Cephalometric evaluation in different phases of Jasper jumper therapy

Long-term stability of Class II malocclusion treatment with the cantilever bite jumper

INTRODUCTION

This study aimed to assess the long-term stability of Class II malocclusion treatment with the Cantilever Bite Jumper (CBJ) after 13 years of follow-up.

METHODS

The treatment group comprised 10 Class II Division 1 malocclusion patients treated with the CBJ, followed by fixed appliances, analyzed at 3 stages: pretreatment (aged 11.56-14.32 years), posttreatment (aged 16.34-19.58 years), and long-term posttreatment (aged 29.04-32.33 years). The control group included 15 subjects with normal occlusion. Intragroup treatment changes comparison was performed with repeated measures and analysis of variance followed by Tukey tests. Intergroup comparisons regarding the long-term posttreatment changes were performed with t tests.

RESULTS

No statistically significant relapse was observed during the follow-up period. Morever, the treated group presented a significantly smaller increase in lower anterior facial height and greater retrusion of the lower lip than the control group in the posttreatment period.

CONCLUSIONS

Treatment with the CBJ, followed by fixed appliances, is a stable alternative for Class II Division 1 malocclusion correction. The dentoskeletal and soft-tissue changes obtained during treatment remained stable in the long-term posttreatment follow-up.

Cephalometric analysis of dental and skeletal effects of Carriere Motion 3D appliance for Class II malocclusion

INTRODUCTION

The objective was to describe the dental and skeletal changes obtained using the Carriere Motion Appliance (CMA), lateral cephalogram, and the corresponding cephalometric tracings.

METHODS

A sample of 29 patients with Class II malocclusion (mean age, 12.6 ± 1.7 years) was retrospectively selected. All patients were treated at a single center using a CMA as the primary sagittal correction device. Cephalometric tracings at the beginning and end of treatment were compared. Each cephalometric tracing was performed 3 times by the same operator.

RESULTS

Using the CMA, the 29 patients studied reached dental Class I in 4.4 ± 0.98 months. All measurements were subjected to statistical analysis, paired t test, and all displayed differences between T0 and T1 (P <0.05) except for the SNA. At the end of treatment, the Wits and ANB values were reduced by 1.38 mm and 0.8°, respectively. Overbite and overjet were also reduced by 1.4 mm and 2 mm, respectively. The SNB, FMA, LAFH, and IMPA increased to a lesser extent (ie, 0.7°, 0.4°, 1.5 mm, and 1.5°, respectively).

CONCLUSIONS

The CMA is a rapid and efficient means of correcting Class II malocclusion. Its effects are predominantly dentoalveolar, with minimal skeletal alteration of little clinical significance.

Mandibular incisor inclination and gingival recession after treatment with the Jasper Jumper: a 10-year follow-up

OBJECTIVE

To evaluate the long-term outcomes of Class II treatment with the Jasper Jumper appliance and comprehensive orthodontic treatment concerning inclination of the mandibular incisors and gingival recession.

METHODS

Sixteen patients with Class II malocclusion at a mean age of 12.54y (SD = 1.17) were treated with the Jasper Jumper appliance and comprehensive orthodontic treatment. The mean treatment time was 2.05y (SD = 0.21). Dental records were taken before (T1), after treatment (T2) and 11.90y (SD = 0.48) after debonding (T3). The frequency of gingival recession, clinical crown height and mandibular incisor position were evaluated using intraoral photographs, digital models and lateral cephalograms. Interphase changes were evaluated using dependent t and McNemar's tests. Correlation between clinical crown height and final position of the mandibular incisors was evaluated using Pearson correlation test (P < 0.05).

RESULTS

The frequency of gingival recessions increased over time and was observed in 6 (9.4%), 12 (18.8%) and 24 (37.5%) of the mandibular incisors at T1, T2 and T3, respectively. A significant increase in labial inclination and protrusion of the mandibular incisors was observed between T1 and T2 interval. The clinical crown height significantly increased in the follow-up period (T3-T2) and in the complete observation time (T3-T1). There was no correlation between the amount of labial inclination and protrusion of the mandibular incisors and clinical crown height for all time intervals.

