43 years; group 2 included 19 subjects with a mean initial age of 12.43 years, treated with Forsus associated with fixed appliances for a mean period of 3.54 years; and group 3 included 22 Class II malocclusion untreated subjects at a mean age of 12.14 years, followed for a mean period of 1.78 years. Intergroup comparison was performed with one-way ANOVA, followed by Tukey test. RESULTS Both treated groups had similar dentoskeletal changes: restrictive effect on the maxilla; clockwise rotation of the occlusal plane; mild increase in lower anterior facial height; limitation on the vertical development of the maxillary molars; labial tipping and intrusion of the mandibular incisors; extrusion of mandibular molars; improvements of the maxillomandibular relationship, overjet, overbite, molar relationship; and retrusion of the upper lip. The mandibular incisors exhibited greater protrusion in group 1 compared to the other groups. In addition, group 2 presented mild protrusion of the lower lip, and groups 1 and 3 showed mild retrusion. CONCLUSION The Jasper Jumper and Forsus appliances were effective and showed similar changes in the treatment of Class II malocclusion.
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Affiliation(s)
- D C Pupulim
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - J F C Henriques
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - K M S Freitas
- Department of Orthodontics, Ingá University Center Uningá, Maringá, Paraná, Brazil
| | - F P H Fontes
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - T M F Fernandes
- Department of Orthodontics, University of North Parana (UNOPAR), Londrina, Paraná, Brazil
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Patel MP, Henriques JFC, Freitas KMS, Almeida R, Janson G. Stability of class II treatment with Pendulum and Jones jig followed by fixed appliances. Orthod Craniofac Res 2020; 24:370-378. [PMID: 33259104 DOI: 10.1111/ocr.12447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 11/16/2020] [Accepted: 11/22/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The present study aimed to evaluate and compare the long-term stability of Class II correction with the Pendulum or Jones jig followed by fixed appliances. SETTINGS AND SAMPLE POPULATION Group 1 comprised 20 Class II malocclusion patients with a mean initial age of 13.97 years (SD = 1.57), treated with Pendulum and fixed appliances for a mean period of 4.72 years (SD = 0.98), and mean long-term post-treatment evaluation of 4.72 years (SD = 0.97). Group 2 consisted of 18 Class II patients with a mean initial age of 13.19 years (SD = 1.26), treated with Jones jig and fixed appliances for a mean period of 3.96 years (SD = 0.92). Mean long-term post-treatment time was 5.50 years (SD = 1.57). METHODS Lateral cephalograms were evaluated at three stages: initial (T1), final (T2) and long-term post-treatment (T3). Intragroup comparisons were performed with repeated measures ANOVA and Tukey's test and intergroup comparisons with independent t test. RESULTS Many treatment changes were observed in both groups. From the long-term post-treatment periods, there was stability for most of the variables. Maxillary second molars and mandibular first molars extruded in the Jones jig group and slightly intruded in the Pendulum appliance group. The nasolabial angle decreased in the Pendulum group and increased in the Jones jig group. CONCLUSION The correction of a Class II malocclusion was shown to be stable with similar long-term post-treatment results with Pendulum or Jones jig followed by fixed orthodontic appliances.
