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Uzunçıbuk H, Marrapodi MM, Meto A, Ronsivalle V, Cicciù M, Minervini G. Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study. J Oral Rehabil 2024; 51:500-509. [PMID: 38041596 DOI: 10.1111/joor.13614] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms. METHODS This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests. RESULTS The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05). CONCLUSIONS Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems.
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Affiliation(s)
- Hande Uzunçıbuk
- Department of Orthodontics, Dentistry Faculty, Trakya University, Edirne, Turkey
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, Tirana, Albania
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Lee YS, Park JH, Kim J, Lee NK, Kim Y, Kook YA. Treatment effects of maxillary protraction with palatal plates vs conventional tooth-borne anchorage in growing patients with Class III malocclusion. Am J Orthod Dentofacial Orthop 2022; 162:520-528. [PMID: 35933257 DOI: 10.1016/j.ajodo.2021.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/05/2021] [Accepted: 05/05/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Evaluate the treatment effects of maxillary protraction using palatal plates and compare them to those with conventional tooth-borne anchorage in growing patients with Class III malocclusion. METHODS Forty patients were divided into 2 groups according to the type of anchorage used: group 1 (n = 20; mean age, 10.5 ± 1.6 years; palatal plates) and group 2 (n = 20; mean age, 10.0 ± 1.2 years; tooth-borne appliances). Lateral cephalograms were taken before and after maxillary protraction. Skeletal, dental, and soft-tissue variables were measured. For statistical analysis, paired and independent t tests were performed. RESULTS Group 1 showed maxilla advancement by 2.3 ± 1.0 mm compared with group 2 by 0.9 ± 0.6 mm, and group 2 indicated clockwise rotation of the mandible, but there was no such clockwise rotation in group 1 (P <0.001). Group 1 had a less lingual inclination of the mandibular incisors than group 2 (IMPA, -1.0° ± 3.8° vs -3.8° ± 2.8°; P <0.05). There was no difference in soft-tissue changes between the 2 groups. CONCLUSIONS A facemask with palatal plate induced maxillary advancement with less mandibular clockwise rotation and dental movement than conventional tooth-borne anchorage. This modality can be used efficiently for maxillary protraction in growing patients with Class III malocclusion.
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Affiliation(s)
- You-Sun Lee
- Graduate School of Clinical Dental Science, Catholic University of Korea, Seoul, South Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz; International Scholar, Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Jaehyun Kim
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Nam-Ki Lee
- Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yoonji Kim
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
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Using orthodontic elastic traction during the active period of distraction osteogenesis to increase the effective vertical extension of hemifacial microsomia patients: A multi-center randomized clinical trial. J Craniomaxillofac Surg 2021; 49:1054-1063. [PMID: 34404588 DOI: 10.1016/j.jcms.2021.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/28/2021] [Accepted: 06/20/2021] [Indexed: 11/22/2022] Open
Abstract
In this study, the aim was to assess whether using elastic traction during the active period of distraction osteogenesis could effectively increase the vertical extension. Patients with Pruzansky-Kaban Type II mandibular deformity were recruited and randomly assigned into Elastic traction + Distraction Osteogenesis group or Distraction Osteogenesis group, respectively. During the active period, the experimental group received orthodontic elastic traction 3 days after distraction osteogenesis implantation, while the control group received no treatment. All the participants underwent computed tomography (CT) examination before surgery, at the end of the active period, 6 months and 2 years after distraction osteogenesis tractor implantation. The primary outcome was the effective vertical extension rate of the mandible from the baseline to the end of the active period after operations, and there were 7 secondary outcomes used. 70 patients were included. The effective vertical extension rates were 85.021% ± 7.432% (mean ± SD) and 68.811% ± 9.510% (mean ± SD) in the experimental and control groups, respectively (P = 0.001). The average distances between the lower middle incisor point to the sagittal plane at the end of the active period were 2.485 ± 1.411 mm and 3.938 ± 2.293 mm in the experimental and control groups, respectively (P = 0.026). At the end of the active period of distraction osteogenesis, the average values of the mandibular occlusal plane canting were -4.887 ± 3.126 mm and -0.177 ± 4.029 mm in the experimental and control groups, respectively (P = 0.026). Elastic traction-assisted distraction osteogenesis could improve traction efficiency and facial symmetry.
