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Wu Q, Zhang Y, Xiao H, Zheng J, Jiang T, Du Y, Cao M, Li F. Evaluation of mandibular motion in adolescents with skeletal class II division 1 malocclusion during mandibular advancement using clear functional aligners: a prospective study. BMC Oral Health 2024; 24:320. [PMID: 38461253 PMCID: PMC10924979 DOI: 10.1186/s12903-024-04082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/27/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the characteristics of mandibular protrusive condylar trajectory in adolescents with skeletal Class II Division 1 malocclusion and the changes of condylar trajectory during mandibular advancement (MA) treatment using clear functional aligners. METHODS This prospective study consisted of a cross-sectional study and a longitudinal study. In cross-sectional study, sixty-one adolescents were divided into two groups: Class I (n = 30) and Class II Division 1 (n = 31). The condylar trajectory was measured and compared using the Mann-Whitney U test. The longitudinal study was the MA treatment group using clear functional aligner and consisted of 16 participants from Class II Division 1group. The condylar trajectory was collected at three-time points: pre-treatment (T1), during MA treatment at approximately 3 months (T2, 105.6 days average), and at the end of MA treatment (T3, 237.6 days average). The changes at T1, T2, and T3, as well as the symmetry between the left and right condyles across all groups, were examined using the Wilcoxon paired test. RESULTS A greater increase in the anteroposterior displacement and space displacement during protrusive movements was observed in the Class II Division 1 group compared with that in the Class I group, with a large difference being observed in the left and right condylar movements. The condylar anteroposterior displacement and space displacement decreased significantly at T2 and increased significantly at T3; however, no significant difference was observed between T1 and T3. A significant difference was observed between the condylar movement on the left and right sides at T1; however, no significant difference was observed at T2 and T3. CONCLUSIONS Adolescents with Class II Division 1 malocclusion had higher protrusive capacity than those with Class I. Moreover, their left and right condylar motion was more asymmetric. The range of condyle motion decreased first and then increased during MA therapy, and the left and right condyle movement became more symmetrical, which may be the adaptive response of neuromuscular function to the changes in jaw position.
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Affiliation(s)
- Qiuyue Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Yueying Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Hua Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Jiajing Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Tianlu Jiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Yusen Du
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Meng Cao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
| | - Feifei Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
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Aghili HA, Yassaei S, Sharifi M. Effect of Low-Level Laser Therapy on Patients With Class II Mandibular Deficiency Treated with Farmand Functional Appliance. J Lasers Med Sci 2023; 14:e12. [PMID: 37583499 PMCID: PMC10423953 DOI: 10.34172/jlms.2023.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 01/21/2023] [Indexed: 08/17/2023]
Abstract
Introduction: Considering the positive effects of a low-level laser on new bone formation, we aimed to investigate the effects of a low-level laser in the treatment of patients with class II mandibular deficiency treated with Farmand functional appliance. Methods: Twenty-two growing patients aged 10-14 years were randomly divided into "Farmand" and "Farmand+Laser" groups. All patients were treated with Farmand functional appliance. Patients in the "Farmand+laser" group were exposed to laser irradiation (980 nm, 100 mw, 4 points around temporomandibular joints, 100 seconds each point) weekly for three months after 3-4 weeks of using the appliance. Lateral cephalometry radiographs were taken from all patients before and after the treatment period, and changes in skeletal and dental parameters were measured. Results: The association of the particular laser irradiation with the functional appliance led to a greater increase in the effective length of the mandible (Co-Gn, P=0.048), the anterior sagittal position of the mandible (SNB, P=0.029), and the length of the ramus (Co-Go, P=0.028), and it showed a further decrease in the discrepancy between the jaws (ANB, P=0.000) compared with the functional appliance alone. Conclusion: The application of the laser with the chosen parameters and protocol in conjunction with the functional appliance improved the effects of the functional appliance and reduced the discrepancy between the two jaws.