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Affiliation(s)
- Mayara Paim Patel
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil.,Department of Orthodontics, Guarulhos University UNG, Guarulhos, Brazil
| | | | - Karina Maria Salvatore Freitas
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil.,Department of Orthodontics, Ingá University Center Uningá, Maringá, Brazil
| | - Renato Almeida
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
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Teeth angulations after class II treatment with the Jones Jig followed by fixed appliances: A retrospective panoramic analysis. Int Orthod 2020; 18:436-442. [DOI: 10.1016/j.ortho.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/09/2020] [Accepted: 06/13/2020] [Indexed: 11/22/2022]
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Ramon Pujols SC, Nogueira CQ, Reis RS, Fonçatti CF, Castanha Henriques JF, Janson G. Stability of Class II malocclusion treatment with the distal jet followed by fixed appliances. Am J Orthod Dentofacial Orthop 2020; 158:363-370. [PMID: 32709576 DOI: 10.1016/j.ajodo.2019.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This retrospective study aimed to assess the stability of Class II malocclusion treatment with the distal jet, followed by fixed appliances. METHODS Seventy-five cephalograms of 30 subjects were divided into 2 groups. The treated group consisted of 15 patients who were evaluated at the pretreatment, posttreatment, and long-term posttreatment stages. The control group consisted of 15 subjects with normal occlusion, comparable to the experimental group at the long-term posttreatment period. Intergroup comparison of posttreatment changes was evaluated with t tests. RESULTS In the long-term posttreatment period, there was no significant change in the anteroposterior position of the maxilla and mandible to the cranial base. The lower anterior face height had a significantly smaller increase in the treated than in the control group. The maxillary molars in the treated group had significantly smaller vertical development, and the mandibular incisors had significantly greater labial tipping and protrusion than the control group. The treatment produced significant improvement in molar relationship and reduction of overbite and overjet, which remained stable in the long-term posttreatment period. There was greater upper lip protrusion in the experimental than in the control group in the long-term posttreatment period. CONCLUSIONS Treatment of Class II malocclusions with the distal jet, followed by fixed appliances, showed good long-term stability in molar relationship, overbite, and overjet.
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Affiliation(s)
| | | | - Rachelle Simões Reis
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Bauru, Brazil
| | | | | | - Guilherme Janson
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Bauru, Brazil
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Rosa AJ, Nascimento RRD, Mucha JN, Vilella ODV. Effects of the cervical headgear in growing Angle Class II malocclusion patients: a prospective study. Dental Press J Orthod 2020; 25:25-31. [PMID: 32490924 PMCID: PMC7265674 DOI: 10.1590/2177-6709.25.2.025-031.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 02/20/2019] [Indexed: 11/22/2022] Open
Abstract
Objective: Evaluate dental and skeletal changes resulting from the exclusive use of the cervical headgear for 15 ± 4 months in the treatment of patients with Class II division 1 malocclusion. Methods: Differences between the beginning (T1) and immediately after the end of the therapy (T2) with the cervical headgear in growing patients (Experimental Group, EG, n = 23) were examined and compared, during compatible periods, with those presented by a group of untreated individuals (Control Group, CG, n =22) with similar malocclusions and chronological age. The cephalometric variables evaluated were: ANB, GoGn.SN, AO-BO, S'-ANS, S'-A, S'-B, S'-Pog and S'-U6 (maxillary first molar). The Shapiro-Wilk and Levene tests were used to evaluate the results. Results: Significant differences were found relative to the ANB, S'-U6, AO-BO, S'-ANS, S'-A, S'-B and S'-Pog variables between T1 and T2 when comparing both groups. No statistically significant variation was found regarding the GoGn.SN angle. Conclusions: The use of cervical headgear promoted distal movement of the maxillary first molars and restricted the anterior displacement of the maxilla, without significantly affecting the GoGn.SN angle.
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Affiliation(s)
- Anderson Jaña Rosa
- Departamento de Ortodontia, Faculdade de Odontologia, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | - José Nelson Mucha
- Departamento de Ortodontia, Faculdade de Odontologia, Universidade Federal Fluminense, Niterói, RJ, Brazil
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Fontes FPH, Bellini-Pereira SA, Aliaga-Del-Castillo A, Patel MP, Freitas MRD, Henriques JFC, Janson G. Comparison of the dentoskeletal and soft tissue changes with the cervical headgear and Jones Jig followed by fixed appliances in Class II malocclusion patients: A retrospective study. Int Orthod 2020; 18:424-435. [PMID: 32278665 DOI: 10.1016/j.ortho.2020.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/03/2020] [Accepted: 03/07/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To retrospectively compare the dentoskeletal and soft tissue changes of patients with Class II malocclusion treated with cervical headgear and Jones Jig appliances, followed by fixed appliances. MATERIAL AND METHODS The sample comprised 46 Class II malocclusion patients divided into two groups. Patients with Class II malocclusion based on the ANB angle and plaster model analyses, needing non-extraction orthodontic treatment, absence of mandibular crowding and no previous orthodontic treatment were eligible to be selected. Group 1 consisted of 25 patients treated with cervical headgear (CH) followed by fixed appliances for a mean period of 3.26 years and group 2 consisted of 21 patients treated with the Jones Jig (JJ) appliance for a mean of 4.29 years. Lateral cephalograms were evaluated at the beginning and at the end of orthodontic treatment. For intergroup comparisons, t and Mann-Whitney tests were performed. RESULTS The cervical headgear group produced significantly greater maxillary anterior displacement restriction (SNA; CH: -0.97°±1.33; JJ: 0.07°±1.73; P=0.025), apical base discrepancy improvement (ANB; CH: -1.52°±1.25; JJ: 0.36°±1.46; P=0.006), FMA reduction (CH: -0.78°±2.68; JJ: 1.07°±2.84; P=0.028) and distal mandibular molar angulation (Md6.PM; CH: 6.97°±3.66; JJ: 2.77°±6.87; P=0.013) than the Jones Jig group. CONCLUSIONS Both distalizers followed by fixed appliances were effective to correct Class II malocclusion. The cervical headgear group presented skeletal effects with less treatment time and there were no significant intergroup differences regarding soft tissue changes.