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Biomechanical analysis for total mesialization of the maxillary dentition: A finite element study. Am J Orthod Dentofacial Orthop 2021; 159:790-798. [DOI: 10.1016/j.ajodo.2020.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/01/2020] [Accepted: 02/01/2020] [Indexed: 12/26/2022]
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Skeletal open bite treated with clear aligners and miniscrews. Am J Orthod Dentofacial Orthop 2021; 159:224-233. [DOI: 10.1016/j.ajodo.2019.07.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/01/2019] [Accepted: 07/01/2019] [Indexed: 11/21/2022]
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Liang S, Xie X, Wang F, Chang Q, Wang H, Bai Y. Maxillary protraction using customized mini-plates for anchorage in an adolescent girl with skeletal Class III malocclusion. Korean J Orthod 2020; 50:346-355. [PMID: 32938827 PMCID: PMC7500574 DOI: 10.4041/kjod.2020.50.5.346] [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: 07/17/2019] [Revised: 11/11/2019] [Accepted: 11/13/2019] [Indexed: 11/10/2022] Open
Abstract
The treatment of skeletal Class III malocclusion in adolescents is challenging. Maxillary protraction, particularly that using bone anchorage, has been proven to be an effective method for the stimulation of maxillary growth. However, the conventional procedure, which involves the surgical implantation of mini-plates, is traumatic and associated with a high risk. Three-dimensional (3D) digital technology offers the possibility of individualized treatment. Customized miniplates can be designed according to the shape of the maxillary surface and the positions of the roots on cone-beam computed tomography scans; this reduces both the surgical risk and patient trauma. Here we report a case involving a 12-year-old adolescent girl with skeletal Class III malocclusion and midface deficiency that was treated in two phases. In phase 1, rapid maxillary expansion and protraction were performed using 3D-printed mini-plates for anchorage. The mini-plates exhibited better adaptation to the bone contour, and titanium screw implantation was safer because of the customized design. The orthopedic force applied to each mini-plate was approximately 400-500 g, and the plates remained stable during the maxillary protraction process, which exhibited efficacious orthopedic effects and significantly improved the facial profile and esthetics. In phase 2, fixed appliances were used for alignment and leveling of the maxillary and mandibular dentitions. The complete two-phase treatment lasted for 24 months. After 48 months of retention, the treatment outcomes remained stable.
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Affiliation(s)
- Shuran Liang
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Xianju Xie
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Fan Wang
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Qiao Chang
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Hongmei Wang
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Yuxing Bai
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
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Yüksel Coşkun E, Esenlik E. A Prospective Study Comparing Adolescent and Post-Adolescent Periods Regarding Effects of Activator Appliance in Patients with Class II Mandibular Retrognathia by Using 3dMDface Analysis and Cephalometry. Med Sci Monit 2020; 26:e921401. [PMID: 32588836 PMCID: PMC7337095 DOI: 10.12659/msm.921401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The purpose of this prospective study was to compare adolescent and post-adolescent growth periods regarding the effectiveness of conventional activator appliance in patients with Class II mandibular retrognathia by using lateral cephalometric radiographs and three-dimensional photogrammetry (3dMDface). MATERIAL AND METHODS We enrolled 2 groups: 15 patients in the adolescent growth period and 17 patients in the post-adolescent growth period. All patients had Class II anomaly with mandibular retrognathia and were treated with conventional activator appliances. Lateral cephalometric radiographs and three-dimensional photogrammetric views were obtained at the beginning and end of the activator treatment of Class II patients. Maxillomandibular discrepancy, mandibular protrusion and lengths, convexity angles, facial heights, and dental measurements were evaluated cephalometrically. Projections of the lips and the chin and volumetric measurements of the lip and the mandibular area were assessed using three-dimensional photogrammetry. RESULTS Conventional activator therapy resulted in similar effects in both growth periods regarding improvements in the mandibular sagittal growth and maxillomandibular relationship (ANB° and the SNB° angles). Mandibular effective length was increased (Co-Gn length) and the maxillary horizontal growth was restricted (decreased SNA° angle) in both groups following the treatment. Treatment duration was significantly longer in the post-adolescent group. Increases in the projections of menton, pogonion, and sublabial points were observed in the three-dimensional photogrammetric views. Total lip volume was reduced while the mandibular volume was significantly increased in both groups. Lower gonial angle showed a greater increase in the post-adolescent group. CONCLUSIONS Correction of Class II anomaly with mandibular retrognathia was achieved with a combination of dental and skeletal changes in both growth periods. Conventional activator therapy may be an alternative treatment approach in the late growth period as it led to significant skeletal and dental changes.
