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Xiaowei W, Haoran L, Xuehui C, Xiaogang P. Analysis of prefabricated myofunctional appliances with different overjet and bumper designs: a three-dimensional finite element analysis. BMC Oral Health 2024; 24:561. [PMID: 38745284 PMCID: PMC11092169 DOI: 10.1186/s12903-024-04325-3] [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: 01/18/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Prefabricated myofunctional appliance can guide tooth eruption, improve dentition alignment, correct myofunctional disorders and harmful oral habits. However, its application to skeletal discrepancy may result in unsatisfactory tooth inclination. This study aimed to construct a novel appliance with overjet design to avoid this side effect and investigated its shape and mechanical changes under occlusion using three-dimensional finite element method. METHODS We established three samples of prefabricated myofunctional appliances. The first one was edge to edge without overjet, and the outer shield of both jaws were flattened. The second one was 3 mm overjet with stepped the outer shield. The last one was 3 mm overjet, and the outer shield of both jaws were flatted, which meant the front wall of lower jaw was strengthened with bumper, termed as lower bumper. A complete dentition model was applied to the study. 150 N occlusal force was applied to each type of appliance and the deformation displacement and the changes in stress was recorded. RESULTS The deformation was significant in the incisors regions, especially in the vertical and lateral dimensions. The maximum displacements of 3 mm overjet with step shield group were 7.08 mm (vertical), 3.99 mm (lateral), and 2.90 mm (sagittal), while it decreased to 3.92 mm(vertical), 1.94 mm (lateral), and 1.55 mm (sagittal) in overjet with bumper group. Moreover, the upper molar regions exhibited higher vertical and sagittal displacement in 3 mm overjet with step shield group, which were 3.03 mm (vertical) and 1.99 mm (sagittal), and the bumper design could decrease the maximum displacement to 1.72 mm (vertical) and 0.72 mm (sagittal). In addition, the Von Mises stress of appliances was analyzed, and results indicated that 3 mm overjet with step shield generated higher stress than other groups, with the maximum Von Mises stress was 0.9387 MP, which were 0.5858 and 0.5657 MP in edge to edge group and 3 mm overjet with lower bumper group, respectively. CONCLUSION The prefabricated myofunctional appliances may cause deformation during occlusion. Compared to step shield group, the application of lower bumper exhibited better resistance to occlusal force.
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Affiliation(s)
- Wu Xiaowei
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, PR China
| | - Lv Haoran
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, PR China
| | - Chen Xuehui
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, PR China
| | - Pan Xiaogang
- Department of Orthodontics, Shanghai Ninth People's Hospital, College of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, PR China.
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Cannatà D, Galdi M, Martina S, Rongo R, D’Antò V, Valletta R, Bucci R. Preformed Elastodontic Appliances: Awareness and Attitude of Orthodontists and General Dental Practitioners. CHILDREN (BASEL, SWITZERLAND) 2024; 11:418. [PMID: 38671635 PMCID: PMC11048748 DOI: 10.3390/children11040418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/11/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Preformed elastodontic appliances (EAs) have been described as safe, cost-effective, and easy-to-use devices for interceptive orthodontic treatment in growing patients. This study aimed to assess the knowledge and the attitude of dentists toward the use of EAs and to compare the behaviors of orthodontists (Os) with those of general dental practitioners (GDPs). METHODS An anonymous survey was distributed among dentists through social media. Twenty-two items were divided as follows: characteristics of respondents; general knowledge about EAs; section for EA-users; and section for EA non-users. Chi-squared tests were used to analyze differences in responses between groups. RESULTS Participants included 226 Os and 168 GDPs. The majority in both groups reported having adequate knowledge about EAs and utilizing them in their practice. GDPs usually use EAs to treat children during the early phase of growth, while Os also use EAs to address orthodontic problems in different stages of dentition, experiencing a chair time reduction compared with traditional appliances. Regarding EA non-users, GDPs seem not to find an application among their patients, whereas Os reported not having enough patient compliance during treatment. CONCLUSIONS Although treatment with EAs is common among all dentists, differences exist between Os and GDPs in the awareness and application, as well as in the reasons provided for not using EAs.
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Affiliation(s)
- Davide Cannatà
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, SA, Italy; (D.C.); (M.G.); (S.M.)
| | - Marzio Galdi
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, SA, Italy; (D.C.); (M.G.); (S.M.)
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, SA, Italy; (D.C.); (M.G.); (S.M.)
| | - Roberto Rongo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, NA, Italy; (R.R.); (V.D.); (R.V.)
| | - Vincenzo D’Antò
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, NA, Italy; (R.R.); (V.D.); (R.V.)
| | - Rosa Valletta
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, NA, Italy; (R.R.); (V.D.); (R.V.)
| | - Rosaria Bucci
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, NA, Italy; (R.R.); (V.D.); (R.V.)