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Affiliation(s)
| | | | | | - Mayara Paim Patel
- University of São Paulo, Bauru Dental School, Department of Orthodontics, Brazil.
| | | | | | - Guilherme Janson
- University of São Paulo, Bauru Dental School, Department of Orthodontics, Brazil.
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Pupulim DC, Henriques JFC, Janson G, Henriques FP, Freitas KMS, Garib D. Comparison of dentoskeletal and soft tissue effects of Class II malocclusion treatment with Jones Jig appliance and with maxillary first premolar extractions. Dental Press J Orthod 2020; 24:56-65. [PMID: 31116288 PMCID: PMC6526763 DOI: 10.1590/2177-6709.24.2.056-065.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 04/24/2018] [Indexed: 11/22/2022] Open
Abstract
Objective: The aim of this study was to compare the cephalometric changes in Class II division 1 malocclusion patients treated with Jones Jig appliance or with maxillary first premolar extractions. Methods: The sample consisted of 88 lateral cephalograms of 44 patients, divided into two groups. Group 1 consisted of 21 patients treated with Jones Jig appliance, with a mean initial age of 12.88 ± 1.23 years and final mean age of 17.18 ± 1.37 years, and a mean treatment time of 4.29 years. Group 2 comprised 23 patients treated with maxillary first premolar extractions, with a mean initial age of 13.59 ± 1.91 years and mean final age of 16.39 ± 1.97 years, and a mean treatment time of 2.8 years. Intergroup treatment changes were compared with t and Mann-Whitney tests. Results: Class II correction in G2 (maxillary first premolar extractions) presented significantly greater maxillary retrusion, reduction of anteroposterior apical base discrepancy, smaller increase in the lower anterior face height and significantly greater overjet reduction than G1 (Jones Jig). Conclusions: Treatment with maxillary first premolar extractions produced greater overjet reduction, but the two treatment protocols produced similar changes in the soft tissue profile.
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Affiliation(s)
- Daniela Cubas Pupulim
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | | | - Guilherme Janson
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | - Fernanda Pinelli Henriques
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | | | - Daniela Garib
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
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Caruso S, Nota A, Ehsani S, Maddalone E, Ojima K, Tecco S. Impact of molar teeth distalization with clear aligners on occlusal vertical dimension: a retrospective study. BMC Oral Health 2019; 19:182. [PMID: 31409348 PMCID: PMC6692944 DOI: 10.1186/s12903-019-0880-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 08/07/2019] [Indexed: 11/24/2022] Open
Abstract
Background A common strategy in the non-extraction treatment of Class II molar relationship is maxillary molar distalization, which could increase lower face height and cause clockwise mandibular rotation. The aim of this retrospective study was to analyse the effects on vertical dentoskeletal dimension of young adults treated with sequential distalization with orthodontic aligners. Methods Lateral cephalometric radiographs of 10 subjects (8 females 2 males; mean age 22.7 ± 5.3 years) treated with upper molars sequential distalization with orthodontic aligners (Invisalign, Align Technology, San Josè, California, USA) were analyzed. Results No statistically significant difference was observed for the primary outcome SN-GoGn between T0 and T1 and it was recorded a mean variation of 0.1 ± 2.0 degrees. Statistically significant differences were found in the linear position of the upper molars (6-PP, 7-PP) the molar class relationship parameter (MR) and the upper incisive inclination (1^PP) with at least p < 0.01. Conclusions Upper molar distalization with orthodontic aligners guarantee an excellent control of the vertical dimension representing an ideal solution for the treatment of hyperdivergent or openbite subjects. It also allows an excellent control of the incisal torque without loss of anchorage during the orthodontic procedure.