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Affiliation(s)
| | - Elçin Esenlik
- Department of Orthodontics, Akdeniz University Faculty of Dentistry, Antalya, Turkey
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Deformation of the zygomaticomaxillary and nasofrontal sutures during bone-anchored maxillary protraction and reverse-pull headgear treatments: An ex-vivo study. Am J Orthod Dentofacial Orthop 2019; 156:745-757. [PMID: 31784008 DOI: 10.1016/j.ajodo.2018.12.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 12/01/2018] [Accepted: 12/01/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Bone-anchored maxillary protraction (BAMP) is an emerging treatment that involves applying a protraction load to the maxillary bone. Although it is believed that such an approach results in better sutural separation, this has not been investigated. This study aimed to assess and compare the deformation of 1 circumaxillary suture (zygomaticomaxillary suture [ZMS]) and 1 facial suture (nasofrontal suture [NFS]) during BAMP and reverse-pull headgear (RPHG) treatment. METHODS The study was performed ex vivo on 15 pig heads. Miniplates were placed in the maxillary bone and the body of the mandible. A molar tube was bonded to the maxillary first molars. Six single-element strain gauges and 3 differential variable reluctance transducers were installed across the ZMS and NFS bilaterally. Each head underwent BAMP and RPHG unilaterally and bilaterally. RESULTS In unilateral experiments, both BAMP and RPHG resulted in tension on the ipsilateral ZMS and NFS and compression on the contralateral side, with higher magnitude in the BAMP group. In bilateral experiments, both modalities resulted in tension at the ZMS, with higher magnitude in the BAMP group. Deformation of the NFS was different between the 2 groups: tension in majority of the BAMP and compression in most of the RPHG heads. CONCLUSIONS Our study shows a higher magnitude of sutural separation in BAMP than in RPHG. The pattern of sutural deformation is consistent with a forward displacement of the midface in BAMP compared with an upward and backward rotation in the RPHG. Rotation of the maxilla was also present in some of the subjects who underwent BAMP.
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Azeem M, Haq AU, Awaisi ZH, Saleem MM, Tahir MW, Liaquat A. Failure rates of miniscrews inserted in the maxillary tuberosity. Dental Press J Orthod 2019; 24:46-51. [PMID: 31721946 PMCID: PMC6833927 DOI: 10.1590/2177-6709.24.5.046-051.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/28/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction: Anchorage conservation in orthodontics has always been a challenge. Objective: The aim of this current study was to find out the failure rate of miniscrews inserted in the maxillary tuberosity (MT) region. Methods: This pilot study consisted of 40 patients (23 female, 17 male; mean age = 20.1±8.9 years) that had received 60 MT miniscrews for orthodontic treatment. Clinical notes and pictures were used to find out the primary outcome of miniscrew failure. Independent failure factors were also investigated. Logistic regression analysis was done for predictor’s relation with MT miniscrews failure. Results: There was no significant correlation in failure rate according to various predictor variables, except for miniscrews installed by lesser experienced operators, which showed significantly more failure. The odds ratio for miniscrew failure placed by inexperienced operators was 4.16. Conclusion: A 26.3% failure rate of mini-implants inserted in the MT region was observed.
