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[Effect of Twin-block appliance in the treatment of Class II and division I malocclusion: a cephalometric study in 12 patients].

PURPOSE: To quantitatively evaluate the skeletal and dentoalveolar changes induced by Twin-block appliance for treatment of Class II,division I malocclusions in growing children. METHODS: Twelve patients with Class II, division I malocclusions aged 10 to 12 years were investigated. The records were evaluated and compared with an age-matched sample of untreated Class II control subjects. The follow-up period was 12 months. Group t test was used for comparison. RESULTS: In the treatment group, the upper incisors retroclination of the upper incisors and the mandibular forward movement contributed more to the overjet reduction. The skeletal and dental effects changes molar correction were almost similar. The mandibular growth in the treatment group was 2.29 mm, greater than that in the control group. The posterior facial height and the anterior lower facial height increased by 2.28 mm and 2.58 mm respectively. On the other hand, unfavorable vertical changes were not observed. CONCLUSIONS: The treatment of Class II division I malocclusion with Twin-block appliance was effective in reducing overjet, correcting molar relationship and improving soft tissue profile. It can also enhance mandibular growth.

Case-Control Studies↗

[A study on the extraoral cervical traction in the treatment of skeletal Class II division 1 malocclusion in mixed dentition].

PURPOSE: To evaluate the effects of extraoral cervical traction on skeletal Class II division 1 malocclusion of early or late mixed dentition and discuss the optimal treatment timing. METHODS: The sample consisted of two groups of skeletal Class II division 1 malocclusion. One group with 11 cases was treated started in early mixed dentition while the other with 15 cases in late mixed dentition. All cases were treated with extraoral cervical traction headgear. Cephalometric analysis was conducted to evaluate the treatment effects. Student's t test was applied for statistical analysis. RESULTS: SNA, ANB and the length of maxilla (A-Ptm) were reduced and the inclination of maxillary incisor was decreased in both two groups. When comparing the two groups, it was found that the reduction of SNA was more notable, which means the inhibition of the maxilla was more evident in late mixed dentition. The difference was statistically significant (P<0.01). There was no significant difference on the distalization of the first upper molar between two groups (P<0.01). CONCLUSIONS: The extraoral cervical traction might be more effective in late mixed dentition to restrain maxillary growth in the treatment of skeletal Class II division 1 malocclusion.

Dentition, Mixed↗

[Investigation on border mandibular movement of adolescent with angle III malocclusion in initial stage of permanent dentition].

OBJECTIVE: To investigate characteristics of the border mandibular movement of the adolescent with Angle III malocclusion and to find the correlations between craniofacial morphology and border mandibular movement function. METHODS: The subjects consisted of 21 adolescent patients with Angle III malocclusion in the initial stage of permanent dentition (mean age 12.3 years). 20 adolescents with individual normal occlusion served as control (mean age 12.8 years). The border mandibular movement of all cases in the two groups were traced and recorded by K6-1 Evaluation System and standardized lateral cephalograms were taken. RESULTS: The results revealed no significant difference in the maximal movement range between two groups, but indicated a positive association between the maximum jaw opening and both the mandible length (Go-Gn) and the L1-MP. The distance from ICP to maximal opening (D) was positively correlated with facial height and the L1-MP. While to adolescents with individual normal occlusion, the wider the maximal jaw opening was, the bigger the posterior facial height and the cephalometric values of mandibular ramus. The distance D positively correlated with the anterior lower facial height. CONCLUSION: Angle III malocclusion had its characteristics in the tracing and had a specific relationship with the craniofacial morphology.

Adolescent↗

Prevalence of malocclusions and their impact on the quality of life of 18-year-old young male adults of Florianópolis, Brazil.