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Affiliation(s)
- Silvia Caruso
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Piazzale Salvatore Tommasi 1, 67100, L'Aquila, Coppito, Italy
| | - Alessandro Nota
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Piazzale Salvatore Tommasi 1, 67100, L'Aquila, Coppito, Italy. .,Dental School, Vita-Salute University and IRCCS San Raffaele Hospital, Via Olgettina, 58, 20132, Milan, Italy.
| | - Shideh Ehsani
- Dental School, Vita-Salute University and IRCCS San Raffaele Hospital, Via Olgettina, 58, 20132, Milan, Italy
| | - Elena Maddalone
- Dental School, Vita-Salute University and IRCCS San Raffaele Hospital, Via Olgettina, 58, 20132, Milan, Italy
| | - Kenji Ojima
- Private Practice of Orthodontics, Tokyo, Japan
| | - Simona Tecco
- Dental School, Vita-Salute University and IRCCS San Raffaele Hospital, Via Olgettina, 58, 20132, Milan, Italy
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Sakuno AC, da Rosa APB, Maeda FA, Trivino T, Carvalho PEG, Torres FC. Tomographic evaluation of dentoskeletal changes due to the treatment of class II malocclusion with Forsus appliance. J Oral Biol Craniofac Res 2019; 9:277-279. [PMID: 31289716 DOI: 10.1016/j.jobcr.2019.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 06/02/2019] [Indexed: 10/26/2022] Open
Abstract
Purpose This study evaluated dentoalveolar skeletal changes promoted by the Forsus appliance, associated to fixed orthodontic appliance, in the correction of Class II, division 1 malocclusion, from Computed Tomography (CT). Methods sample consisted of 10 youngsters (7 males and 3 females), with a mean age of 13.86 years. Two Forsus® models were installed after the alignment and leveling phase of the teeth. Two tomographic images of each patient, T1 and T2 (initial and immediately after removal of Forsus® appliance) were done to perform the anatomical tracings and obtain the variables of interest. The data were described by means and standard deviations. For the comparison between the initial and final phases, the paired "t" test was used and a significance level of 5% was considered (p < 0.05). Results small skeletal changes were observed, such as posterior maxillary displacement and a slight mandibular growth. Larger dentoalveolar changes occurred as extrusion, retrusion and lingualization of upper incisors; Intrusion, protrusion and vestibularization of the lower incisors; Mesialization and extrusion of lower molars. Conclusion Considering the patients evaluated in this study, Forsus® presented similar results to other mandibular propulsion appliances, with dentoalveolar effects that favored Class II correction, however, with very slight skeletal modifications.
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Affiliation(s)
- Antonio Carlos Sakuno
- Department of Orthodontics, University of Metodista, São Bernardo do Campo, São Paulo, Brazil
| | | | - Fernando Akio Maeda
- Department of Orthodontics, UNICID - University of São Paulo City, São Paulo, São Paulo, Brazil
| | - Tarcila Trivino
- Department of Orthodontics, UNICID - University of São Paulo City, São Paulo, São Paulo, Brazil
| | | | - Fernando César Torres
- Department of Orthodontics, UNICID - University of São Paulo City, São Paulo, São Paulo, Brazil
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Vilanova L, Henriques JFC, Janson G, Patel MP, Reis RS, Aliaga-Del Castillo A. Class II malocclusion treatment effects with Jones Jig and Distal Jet followed by fixed appliances. Angle Orthod 2017; 88:10-19. [PMID: 28985105 DOI: 10.2319/022517-142.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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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18
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Henriques FP, Janson G, Henriques JFC, Pupulim DC. Effects of cervical headgear appliance: a systematic review. Dental Press J Orthod 2017; 20:76-81. [PMID: 26352849 PMCID: PMC4593534 DOI: 10.1590/2176-9451.20.4.076-081.oar] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: Although much has been investigated about the effects of cervical headgear, there
remains some controversy. Therefore, the objective of this systematic review is to
disclose the actual effects of the cervical headgear appliance, based on articles
of relevant quality. METHODS: A literature review was conducted using PubMed, Web of Science, Embase, Scopus
and Cochrane databases. Inclusion criteria consisted of human studies written in
English; published between 1970 and 2014; in which only the cervical headgear was
used to correct Class II malocclusion; prospective or retrospective; with a clear
description of cervical headgear effects; with a sample size of at least 15
individuals. No comparative studies, clinical cases or cases with dental
extractions were included and the sample should be homogeneous. RESULTS: Initially, 267 articles were found. A total of 42 articles were selected by title
and had their abstracts read. Finally, 12 articles were classified as with high
quality and were used in this systematic review. CONCLUSIONS: The cervical headgear appliance proved efficient to correct Class II, Division 1
malocclusion. Its effects consisted in correction of the maxillomandibular
relationship by restriction of maxillary anterior displacement; distalization and
extrusion of maxillary molars; and slight maxillary expansion.