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Affiliation(s)
| | | | - Mohadeseh Sharifi
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Tortarolo A, di Benedetto L, Tonni I, Tepedino M, Vallelonga T, Piancino MG. Improvement in the transverse dimension of dental arches in mixed dentition patients with posterior crossbite treated with functional therapy. Angle Orthod 2023; 93:490509. [PMID: 36719268 PMCID: PMC10117205 DOI: 10.2319/091622-647.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/01/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES To evaluate the effects of treatment of posterior crossbite (PXB) in the mixed dentition with the Function Generating Bite (FGB) appliance on the transverse dimension of the dental arches. MATERIALS AND METHODS This study included 84 PXB patients (female = 46; male = 38; mean age, 8.2 ± 1.8 years) and 69 control (C) patients (female = 31; male = 38; mean age, 8.9 ± 1.4 years). Measurements were taken with digital calipers on maxillary and mandibular study casts before (T0) and after (T1) treatment for the following measures: intermolar (IMD), intermolar gingival (IMGD), intercanine (ICD), and intercanine gingival distances (ICGD). RESULTS At T0, there was a significant difference in all maxillary measurements between the PXB and C groups (P < .001), reflecting maxillary hypoplasia in PXB patients. At T1, there was no difference between the groups. In PXB patients, the mean increase between T0 and T1 for IMD was 4.34 ± 2.42 mm; this difference measured 3.51 ± 2.19 mm for IMGD, 2.78 ± 2.37 mm for ICS, and 1.89 ± 1.7 mm for ICGD. There was no significant difference in mandibular measurements between groups at T0 and T1. CONCLUSIONS Functional therapy with FGB is effective in significantly increasing the transverse dimension of the maxillary dental arch in PXB patients. Considering its efficacy in treating masticatory dysfunction, FGB may be considered a good treatment option for the correction of PXB in growing children.
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Bariani RCB, Bigliazzi R, Cappellette Junior M, Moreira G, Fujita RR. Effectiveness of functional orthodontic appliances in obstructive sleep apnea treatment in children: literature review. Braz J Otorhinolaryngol 2021; 88:263-278. [PMID: 33757756 PMCID: PMC9422464 DOI: 10.1016/j.bjorl.2021.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/22/2020] [Accepted: 02/12/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Obstructive sleep apnea syndrome is a common condition in childhood and if left untreated can result in many health problems. An accurate diagnosis of the etiology is crucial for obstructive sleep apnea treatment success. Functional orthodontic appliances that stimulate mandibular growth by forward mandibular positioning are an alternative therapeutic option in growing patients. Objective To perform a literature review about the effects of functional orthodontic appliances used to correct the mandibular deficiency in obstructive sleep apnea treatment. Methods The literature search was conducted in June 2020 using Cochrane Library; PubMed, EBSCO (Dentistry & Oral Sciences Source), LILACS Ovid; SciELO Web of Science; EMBASE Bireme and BBO Bireme electronic databases. The search included papers published in English, until June 2020, whose methodology referred to the types and effects of functional orthopedic appliances on obstructive sleep apnea treatment in children. Results The search strategy identified thirteen articles; only four articles were randomized clinical studies. All studies using the oral appliances or functional orthopedic appliances for obstructive sleep apnea in children resulted in improvements in the apnea-hypopnea index score. The cephalometric (2D) and tomographic (3D) evaluations revealed enlargement of the upper airway and increase in the upper airspace, improving the respiratory function in the short term. Conclusion Functional appliances may be an alternative treatment for obstructive sleep apnea, but it cannot be concluded that they are effective in treating pediatric obstructive sleep apnea. There are significant deficiencies in the existing evidence, mainly due to absence of control groups, small sample sizes, lack of randomization and no long-term results.
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Affiliation(s)
- Rita Catia Brás Bariani
- Universidade Federal de São Paulo (Unifesp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
| | | | - Mario Cappellette Junior
- Universidade Federal de São Paulo (Unifesp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Gustavo Moreira
- Universidade Federal de São Paulo (Unifesp), Departamento de Psicobiologia, São Paulo, SP, Brazil
| | - Reginaldo Raimundo Fujita
- Universidade Federal de São Paulo (Unifesp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
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Aras I, Pasaoglu A, Olmez S, Unal I, Aras A. Upper airway changes following single-step or stepwise advancement using the Functional Mandibular Advancer. J Orofac Orthop 2016; 77:454-62. [PMID: 27770150 DOI: 10.1007/s00056-016-0062-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/11/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Purpose of the present study was to determine and compare possible changes in the dimensions of the pharyngeal airway, morphology of the soft palate, and position of the tongue and hyoid bone after single-step or stepwise mandibular advancement using the Functional Mandibular Advancer (FMA). PATIENTS AND METHODS The sample included 51 peak-pubertal Class II subjects. In all, 34 patients were allocated to two groups using matched randomization: a single-step mandibular advancement group (SSG) and a stepwise mandibular advancement group (SWG). Both groups were treated with FMA followed by fixed appliance therapy; the remaining 17 subjects who underwent only fixed appliance therapy constituted the control group (CG). The study was conducted using pre- and posttreatment lateral cephalometric radiographs. Data were analyzed by paired t test, one-way analysis of variance, and Pearson's correlation coefficient. RESULT In the SWG and SSG, although increases in nasopharyngeal airway dimensions were not significant compared with those in the CG, enlargements in the oropharyngeal airway dimensions at the level of the soft palate tip and behind the tongue, and decreases in soft palate angulation, were significant. Tongue height increased significantly only in the SWG. Compared with the CG, while forward movement of the hyoid was more prominent in SSG and SWG, the change in the vertical movement of the hyoid was not significant. No significant difference between SWG and SSG was observed in pharyngeal airway, soft palate, tongue or hyoid measurements. CONCLUSIONS The mode of mandibular advancement in FMA treatment did not significantly affect changes in the pharyngeal airway, soft palate, tongue, and hyoid bone.