PURPOSE: To evaluate the prevalence and the impact of malocclusions on the quality of life of 18-year-old young male adults. MATERIALS AND METHODS: Cross-sectional study involving young adults who applied for military service in the city of Florianópolis in the year 2003 (N = 3735). The sample size was 414 individuals randomly selected during the health examination days. The malocclusion data were obtained through the Dental Aesthetic Index variables. The impact of the oral health conditions on the quality of life was obtained through the Oral Impact on Daily Performance. RESULTS: The highest prevalence was the molar relationship in mesio- or disto-occlusion with 57.3% (95% CI 52.5 - 62.1); 36.4% (95% CI 28.6% - 4.2%) of the applicants reported an impact on their quality of life as a result of the oral health condition. Results from the multiple logistic regression analysis showed that only the incisal crowding [OR 1.9 (95% CI 1.2 - 3.1)] (p = 0.008) showed an impact on the applicants' quality of life. CONCLUSION: The malocclusion of highest prevalence was molar relationship disorders (57.3%), and only the dental crowding generated an impact on the quality of life.

Adolescent↗

[Use of PAR index to evaluate the treatment outcome for Class II division 1 malocclusion with different tooth extraction patterns].

PURPOSE: To assess the outcome of orthodontic treatment for Class II division 1 malocclusion with different tooth extraction patterns using PAR index. METHODS: PAR index was applied on pre- and post-orthodontic treatment cast for 64 Class II division 1 malocclusion patients with two different tooth extraction patterns: extraction of maxillary teeth only (Group 1), and extraction of maxillary and mandibular teeth(Group 2). SPSS 10.0 software package was used for Student's t test. RESULTS: The PAR index of group 1 and group 2 pre-orthodontic treatment was 36.21+/-6.82 and 38.34+/-7.51. There were no significant difference (P>0.05) between the two groups. The PAR index of group 1 and group 2 post-orthodontic treatment was 6.13+/-1.64 and 5.89+/-1.75. There were no significant difference (P>0.05) between the two groups. The decrement and the rate of reduction of group 1 was 30.05+/-7.43 and 85.33%+/-5.68%. The decrement and the rate of reduction of group 2 was 32.38+/-8.12 and 87.47%+/-5.21%. The occlusal relationship improved significantly in the two groups after treatment. CONCLUSIONS: Treatment for Class II division 1 malocclusion with different extraction patterns can both acquire satisfactory results.

Humans↗

Acute malocclusion.

Acute malocclusion can result from disturbances in the maxillary/mandibular tooth relationship. These alterations in the occlusal position can result from high fillings, sinus problems, abscesses, periodontal disease, and moving or erupting teeth. Conditions seen less frequently include acute malocclusions secondary to an event (such as trauma) that make a stable dental relationship an unstable one. Patients can demonstrate any of a number of clinical conditions that interfere with their comfort and ability to function. This article provides information on some of the less familiar causes of acute malocclusion.

Acute Disease↗

Severe skeletal Class III malocclusion treated without surgery or extraction.

Among the malocclusions involving skeletal discrepancies, Class III occurs with the least frequency; however, it is also severe in the majority of cases. Compared with a Class II malocclusion, the mesial occlusion invariably manifests itself with greater deforming characteristics of facial harmony. The deficiency in the middle third of the face and/or the excessive length of the lower third of the face leads to significant loss of the profile's harmony. Good treatment strategies for this type of malocclusion could involve anything from intervening in the mixed dentition and/or permanent dentition in young adults to the combined orthodontic and surgical approach in patients without growth potential, who do not allow for compensations. This case report illustrates a Class III adolescent patient with severe facial profile deformity during the pubescent growth spurt, treated without extractions or orthognathic surgery.

Cephalometry↗

[Prevalence of caries and malocclusion in Ferrara school children].

The Authors examined 459 children for caries and malocclusion in Argenta. 77% of the whole sample had caries and 65% of children had malocclusion. Dental health education and public preventive programs should be organized to prevent caries and malocclusion. An extension and improvement of local epidemiological studies are needed to achieve this purpose.

Child↗

[The gnathometric evaluation of the effect of bionator in the treatment of Class II Division 1 malocclusions].