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Affiliation(s)
| | - Guilherme Janson
- School of Dentistry, Universidade de São Paulo, Bauru, São Paulo, BR
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19
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Kang JM, Park JH, Bayome M, Oh M, Park CO, Kook YA, Mo SS. A three-dimensional finite element analysis of molar distalization with a palatal plate, pendulum, and headgear according to molar eruption stage. Korean J Orthod 2016; 46:290-300. [PMID: 27668192 PMCID: PMC5033768 DOI: 10.4041/kjod.2016.46.5.290] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 02/04/2016] [Accepted: 02/16/2016] [Indexed: 12/12/2022] Open
Abstract
Objective This study aimed to (1) evaluate the effects of maxillary second and third molar eruption status on the distalization of first molars with a modified palatal anchorage plate (MPAP), and (2) compare the results to the outcomes of the use of a pendulum and that of a headgear using three-dimensional finite element analysis. Methods Three eruption stages were established: an erupting second molar at the cervical one-third of the first molar root (Stage 1), a fully erupted second molar (Stage 2), and an erupting third molar at the cervical one-third of the second molar root (Stage 3). Retraction forces were applied via three anchorage appliance models: an MPAP with bracket and archwire, a bone-anchored pendulum appliance, and cervical-pull headgear. Results An MPAP showed greater root movement of the first molar than crown movement, and this was more noticeable in Stages 2 and 3. With the other devices, the first molar showed distal tipping. Transversely, the first molar had mesial-out rotation with headgear and mesial-in rotation with the other devices. Vertically, the first molar was intruded with an MPAP, and extruded with the other appliances. Conclusions The second molar eruption stage had an effect on molar distalization, but the third molar follicle had no effect. The application of an MPAP may be an effective treatment option for maxillary molar distalization.
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Affiliation(s)
- Ju-Man Kang
- Department of Dentistry, Graduate School, The Catholic University of Korea, Seoul, Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA.; Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Mohamed Bayome
- Department of Dentistry, Graduate School, The Catholic University of Korea, Seoul, Korea.; Department of Postgraduate Studies, the Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Moonbee Oh
- Department of Orthodontics, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chong Ook Park
- Private Practice, Seoul, Korea.; Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Seo Mo
- Department of Orthodontics, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul, Korea
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20
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Lione R, Franchi L, Laganà G, Cozza P. Effects of cervical headgear and pendulum appliance on vertical dimension in growing subjects: a retrospective controlled clinical trial. Eur J Orthod 2014; 37:338-44. [PMID: 25316493 DOI: 10.1093/ejo/cju061] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To analyze the effects on vertical dentoskeletal dimension produced by cervical headgear (CHG) or Pendulum (P) both followed by full fixed appliances in growing patients with Class II malocclusion. MATERIAL AND METHODS The CHG group (CHGG) consisted of 40 patients (25 females, 15 males) with a mean age of 11.5 years. The P group (PG) comprised 40 patients (21 females, 19 males) with a mean age of 11.6 years. Mean treatment duration with the CHG and P appliances were 1.5 years and 8.2 months, respectively. Lateral cephalograms were available before treatment (T1) and at the end of fixed therapy (T2) with a mean interval of 3.5 years. The effects of the 2 protocols were compared with a matched control group (CG) of 25 untreated Class II subjects (13 females, 12 males). The ANOVA with Tukey's post hoc tests was used to evaluate between-group differences at T1 and during the T1-T2 interval (P < 0.05). RESULTS CHGG showed significantly greater decreases in both Sella-Nasion to A point angle and A-Nasion-B point anglel when compared with both PG (-1.2 and -0.9 degrees, respectively) and CG (-1.9 and -1.5 degrees, respectively). No significant between-group differences were recorded for any of the vertical skeletal measurements. Both CHGG and PG showed significantly greater improvement in molar relationships with respect to CG (+2.5mm). CONCLUSIONS Both distalizing protocols were effective in the correction of Class II malocclusion without increasing the vertical dimension at the end of comprehensive treatment.