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Ronsivalle V, Nucci L, Bua N, Palazzo G, La Rosa S. Elastodontic Appliances for the Interception of Malocclusion in Children: A Systematic Narrative Hybrid Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1821. [PMID: 38002912 PMCID: PMC10670240 DOI: 10.3390/children10111821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Interceptive orthodontic treatment aims to eliminate factors that prevent the harmonious development of the maxillary and mandibular arches during childhood, and elastodontic appliances (EAs) represent a group of devices with an increasingly important role. This systematic narrative hybrid review (HR) aims to provide an overview of the clinical indications for the use of EAs according to the available evidence and to identify potential research areas for unexplored applications. MATERIALS AND METHODS To assess the available literature on the subject, selective database searches were performed between July 2023 and September 2023. With the assistance of a health sciences librarian, a search strategy that utilized terms related to elastodontic therapy was developed. Embase, Scopus, PubMed, and Web of Science were the databases used. RESULTS The current literature addressing the usability of EAs is scarce and mostly limited to case reports and case series. After 2168 citations were found through the searches, 13 studies were ultimately included. In this regard, information about the clinical use and effectiveness of EAs are reported in a narrative form, defining specific domains of the application that are clinically oriented, including sagittal and transversal discrepancies, atypical swallowing, teeth malposition, two-phase orthodontics and a lack of teeth retention. CONCLUSIONS Within the intrinsic quality limitation of the available literature, it seems that EAs may represent a promising treatment alternative for managing mild-to-moderate malocclusion in children as an adjuvant therapy to the interruption of spoiled habits.
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Affiliation(s)
- Vincenzo Ronsivalle
- Department of Medical-Surgical Specialties—Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, 95123 Catania, Italy; (N.B.); (G.P.); (S.L.R.)
| | - Ludovica Nucci
- Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80100 Naples, Italy
| | - Nicolò Bua
- Department of Medical-Surgical Specialties—Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, 95123 Catania, Italy; (N.B.); (G.P.); (S.L.R.)
| | - Giuseppe Palazzo
- Department of Medical-Surgical Specialties—Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, 95123 Catania, Italy; (N.B.); (G.P.); (S.L.R.)
| | - Salvatore La Rosa
- Department of Medical-Surgical Specialties—Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario “G. Rodolico-San Marco”, 95123 Catania, Italy; (N.B.); (G.P.); (S.L.R.)
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Arpalahti A, Saarnio-Syrjäläinen A, Laaksonen S, Arponen H. Early orthodontic treatment in a Finnish public health centre: a retrospective cross-sectional study. Acta Odontol Scand 2022:1-6. [PMID: 36565231 DOI: 10.1080/00016357.2022.2161623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The aim of this observational cross-sectional one-centre study was to assess whether the previously described national orthodontic treatment practises and international recommendations are implemented in a public health care centre in Finland. We also assessed early treatment practices and appliances used. METHODS The study group comprised 801 children born in 2011 and 2012 residing in the Riihimäki health centre catchment area in Finland, representing 80% of the age cohort. The patient records were examined for data on orthodontic treatment, timing of treatment, appliances used, and occlusal traits. RESULTS The children had been examined by four orthodontist specialists and two orthodontic postgraduate students. Mean age at occlusal examination had been 9 years. Of the children, 212 (26%) were undergoing or had undergone orthodontic treatment. An additional 4.4% were scheduled for treatment. The proportion of children deemed to need treatment was significantly different between the different orthodontists. The most frequently used appliances were quad-helix (30%), eruption guidance appliance (20%), head gear (14%), fixed appliances (10%), protraction facemask (10%), and passive mandibular lingual arch (6%). CONCLUSIONS Nearly one-third of children aged less than 12 years in the health centre were currently or had been in orthodontic treatment. Approximately half had received treatment with either quad-helix or eruption guidance appliance.