CONCLUSION

No significant correlation between the amount of labial movement of the mandibular incisor and clinical crown height increase was found.

Soft tissue profile changes in Angle class II patients treated with Twin Force or intermaxillary elastics-a comparison

PROPOSITION

This study aimed to compare soft tissue profile changes in Angle class II malocclusion patients treated with a Twin Force appliance (Ortho Organizers, Inc., Carlsbad, CA, USA) or class II elastics.

METHODS

The sample comprised 47 class II malocclusion patients treated orthodontically without extractions, divided into two groups. Group 1 (Twin Force): 25 patients were treated with the Twin Force, with initial and final mean ages of 17.91 and 20.45 years, respectively, and mean treatment time of 2.53 years. Group 2 (elastics): 22 patients were treated with class II elastics, with initial and final mean age of 15.87 and 18.63 years, respectively, and mean treatment time of 2.75 years. The lateral cephalograms were evaluated at the initial and final stages. Intragroup comparisons were performed with dependent t-tests and intergroup comparisons were performed with independent t-tests.

RESULTS

Treatment-related changes in the Twin Force group included reduction of facial convexity, retrusion of the upper lip, increase of the H‑Nose distance, and decrease in Sn‑H distance, indicating improvement in facial profile. In the elastics group, treatment resulted in an increase in nasolabial angle, retrusion of the upper lip, increase of the H‑Nose distance, and decrease in Sn‑H distance, indicating improvement in facial profile. The Twin Force group showed a greater reduction of the facial convexity with treatment than the elastics group.

CONCLUSIONS

Class II patients treated with the Twin Force appliance showed greater reduction in facial convexity than patients treated with class II elastics. The other soft tissue changes were similar for both groups.

Dentoskeletal and soft-tissue changes comparison between the Jasper Jumper and Twin Force Bite Corrector in Class II malocclusion patients: A retrospective study

OBJECTIVE

This retrospective study aimed to compare the dentoskeletal and soft-tissue changes in Class II malocclusion patients treated with Jasper Jumper and Twin Force Bite Corrector associated with fixed orthodontic appliances.

MATERIAL AND METHODS

The sample comprised 60 subjects divided into 3 groups. Patients with Class II malocclusion, mandibular retrusion, slight or no crowding and with no previous orthodontic treatment were eligible. Group 1 comprised 20 patients treated with the Jasper Jumper (JJ), with an initial age of 12.39 years. Group 2 comprised 20 patients treated with the Twin Force (TF), with an initial age of 11.83 years. The control group consisted of 20 untreated Class II subjects with an initial age of 12.13 years. Intergroup pretreatment comparisons were performed with One-way analysis of variance and intergroup treatment changes were compared with the Analysis of Covariance, both followed by Tukey test.

RESULTS

The TF group showed greater increase in mandibular length (6.23mm±4.64, P=0.004) than the control group (2.94mm±1.75). The mandibular incisors in the experimental groups presented significantly greater labial inclination and protrusion than the control (Md1.NB; JJ: 4.19°±2.09; TF: 4.46°±6.83; control: 1.13°±2.08, P=0.000/Md1-NB; JJ: 1.95mm±1.45; TF: 1.74mm±1.79; control: 0.31mm±0.81, P=0.000). In addition, the treated groups also showed significantly improvement of the dental relationships (Overjet; JJ: -4.05mm±4.64; TF: -3.80mm±2.12; control: 0.05mm±1.12, P=0.000/Overbite; JJ: -2.52mm±1.46; TF: -2.93mm±2.13; control: -0.63mm±1.35, P=0.000).

CONCLUSION

The Jasper Jumper and Twin Force associated to fixed appliances were effective in correcting Class II malocclusion with a combination of skeletal and dentoalveolar changes. However, the TF seems to provide more skeletal effects with greater maxillary growth restriction and mandibular length increase when compared to the JJ.