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Affiliation(s)
- Roberta Lione
- *Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Italy
| | - Lorenzo Franchi
- **Department of Surgery and Translational Medicine, University of Florence, Florence, Italy, ***Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Giuseppina Laganà
- *Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Italy
| | - Paola Cozza
- *Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Italy
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Caprioglio A, Cozzani M, Fontana M. Comparative evaluation of molar distalization therapy with erupted second molar: Segmented versus Quad Pendulum appliance. Prog Orthod 2014; 15:49. [PMID: 25139288 PMCID: PMC4138551 DOI: 10.1186/s40510-014-0049-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 06/26/2014] [Indexed: 11/16/2022] Open
Abstract
Background There are controversial opinions about the effect of erupted second molars on distalization of the first molars. Most of the distalizing devices are anchored on the first molars, without including second molars; so, differences between sequentially distalize maxillary molars (second molar followed by the first molar) or distalize second and first molars together are not clear. The aim of the study was to compare sequential versus simultaneous molar distalization therapy with erupted second molar using two different modified Pendulum appliances followed by fixed appliances. Methods The treatment sample consisted of 35 class II malocclusion subjects, divided in two groups: group 1 consisted of 24 patients (13 males and 11 females) with a mean pre-treatment age of 12.9 years, treated with the Segmented Pendulum (SP) and fixed appliances; group 2 consisted of 11 patients (6 males and 5 females) with a mean pre-treatment age of 13.2 years, treated with the Quad Pendulum (QP) and fixed appliances. Lateral cephalograms were obtained before treatment (T1), at the end of distalization (T2), and at the end of orthodontic fixed appliance therapy (T3). A Student t test was used to identify significant between-group differences between T1 to T2, T2 to T3, and T1 to T3. Results QP and SP were equally effective in distalizing maxillary molars (3.5 and 4 mm, respectively) between T1 and T2; however, the maxillary first molar showed less distal tipping (4.6° vs. 9.6°) and more extrusion (1.1 vs. 0.2 mm) in the QP group than in the SP group, as well as the vertical facial dimension, which increased more in the QP group (1.2°) than in the SP group (0.7°). At T3, the QP group maintained greater increase in lower anterior facial height and molar extrusion and decrease in overbite than the SP group. Conclusion Quad Pendulum seems to have greater increase in vertical dimension and molar extrusion than the Segmented Pendulum.
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Affiliation(s)
- Alberto Caprioglio
- Chairman Postgraduate Programme in Orthodontics, School of Medicine, University of Insubria, Varese, Italy.
| | - Mauro Cozzani
- Professor of Orthodontics, School of Medicine, University of Cagliari, Cagliari, Italy.
| | - Mattia Fontana
- Research Fellow in Orthodontics, University of Insubria, Varese, Italy.