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Affiliation(s)
- Annika Arpalahti
- Riihimäki Region Health Center Federation of Municipalities, Riihimäki, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Head and Neck Center, Helsinki University Hospital, Helsinki, Finland
| | - Anni Saarnio-Syrjäläinen
- Riihimäki Region Health Center Federation of Municipalities, Riihimäki, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Sirkku Laaksonen
- Riihimäki Region Health Center Federation of Municipalities, Riihimäki, Finland
| | - Heidi Arponen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Head and Neck Center, Helsinki University Hospital, Helsinki, Finland.,City of Vantaa Oral Healthcare Corporation, Vantaa, Finland
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Huang S, Chen Y, Chen T, Mallineni SK, McGrath C, Hagg U. Clinical effectiveness of the Eruption Guidance Appliances in treating malocclusion in the mixed dentition: A systematic review and meta-analysis. Int J Paediatr Dent 2022; 32:843-855. [PMID: 35191109 DOI: 10.1111/ipd.12961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/26/2021] [Accepted: 02/11/2022] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the clinical effectiveness of the eruption guidance appliances (EGAs) in treating malocclusion in the early mixed dentition. DESIGN Electronic databases were comprehensively searched for the eligibility literature of the EGA treatment for a period spanning from the earliest available date in each database up to July 2021. Randomized controlled trials, controlled clinical trials, and prospective and retrospective cohort studies were included in the present review. The quality of clinical trials was assessed according to the Cochrane Collaboration's tools (RoB2.0 and ROBINS-I), whereas cohort studies were based on the Newcastle-Ottawa Scale (NOS). The data were gathered and synthesized with the Stata software (version 12). RESULTS The screen yielded 436 articles, of which 17 papers were potentially eligible, and 7 articles from 3 studies (1 RCT, 1 CCT, and 1 PCS) were qualified for the final review and analysis. The meta-analysis showed both favorable dentoalveolar and skeletal changes in short term. Both overjet and overbite had a significant decrease after treatment (MD = -2.38 mm, 95% CI: -2.82 to -1.94, p < .001, and MD = -2.43 mm, 95% CI: -3.52 to -1.35, p < .001, respectively), and SNB increased significantly by 0.73 degrees (95% CI: 0.17-1.28, p = .01). After the retention period, however, overbite had a significant increase of 0.88mm, which indicated the occurrence of a relapse (95% CI: 0.60-1.16, p < .001). CONCLUSIONS According to the existing evidence, the EGA treatment is effectively correcting overjet and overbite in the early mixed dentition in short term; furthermore, high-quality and long-term studies are warranted to determine its long-term effectiveness.
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Affiliation(s)
- Shuying Huang
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | - Yong Chen
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Sreekanth Kumar Mallineni
- Department of Preventive Science, College of Dentistry, Majmaah University, Almajmaah, Saudi Arabia.,Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Colman McGrath
- Discipline of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Urban Hagg
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
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Marra PM, Fiorillo L, Cervino G, Cardarelli F, Cicciù M, Laino L. Elastodontic treatment with oral bio-activators in young children. Minerva Dent Oral Sci 2022; 71:270-276. [PMID: 36321621 DOI: 10.23736/s2724-6329.22.04696-4] [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: 06/16/2023]
Abstract
BACKGROUND Elastodontic therapy can correct bad oral habits and malocclusions in young patients by guiding jaw growth, eliminating functional disorders, and improving tooth position. The aim of this study was to assess the effects of bio-activator therapy on the presence of atypical swallowing with tongue thrust in growing patients. METHODS A retrospective study was conducted. Data regarding the early orthodontic treatment of 40 consecutive patients with atypical swallowing and tongue thrust (23 males and 17 females) were assembled from January 2019 to January 2020. All patients (≥7 and ≤15 years of age) were monitored for 1 year in a private practice in Isernia, Italy. RESULTS The mean age at commencement of orthodontic treatment was 8.5 years (range=7.1-14.9 years), and the mean total duration of therapy was 1 year (range=11 months-1 year). Final lateral radiographs demonstrated a mean of improvement of 8° for upper and lower incisor proclination (I/SN) and 3.5° for incisor mandibular plane angle (IMPA) in 36 patients, and 5° of I/SN and 2° of IMPA in the remaining 4 children after 1 year of treatment. CONCLUSIONS Bad oral habits in younger patients must not be ignored. The duration of treatment can differ depending on the severity of the open bite and the patient's cooperation. This study demonstrates the short-term efficacy of these myofunctional appliances in the treatment of atypical swallowing. In order to quickly eliminate factors which endanger healthy development of dento-skeletal structure, it is important to closely monitor patients during their development phase.
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Affiliation(s)
- Paola M Marra
- Complex Operative Unit of Stomatological Surgery in Developmental Age, Luigi Vanvitelli University of Campania, Naples, Italy -
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
- Department of Implantology, Faculty of Dentistry, University of Aldent, Tirana, Albania
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Filippo Cardarelli
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Bari, Italy
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
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Elastodontic Therapy of Hyperdivergent Class II Patients Using AMCOP® Devices: A Retrospective Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073259] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background: The management of a hyperdivergent growth pattern is one of the most challenging in orthodontics and different treatments are advocated. The present study analyses the effectiveness of elastodontic therapy with AMCOP® devices in treating children with hyperdivergent class II malocclusion and the effect on the upper airway patency. Methods: The study group included 21 patients (10 males and 11 females, mean age 8.22 ± 1.17 years) with a hyperdivergent growth and a class II malocclusion treated with AMCOP® devices. Cephalometric analysis was performed before treatment (T0) and after treatment (T1). Results: After treatment, the cephalometric analysis revealed a correction of the class II malocclusion and a modification of the growth pattern with a divergence reduction. The improvement of the upper airway space was also observed. Conclusion: The elastodontic therapy effectively corrected hyperdivergent class II malocclusion in growing patients over a short period.