Effects of Class II division 1 malocclusion treatment with three types of fixed functional appliances

Objective:

This study aimed at comparing the dentoskeletal changes in patients with Class II division 1 malocclusion, treated with three types of fixed functional appliances.

Methods:

A sample comprising 95 patients with the same malocclusion, retrospectively selected, and divided into four groups, was used: G1 consisted of 25 patients (mean age 12.77 ± 1.24 years) treated with Jasper Jumper appliance; G2, with 25 patients (mean age 12.58 ± 1.65 years) treated with the Herbst appliance; G3, with 23 patients (mean age 12.37 ± 1.72 years) treated with the Mandibular Protraction Appliance (MPA); and a Control Group (CG) comprised of 22 untreated subjects (mean age 12.66 ± 1.12 years). Intergroup comparison was performed with ANOVA, followed by Tukey test.

Results:

The Jasper Jumper and the Herbst group showed significantly greater maxillary anterior displacement restriction. The Jasper Jumper demonstrated significantly greater increase in the mandibular plane angle, as compared to the control group. The MPA group demonstrated significantly greater palatal inclination of the maxillary incisors. Vertical development of the maxillary molars was significantly greater in the Herbst group.

Conclusions:

Despite some intergroup differences in the amount of dentoskeletal changes, the appliances were effective in correcting the main features of Class II malocclusions.

Comparative effects of the Mandibular Protraction Appliance in adolescents and adults

Objective:

The aim of this study was to compare the skeletal, dental, and soft tissue effects of the Mandibular Protraction Appliance (MPA) application in adolescent and adult Class II malocclusion patients.

Methods:

The sample comprised the pretreatment and posttreatment lateral cephalograms of 39 subjects presenting Class II malocclusion treated with the MPA and fixed appliances. Sample was divided into two groups: Group 1 comprised 23 subjects (10 male; 13 female), at a mean pretreatment age of 11.75 years, with a mean treatment time of 3.32 years; Group 2 included 16 subjects (7 male; 9 female), at a mean pretreatment age of 22.41 years, with a mean treatment time of 4.24 years. Intergroup comparison of the initial and final stages and treatment changes between the groups was performed with t tests, at p< 0.05.

Results:

The adults showed less significant amounts of skeletal, dentoalveolar and soft tissue changes than the adolescents. There was significantly greater palatal tipping of the maxillary incisors and retrusion of the upper lip in the adolescents. The adult group showed greater mandibular incisor proclination in the posttreatment stage.

Conclusion:

Adult patients treated with MPA showed less significant amounts of skeletal, dentoalveolar and soft tissue changes than adolescents.

Long-term stability of Class II treatment with the Jasper jumper appliance

INTRODUCTION

Treatment of Class II Division 1 malocclusion with orthopedic devices combined with fixed orthodontic appliances has shown excellent results when used in growing patients. We aimed to evaluate the long-term stability of the cephalometric changes obtained during Class II malocclusion correction with the Jasper jumper associated with fixed appliances.

METHODS

The treatment group comprised 24 patients who were evaluated at 3 stages: pretreatment, posttreatment, and long-term posttreatment. The control group comprised 15 subjects with normal occlusion. Intratreatment group comparisons among the 3 stages were performed with repeated measures analysis of variance, followed by Tukey tests. Intergroup comparisons of posttreatment changes and normal growth changes of the treatment group were performed with t tests.

RESULTS

Apical base relationship, maxillary incisor anteroposterior position, and overjet demonstrated significant relapses in relation to the control group.

CONCLUSIONS

Most dentoalveolar changes obtained with the Jasper jumper followed by fixed appliances during treatment remained stable in the long term. However, apical base relationship, maxillary incisor anteroposterior position, and overjet demonstrated significant relapses in relation to the control group. Therefore, active retention time should be increased in the posttreatment period.