Treatment of class II division 1 malocclusion has a very important place in orthodontics because of the high frequency of this group of anomalies, as well as its special effect upon the face. The functional jaw orthopedics is of a special importance with its wide choice of orthodontic devices of which the Balter's Bionator can be put apart. The objective of this study was to gnatometrically check the efficiency of Bionator in the treatment of class II/division 1 malocclusions. Ten patients of both sexes aged from 10 to 12 years were examined and diagnosed in accordance with the clinical criterion. The following are conclusions: After twelve month of treatment, class I sagittal occlusal relation was established in all the patients. The normal values of the sagittal incisal scale were established. Bionator has shown the largest influence upon the sagittal jaw relation, whereas the effects of the transversal dimension could be neglected. Because of its obvious positive effects, the Bionator I can be recommended as the best method in the treatment of class II/division 1 malocclusion.

Activator Appliances↗

[EMG investigation on mentalis, masseter and OOS muscles of adults with Class III malocclusion].

In this study mean amplitude values obtained from mentalis, Masseter and OOS muscles electromyographic records of adults with normal occlusion and with Class III malocclusion were compared. As regards to Class III malocclusion, it was determined that mean amplitude values decrease and enough interference could not be formed due to the hypofunction of mentalis muscle related to mandibular protrusion and increase in low face height. There was no significant differences between normal and Class III malocclusion cases for the masseter muscle. Decrease of mean amplitude values were observed for the OOS muscle it was not showing maximal contraction due to the its hypofunction.

Adult↗

[Some considerations on the failures in malocclusion treatment].

In the interpretation of the author failures in the treatment of malocclusion include lack of achieving of the planned change of the primary occlusion shape despite good prognosis. The failures may be divided into: persistence of the initial morphological and functional conditions throughout the whole time of treatment, return on the initial occlusion shape after some time despite obtaining of apparent success of treatment. The appearance during the treatment of additional pathological factors, the manifestation of new pathological features in juvenile life period despite reshaping of occlusion in childhood according to treatment plan, increased mobility of teeth, hypertrophy, atrophy or decubitus ulcers of the oral mucosa and development of necrotic foci in the periosteum and pulp necrosis. Among the causes of failures in malocclusion treatment the author gives attention to the activities of the dentist and the attitude of the patient towards the treatment. Attention is called also to difficulties in collection of documentation of failures in the treatment of malocclusion. It is suggested that even fragmentary observations could help in improvement of therapeutic methods.

Dentist-Patient Relations↗

[Assessment of the condition of the parodontium in children undergoing maxillary-orthopaedic treatment with reference to malocclusion, groups of teeth and duration of treatment with orthodontic devices].

The condition of the parodontium was studied in 281 children. Group I comprised children with malocclusion treated by maxillary orthopaedic methods, group II--children with non-treated malocclusion, group III--children with normal occlusion. The condition of the parodontium was assessed in various types of malocclusion, in groups of teeth and in relation to the duration of treatment with maxillary-orthopaedic devices. The parodontium was evaluated using the indices GI and PMA. The highest prevalence of parodontitis was found in cases of isolated crowding of teeth. Changes were observed, most frequently, at the lower incisors. With time of device use the values of the GI and PMA indices increased to a peak value in the 2nd year of the treatment, while past that time these values fell.

Child↗

[Importance of posterior tooth-to-denture base discrepancy in the development of skeletal open-bite malocclusion].

This paper describes the relationship between the development of skeletal open-bite malocclusion and the tooth-to-denture base discrepancy. The cases which have a severe skeletal open-bite malocclusion are presented to evaluate the causing factor of the anterior open-bite. The anterior open-bite was associated with inferiorly positioned maxillary molars caused by the squeezing out effect of the tooth-to-denture base discrepancy, especially those in posterior part of dentition (posterior discrepancy), which provided a less steep maxillary occlusal plane in the denture frame. It was suggested that the posterior discrepancy induced a descending movement of the posterior teeth followed by a change of the occlusal plane and this effect of the posterior discrepancy was important factor in developing anterior open-bite malocclusion.

Cephalometry↗

[Prevalence of malocclusions and demand for orthodontic treatment among students at a women's high school].