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Migliaccio S. La distalizzazione ottenuta con il pendulum di Hilgers: revisione della letteratura. DENTAL CADMOS 2014. [DOI: 10.1016/s0011-8524(14)70160-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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23
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Jambi S, Thiruvenkatachari B, O'Brien KD, Walsh T. Orthodontic treatment for distalising upper first molars in children and adolescents. Cochrane Database Syst Rev 2013; 2013:CD008375. [PMID: 24155018 PMCID: PMC6464757 DOI: 10.1002/14651858.cd008375.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND When orthodontic treatment is provided with fixed appliances, it is sometimes necessary to move the upper molar teeth backwards (distalise) to create space or help to overcome anchorage requirements. This can be achieved with the use of extraoral or intraoral appliances. The most common appliance is extraoral headgear, which requires considerable patient co-operation. Further, reports of serious injuries have been published. Intraoral appliances have been developed to overcome such shortcomings. The comparative effects of extraoral and intraoral appliances have not been fully evaluated. OBJECTIVES To assess the effects of orthodontic treatment for distalising upper first molars in children and adolescents. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 10 December 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 11), MEDLINE via OVID (1946 to 10 December 2012) and EMBASE via OVID (1980 to 10 December 2012). No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA Randomised clinical trials involving the use of removable or fixed orthodontic appliances intended to distalise upper first molars in children and adolescents. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by The Cochrane Collaboration. We performed data extraction and assessment of the risk of bias independently and in duplicate. We contacted authors to clarify the inclusion criteria of the studies. MAIN RESULTS Ten studies, reporting data from 354 participants, were included in this review, the majority of which were carried out in a university dental hospital setting. The studies were published between 2005 and 2011 and were conducted in Europe and in Brazil. The age range of participants was from nine to 15 years, with an even distribution of males and females in seven of the studies, and a slight predominance of female patients in three of the studies. The quality of the studies was generally poor; seven studies were at an overall high risk of bias, three studies were at an unclear risk of bias, and we judged no study to be at low risk of bias.We carried out random-effects meta-analyses as appropriate for the primary clinical outcomes of movement of upper first molars (mm), and loss of anterior anchorage, where there were sufficient data reported in the primary studies. Four studies, involving 159 participants, compared a distalising appliance to an untreated control. Meta-analyses were not undertaken for all primary outcomes due to incomplete reporting of all summary statistics, expected outcomes, and differences between the types of appliances. The degree and direction of molar movement and loss of anterior anchorage varied with the type of appliance. Four studies, involving 150 participants, compared a distalising appliance versus headgear. The mean molar movement for intraoral distalising appliances was -2.20 mm and -1.04 mm for headgear. There was a statistically significant difference in mean distal molar movement (mean difference (MD) -1.45 mm; 95% confidence interval (CI) -2.74 to -0.15) favouring intraoral appliances compared to headgear (four studies, high or unclear risk of bias, 150 participants analysed). However, a statistically significant difference in mean mesial upper incisor movement (MD 1.82 mm; 95% CI 1.39 to 2.24) and overjet (fixed-effect: MD 1.64 mm; 95% CI 1.26 to 2.02; two studies, unclear risk of bias, 70 participants analysed) favoured headgear, i.e. there was less loss of anterior anchorage with headgear. We reported direct comparisons of intraoral appliances narratively due to the variation in interventions (three studies, high or unclear risk of bias, 93 participants randomised). All appliances were reported to provide some degree of distal movement, and loss of anterior anchorage varied with the type of appliance.No included studies reported on the incidence of adverse effects (harm, injury), number of attendances or rate of non-compliance. AUTHORS' CONCLUSIONS It is suggested that intraoral appliances are more effective than headgear in distalising upper first molars. However, this effect is counteracted by loss of anterior anchorage, which was not found to occur with headgear when compared with intraoral distalising appliance in a small number of studies. The number of trials assessing the effects of orthodontic treatment for distilisation is low, and the current evidence is of low or very low quality.
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Affiliation(s)
| | | | - Kevin D O'Brien
- School of Dentistry, The University of ManchesterHigher Cambridge StreetManchesterUKM15 6FH
| | - Tanya Walsh
- School of Dentistry, The University of ManchesterHigher Cambridge StreetManchesterUKM15 6FH
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Lima KJRSD, Henriques JFC, Janson G, Pereira SCDC, Neves LS, Cançado RH. Dentoskeletal changes induced by the Jasper jumper and the activator-headgear combination appliances followed by fixed orthodontic treatment. Am J Orthod Dentofacial Orthop 2013; 143:684-94. [PMID: 23631970 DOI: 10.1016/j.ajodo.2013.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 01/01/2013] [Accepted: 01/01/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The aim of this study was to compare the dentoskeletal changes of patients with Class II Division 1 malocclusion treated with either the Jasper jumper appliance or the activator-headgear combination, both associated with fixed appliances. METHODS The sample comprised 72 subjects with Class II Division 1 malocclusion divided into 3 groups: group 1 included 25 subjects treated with fixed appliances and the force modules of the Jasper jumper at an initial mean age of 12.72 years, group 2 included 25 subjects treated with the activator-headgear combination followed by fixed appliances at an initial mean age of 11.07 years, and group 3 included 22 untreated subjects at an initial mean age of 12.67 years. Initial cephalometric characteristics and dentoskeletal changes were compared with analysis of variance. RESULTS Both experimental groups had similar dentoskeletal changes: restrictive effect on the maxilla, clockwise mandibular rotation and a slight increase in anterior face height, retrusion of the maxillary incisors, distalization of the maxillary molars, protrusion of the mandibular incisors, extrusion of the mandibular molars, and significant improvements of the maxillomandibular relationship, overjet, overbite, and the molar relationship. CONCLUSIONS The effects of the Jasper jumper and the activator-headgear combination followed by fixed orthodontic appliances were similar in Class II malocclusion treatment.