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Affiliation(s)
- Muhammad Azeem
- Faisalabad Medical University, Punjab Medical College - Dental Section, Department of Orthodontics (Faisalabad, Pakistan)
| | - Arfan Ul Haq
- De'Montmorency College of Dentistry, Department of Orthodontics (Lahore, Pakistan)
| | | | - Muhammad Mudassar Saleem
- Islamabad Medical & Dental College, Department of Oral and Maxillofacial Surgery (Islamabad, Pakistan)
| | - Muhammad Waheed Tahir
- Allama Iqbal Medical College, Jinnah Hospital, Department of Oral and Maxillofacial Surgery (Lahore, Pakistan)
| | - Ahmad Liaquat
- University of Lahore, Department of Oral and Maxillofacial Surgery (Lahore, Pakistan)
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Fakharian M, Bardideh E, Abtahi M. Skeletal Class III malocclusion treatment using mandibular and maxillary skeletal anchorage and intermaxillary elastics: a case report. Dental Press J Orthod 2019; 24:52-59. [PMID: 31721947 PMCID: PMC6833933 DOI: 10.1590/2177-6709.24.5.052-059.oar] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/02/2018] [Indexed: 11/21/2022] Open
Abstract
Introduction: Skeletal Class III malocclusion is one of the most challenging malocclusions to treat. In around 40% of Class III patients, maxillary retrognathia is the main cause of the problem and in most patients, orthopedic/surgical treatments includes some type of maxillary protraction. Objective: The aim of this case report was to describe a treatment method for a patient with maxillary retrognathia and Class III skeletal discrepancy using mandibular and maxillary skeletal anchorage with intermaxillary elastics. Case report: A 13-year-old boy with maxillary retrognathia and mandibular prognathism was treated using bilateral miniplates. Two miniplates were inserted in the mandibular canine area and two other miniplates were placed in the infrazygomatic crests of the maxilla. Class III intermaxillary elastics were used between the miniplates. Results: After eight months of orthopedic therapy, ANB angle increased by 4.1 degrees and ideal overjet and overbite were achieved. Mandibular plane angle was increased by 2.1 degrees and the palatal plane was rotated counterclockwise by 4.8 degrees. Conclusion: This case showed that the skeletal anchorage treatment method may be a viable option for treating patients with Class III skeletal malocclusion.
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Affiliation(s)
- Mehrnaz Fakharian
- Torbat Heydarieh University of Medical Sciences, Department of Orthodontics (Torbat Heydarieh, Iran)
| | - Erfan Bardideh
- Mashhad University of Medical Sciences, School of Dentistry, Postgraduate Program in Orthodontics (Mashhad, Iran)
| | - Mostafa Abtahi
- Mashhad University of Medical Sciences, Dental Research Center, Department of Orthodontics (Mashhad, Iran)
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Treatment of Class III with Facemask Therapy. Case Rep Dent 2016; 2016:6390637. [PMID: 26925273 PMCID: PMC4748064 DOI: 10.1155/2016/6390637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/04/2015] [Accepted: 12/13/2015] [Indexed: 12/01/2022] Open
Abstract
Class III malocclusion is one of the most difficult problems to treat in the mixed dentition. It has a multifactorial etiology involving both genetic and environmental causes. The dental and skeletal effects of maxillary protraction with a facemask are well documented in several studies. Although treatment in the late mixed or early permanent dentition can be successful, results are generally better in the deciduous or early mixed dentition. The following case shows early treatment of a young patient with severe sagittal and transverse discrepancy of the maxilla and mandible, using a facemask.
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Ryu HK, Chong HJ, An KY, Kang KH. Short-term and long-term treatment outcomes with Class III activator. Korean J Orthod 2015; 45:226-35. [PMID: 26445717 PMCID: PMC4593867 DOI: 10.4041/kjod.2015.45.5.226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/16/2015] [Accepted: 05/01/2015] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The purpose of this retrospective study was to investigate short-term and long-term skeletodental outcomes of Class III activator treatment. METHODS A Class III activator treatment group (AG) comprised of 22 patients (9 boys, 13 girls) was compared with a Class III control group (CG) comprised of 17 patients (6 boys, 11 girls). The total treatment period was divided into three stages; the initial stage (T1), the post-activator treatment or post-mandibular growth peak stage (T2), and the long-term follow-up stage (T3). Cephalometric changes were evaluated statistically via the Mann-Whitney U-test and the Friedman test. RESULTS The AG exhibited significant increases in the SNA angle, ANB angle, Wits appraisal, A point-N perpendicular, Convexity of A point, and proclination of the maxillary incisors, from T1 to T2. In the long-term follow-up (T1-T3), the AG exhibited significantly greater increases in the ANB angle, Wits appraisal, and Convexity of A point than the CG. CONCLUSIONS Favorable skeletal outcomes induced during the Class III activator treatment period were generally maintained until the long-term follow-up period of the post-mandibular growth peak stage.
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Affiliation(s)
- Hyo-Kyung Ryu
- Department of Orthodontics, College of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
| | | | - Ki-Yong An
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Kyung-Hwa Kang
- Department of Orthodontics, College of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
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