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Ciavarella D, Campobasso A, Campa R, Suriano C, Illuzzi G, Cazzolla AP, Tepedino M. Cephalometric effects of the elastodontic appliance in managing skeletal Class II division 1 cases. AUSTRALASIAN ORTHODONTIC JOURNAL 2021. [DOI: 10.21307/aoj-2021.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Abstract
Aim
The aim of the study was to evaluate the cephalometric effects of the elastodontic appliance (EA) in the management of patients presenting with a skeletal Class II/1 malocclusion.
Methods
Twenty Class II patients treated using the EA (Group EA) were compared with 20 Class II untreated children (Group C). Cephalograms were compared at the start (T0) and after 24 months (T1) after which time, skeletal, dental, and aesthetic variables were evaluated. A statistical evaluation was conducted by applying an unpaired t-test for normally distributed variables.
Results
From T0 to T1, the EA group showed a significant increase in lower facial height (LFH), in mandibular length (Co-Gn), in the upper incisor and cranial plane angle (1 + SN) and in the distance between a true vertical line (TVL)-soft tissue B (B’) and TVL-soft tissue Pogonion (Pog’) points. From T0 to T1, group C showed a significant decrease in SN-occlusal plane (PO) (p < 0.01), of SN-mandibular plane (Go-Me) (p < 0.01) and of total gonial (N-Go-Me) angles (p < 0.05); a significant reduction of the distance between TVL-upper incisor (1+), TVL-lower lip (Li), and TVL-Pog’ was shown. No statistical differences were observed between the groups in dental and aesthetic outcomes, except for a skeletal increase in LFH (p < 0.05) and in Co-Gn length (p < 0.05), which was statistically significant in the EA group.
Conclusion
In Class II growing patients, the EA induces minor skeletal effects, compared to untreated control patients.
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Abela S, Bister D. Minimum intervention in orthodontics. Br Dent J 2020; 229:467-471. [DOI: 10.1038/s41415-020-2152-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/11/2020] [Indexed: 11/09/2022]
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Moro A, Mattos CFP, Borges SW, Flores-Mir C, Topolski F. Stability of Class II corrections with removable and fixed functional appliances: A literature review. J World Fed Orthod 2020; 9:56-67. [PMID: 32672656 DOI: 10.1016/j.ejwf.2020.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Class II functional appliances have been used in orthodontics for over 100 years. Although the stability of corrections is one of the main goals of orthodontic treatment, there is a paucity of longitudinal studies on the long-term stability of treatment of Class II malocclusion based on functional appliances. METHODS This narrative review attempts to summarize the limited related evidence available and discusses the clinical implications of important aspects related to occlusal and skeletal changes that arise after Class II malocclusion treatment with functional appliances. RESULTS The occlusal changes obtained through Class II functional treatment do mostly exhibit long-term stability. While mild posttreatment changes occurred, they were most likely due to physiologic aging processes and not likely associated with actual treatment relapse. Long-term retention in the lower jaw would be particularly beneficial. A stable occlusion with good intercuspation in the posterior arches seems more likely to preserve a Class I occlusion after treatment through dentoalveolar compensatory mechanisms. After treatment, the maxilla and the mandible do grow anteriorly, with the mandible growing more than the maxilla. Patients treated with functional appliances are not likely to develop TMJ disorders over the long term. CONCLUSIONS Long term skeletal corrections achieved with functional appliances seem to be overall stable. Class II molar and overjet relapses can be likely explained by a combination of tooth movement and an unfavorable posttreatment maxillomandibular growth pattern, especially when combined with unstable interdigitation of the posterior teeth. No specific intermaxillary retention approach has been assessed yet.
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Affiliation(s)
- Alexandre Moro
- Professor, School of Health Sciences, Universidade Positivo, Curitiba, Paraná, Brazil; Professor, Department of Orthodontics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
| | - Camila F P Mattos
- Student, MSc Program in Dentistry, School of Health Sciences, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Suelen W Borges
- Student, PhD Program in Dentistry, School of Health Sciences, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Carlos Flores-Mir
- Professor, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Francielle Topolski
- Professor, School of Health Sciences, Universidade Positivo, Curitiba, Paraná, Brazil
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