Sambale J, Jablonski-Momeni A, Korbmacher-Steiner HM. Impact of initial lip competence on the outcome of class II functional appliances therapy.
Clin Oral Investig 2024;
28:126. [PMID:
38286891 PMCID:
PMC10824814 DOI:
10.1007/s00784-024-05511-x]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES
The aim of this prospective clinical study was to evaluate the impact of initial lip position on class II functional appliance therapy.
MATERIALS AND METHODS
In total, 34 class II division 1 patients (23 females, 19 males; mean age 12.4 ± 0.9 years) that met the inclusion criteria (> ½ class II molar relationship, overjet > 6 mm, ANB > 4°, neutral or horizontal growth pattern, cervical vertebral maturation stage (CVMS) II - III, mean wear-time > 10 h/day) were consecutively divided into two groups (lip incompetence (LI); lip competence (LC)). All patients were treated with the Sander bite jumping appliance (BJA). Wear time was microelectronically measured. Lateral cephalograms were taken at the beginning (T0) and after 1 year of treatment (T1). An untreated class II group served as a control (CG). Inter-group comparisons were determined with Mann-Whitney U tests for independent samples.
RESULTS
Significant skeletal treatment effects were found in both treated groups when compared to the CG with significantly more pronounced mandibular skeletal effects in the LI than in the LC group (mandibular base length p < 0.001, composite mandibular base length p < 0.001, condylar head growth p = 0.002, co-pg p < 0.00, go-pg p = 0.003, reduction of the ANB angle p = 0.009, and Wits appraisal p < 0.001).
CONCLUSION
The more pronounced mandibular effects in the LI group were composed of the functional orthopedic effect plus harmonization of the lip competence.
CLINICAL RELEVANCE
Functional harmonization of lip incompetence with BJA enhances mandibular growth stimulation. Lip incompetence seems to impede mandibular growth and its harmonization seems to be a preventive approach.
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