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Burhan AS. Combined treatment with headgear and the Frog appliance for maxillary molar distalization: a randomized controlled trial. Korean J Orthod 2013; 43:101-9. [PMID: 23671835 PMCID: PMC3650212 DOI: 10.4041/kjod.2013.43.2.101] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 10/30/2012] [Accepted: 10/31/2012] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate the efficiency of the Frog appliance (FA) alone or in combination with headgear for distalizing the maxillary molars. Methods Fifty patients (25 males and 25 females) aged 12.6 - 16.7 years who received treatment for Class II malocclusion at the Orthodontic Clinic of Al-Baath University were selected for this study and randomly divided into 2 equal groups. Maxillary molar distalization was achieved using the FA alone (group 1) or a combination of the FA with high-pull headgear worn at night (group 2). Lateral cephalograms were obtained before and after treatment. Results The maxillary molars moved distally by 5.51 and 5.93 mm in groups 1 and 2, respectively. Distal movements were associated with axial tipping by 4.96° and 1.25°, and with loss of anchorage by mesial movement of the second maxillary premolars by 2.70 and 0.90 mm in groups 1 and 2, respectively. The combined use of the FA and nighttime high-pull headgear decreased the distalization time and improved the ratio of maxillary molar distalization movement relative to the overall opening space between the first maxillary molars and second premolars. Conclusions The FA can effectively distalize the maxillary molars, this distalization associates with some unfavorable changes. Nighttime use of high-pull headgear combined with the FA can reduce these unfavorable changes and improve treatment outcomes.
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Fontana M, Cozzani M, Caprioglio A. Non-compliance maxillary molar distalizing appliances: an overview of the last decade. Prog Orthod 2012; 13:173-84. [PMID: 23021121 DOI: 10.1016/j.pio.2011.10.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 10/26/2011] [Accepted: 10/30/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES To perform a literature review focusing on the use of non-compliance intraoral appliances for molar distalization therapy. MATERIALS AND METHODS A literature search ranged from January 1999 to December 2009 in order to describe dento-alveolar changes and skeletal vertical modifications following the use of conventional anchorage intraoral distalizing appliances. The quality of the retrieved studies was ranked on a 12-points scale, from low to high quality. RESULTS A total of 214 articles were found and only 24 were considered eligible for the critical examination. Maxillary first molar distalization ranged from 6.4mm to 0.5mm with a concomitant distal tipping from 18.5° to bodily distalization. A smaller amount of distal movement and a greater amount of crown tipping can be noted at second molars. Premolar anchorage loss and incisor proclination represent an unavoidable side-effect and ranged from 4.33 mm to 0.73 mm and from 13.7° to 0.6° respectively. Skeletal vertical modifications were noted. Increase in vertical facial dimension ranged from 1.5° to -1.8° and lower anterior facial height ranged from an increase of 3.2 to a decrease of 0.6 mm. The assessment of study quality showed that 19 studies were of low quality, 3 of medium quality and 2 of medium-high quality. CONCLUSIONS Maxillary molar distalization can be effectively performed with the use of noncompliance intraoral appliances. As a consequence, premolar anchorage loss, incisor proclination and a slight increase in vertical facial dimension can occur. Because of the lack of high-quality studies the findings of this review should be carefully interpreted.
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