Prevalences of malocclusions were investigated in a sample of 3,520 girls recorded between 1984 and 1986 at a private high school. Also, proportions of students who had received and were under treatment were surveyed for 3,501 students in 1989. In addition, ratios of a number of those who were judged to reveal maxillary protrusion with respect to that of the whole sample examined were evaluated as a function of overjet. The results of the surveys are as follows. SURVEY I) A total prevalence of malocclusion was 57.9% in the Grade 7 (G7) and 56.4% in the Grade 10 (G10). Among malocclusions surveyed, maxillary protrusion was found in 8.1% of the G7 and in 7.8% of the G10. Deep overbite was determined in 7.9% of the G7 and in 7.6% of the G10, mandibular protrusion was found in 2.4% of the G7 and in 2.7% of the G10. Edge-to-edge incisor relationships were determined in 6.4% of the G7 and in 7.6% of the G10. Anterior open bite was found in 2.4% of the G7 and in 2.9% of the G10. Crowding was found in 37.3% of the G7 and in 33.9% of the G10. SURVEY II) Prevalence of students who had orthodontic treatment at the time of survey, was 6.4% in the G7, 7.0% in the G8, 6.0% in the G9, 6.0% in the G10, 5.4% in the G11, and 3.6% in the G12. Those who had had orthodontic treatment revealed proportions of 8.1% in the G7, 8.0% in the G8, 7.7% in the G9, 11.3% in the G10, 12.2% in the G11, and 13.7% in the G12 students. SURVEY III) A proportion of 73.5% of those who had overjets more than 6 mm were judged to have maxillary protrusion.

Adolescent↗

[The treatment of secondary malocclusion in patients with periodontal disease].

The loss of osseous support resulting from periodontal disease is an etiological factor in the development of secondary malocclusions. Correction of these malocclusions demand a) advanced techniques, b) an understanding of the biological situation present in the patient with periodontal disease and c) adaptation of these techniques and forces to the reduced support. According to the treatment of malocclusion there are improvements in plaque accumulation and the distribution of occlusal forces. These factors, maintain the long term health of the teeth and their periodontium. These kind of treatment requires the maximum interdisciplinary collaboration.

Alveolar Bone Loss↗

[Incidence of temporomandibular joint disorders in patients with malocclusion].

In order to examine the relationship between the incidence of temporomandibular joint (TMJ) disorders and the occlusal problems, epidemiological surveys regarding the signs of TMJ disorders (joint noise, pain and disturbance of mandibular movement) were carried out to 149 untreated patients (54 males and 95 females) with malocclusion. The results indicated as follows: 1) Incidence of TMJ disorders was 33.6% of total samples, 27.8% of males and 36.8% of females. 2) In symptomatic subjects, the most frequent sign of TMJ disorders was joint noise (76.0%), the second was joint pain (68.0%) and the third was disturbance of mandibular movement (38.0%). 3) The incidence of TMJ disorders increased after 8 years of age, while it decreased slightly from 15 to 18 years of age and showed high frequency after 19 years of age. It was suggested that these changes were related with the occlusal configurations such as the exfoliation followed by the eruption of permanent successors or the eruption of the third molars. 4) Symmetrical anterior cross-bite malocclusion showed low incidence of TMJ disorders. In posterior cross-bite malocclusion and mandibular lateral displacement case, however, the signs of TMJ disorders were found frequently. These results suggested that the lateral shift of mandibular head in fossa may relate with the appearance of TMJ disorders.

Adolescent↗

[Frequency of malocclusion in 800 school children in the province of Pavia].

After a brief review of the literature on the subject, the results of a study of the frequency of malocclusions in 800 primary school children are reported. A very high percentage (80.3%) was observed, with a prevalence of males(83%) over females (77%). The relationships between malocclusions and age and between malocclusions an; caries are also examined.

Age Factors↗

Effect of malocclusion on mandibular movement during speech.

To investigate the effect of malocclusion on mandibular movement during speech, the Sirognathograph Analyzing System was used to analyze the form of the envelope of motion during speech, as well as the relationship between the envelope of motion and eccentric movement paths, in 10 normal subjects and 60 subjects having malocclusion. Location of the envelope of motion, and the relationship between the envelope of motion and eccentric movement paths, were closely related to specific malocclusions. It is suggested that analysis of the envelope of motion during speech has diagnostic value in speech function assessment and that its detailed analysis offers valuable information for diagnosis and initiation of dental treatment.

Adult↗