Dentoskeletal effects produced by a Jasper Jumper with an anterior bite plane

OBJECTIVE

The aim of this retrospective study was to evaluate the dentoskeletal effects produced by a modified Jasper Jumper with an anterior bite plane for the correction of Class II division 1 malocclusion.

MATERIALS AND METHODS

A sample of 32 growing patients (mean age  =  11.9 ± 1.4 years) with Class II division 1 malocclusion and increased overbite were treated with a modified Jasper Jumper (JJ) and anterior bite plane protocol and compared with a matched control group of 30 subjects with untreated Class II malocclusion (mean age 12.2 ± 0.8 years). Lateral cephalograms were taken before treatment (T1) and at the end of comprehensive treatment (T2). Mean treatment duration was 2.1 ± 0.4 years. The T1-T2 changes in the two groups were compared with Student's t-tests for independent samples.

RESULTS

The JJ group was successfully treated to a Class I occlusal relationship with a significant reduction in overjet (-3.9 mm, P < .001) and overbite (-3.1 mm, P < .001). The JJ group exhibited a significant increase in mandibular length and a significant improvement in maxillomandibular sagittal skeletal relationships. The lower incisors were significantly proclined, while the lower first molars demonstrated significant movement in a mesial direction.

CONCLUSIONS

Use of a modified JJ appliance and anterior bite plane is an effective protocol for the treatment of Class II malocclusion with increased overbite and greater skeletal (75%) than dentoalveolar (25%) effects mainly at the mandibular level.

Correction of Angle Class II division 1 malocclusion with a mandibular protraction appliances and multiloop edgewise archwire technique

A Brazilian girl aged 14 years and 9 months presented with a chief complaint of protrusive teeth. She had a convex facial profile, extreme overjet, deep bite, lack of passive lip seal, acute nasolabial angle, and retrognathic mandible. Intraorally, she showed maxillary diastemas, slight mandibular incisor crowding, a small maxillary arch, 13-mm overjet, and 4-mm overbite. After the diagnosis of severe Angle Class II division 1 malocclusion, a mandibular protraction appliance was placed to correct the Class II relationships and multiloop edgewise archwires were used for finishing. Follow-up examinations revealed an improved facial profile, normal overjet and overbite, and good intercuspation. The patient was satisfied with her occlusion, smile, and facial appearance. The excellent results suggest that orthodontic camouflage by using a mandibular protraction appliance in combination with the multiloop edgewise archwire technique is an effective option for correcting Class II malocclusions in patients who refuse orthognathic surgery.

Mechanism of Class II correction in prepubertal and postpubertal patients with Twin Force Bite Corrector

OBJECTIVE

To compare the dentoskeletal effects and treatment efficiency of the Twin Force Bite Corrector (TFBC) appliance in Class II correction of patients treated before or after the pubertal growth spurt.

MATERIALS AND METHODS

Forty-one normodivergent Class II patients treated with the TFBC appliance were divided into two groups based on their cervical vertebral maturation stage (CVMS). Group 1 (G1) consisted of 23 patients (mean age 12.44 ± 1.59 years) where treatment was initiated before the pubertal growth spurt (CVMS I and II), while group 2 (G2) consisted of 18 patients (mean age 13.76 ± 1.44 years) where treatment was started after the pubertal growth spurt (CVMS III to V). Dentoskeletal measurements were made on lateral cephalograms taken before (T1) and after orthodontic treatment (T2).

RESULTS

During treatment, G1 had significantly greater skeletal correction than G2, with more dentoalveolar effects being observed in G2 than G1. However, on comparing both groups at the end of treatment (T2) when growth is complete, no differences in the parameters measured were observed. Overall, treatment time was significantly longer for G1 (3.67 ± 1.45 years) compared to G2 (2.75 ± 1.07 years).

CONCLUSIONS

There is no difference in overall dentoskeletal effects obtained at the end of treatment by the TFBC appliance in normodivergent prepubertal vs postpubertal patients. However, treatment efficiency based on treatment timing is significantly greater for the postpubertal group.