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Aras I, Pasaoglu A, Olmez S, Unal I, Tuncer AV, Aras A. Comparison of stepwise vs single-step advancement with the Functional Mandibular Advancer in Class II division 1 treatment. Angle Orthod 2016; 87:82-87. [PMID: 27366817 DOI: 10.2319/032416-241.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare two groups of subjects at the peak of the pubertal growth period treated with the Functional Mandibular Advancer (FMA; Forestadent, Pforzheim, Germany) appliance using either single-step or stepwise mandibular advancement. MATERIALS AND METHODS This study was conducted on 34 Class II division 1 malocclusion subjects at or just before the peak phase of pubertal growth as assessed by hand-wrist radiographs. Subjects were assigned to two groups of mandibular advancement, using matched randomization. Both groups were treated with the FMA. While the mandible was advanced to a super Class I molar relation in the single-step advancement group (SSG), patients in the stepwise mandibular advancement group (SWG) had a 4-mm initial bite advancement and subsequent 2-mm advancements at bimonthly intervals. The material consisted of lateral cephalograms taken before treatment and after 10 months of FMA treatment. Data were analyzed by means paired t-tests and an independent t-test. RESULTS There were statistically significant changes in SNB, Pg horizontal, ANB, Co-Gn, and Co-Go measurements in both groups (P < .001); these changes were greater in the SWG with the exception of Co-Go (P < .05). While significant differences were found in U1-SN, IMPA, L6 horizontal, overjet, and overbite appraisals in each group (P < .001), these changes were comparable (P > .05). CONCLUSION Because of the higher rates of sagittal mandibular skeletal changes, FMA using stepwise advancement of the mandible might be the appliance of choice for treating Class II division 1 malocclusions.
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Alvares JCDC, Cançado RH, Valarelli FP, de Freitas KMS, Angheben CZ. Class II malocclusion treatment with the Herbst appliance in patients after the growth peak. Dental Press J Orthod 2013; 18:38-45. [PMID: 24352386 DOI: 10.1590/s2176-94512013000500008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate dentoskeletal effects in the treatment of Class II malocclusion performed with the Herbst appliance in patients at post-peak stage of growth. METHODS The sample consisted of 16 patients with Class II malocclusion and average initial and final ages of 14.04 (ranging from 11.50 to 35.66) and 17.14 (ranging from 13.68 to 38.64) years, respectively, who were treated for an mean time of 2.52 years. Lateral cephalograms were obtained at treatment onset (T1) and completion (T2) to evaluate the effects of therapy. Initial dental casts were also used to evaluate the overjet and the anteroposterior severity of molar relationship at treatment onset. The cephalometric changes between initial and final stages were compared by means of the non-parametric Wilcoxon test. RESULTS The results showed that the Herbst appliance did not promote significant changes in the maxillary component and the effective length of the mandible significantly increased without improving the maxillomandibular relationship. Changes in the maxillary and mandibular dentoalveolar components revealed that the maxillary incisors exhibited retrusion and lingual tipping, while the mandibular incisors presented increased protrusion and buccal tipping. The dental relationships exhibited significant improvements with the treatment. CONCLUSION Based on the present results, it was concluded that the effects of treatment performed with the Herbst appliance in patients at post-peak stage of growth are predominantly of dentoalveolar nature.
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