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Mariscal JF, Ravelli DB, Dos Santos Pinto A, Dominguez GC, de Arruda Aidar LA, Jacob HB. Comparisons of soft tissue changes after Herbst appliance treatment in three different growth phases. J World Fed Orthod 2024; 13:78-85. [PMID: 38155063 DOI: 10.1016/j.ejwf.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/21/2023] [Accepted: 11/06/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND This study aimed to compare the soft tissue effects of Herbst appliance in Class II malocclusion patients treated in three different craniofacial growth phases: prepubertal (PRE), circumpubertal (CIR), and postpubertal (POS). METHODS In total, 95 patients with Class II Division 1 malocclusion previously treated with a Herbst appliance were analyzed. Through the cervical vertebral maturation stages method, patients were allocated into three groups depending on the growth craniofacial phase at the beginning of treatment: PRE, CIR, and POS. Seventeen cephalometric measures were evaluated from each lateral radiograph before and after Herbst therapy using the Radiocef 2 software (Radio Memory, Belo Horizonte). Intragroup and intergroup treatment changes were compared statistically using a paired t test and MANOVA test, respectively. RESULTS Soft tissue thickness changes were related only to mandible; all three mandibular measurements (L1_LL, B_B', and Pog_Pog') showed thickening for the PRE group ranging from 0.92 mm (Pog_Pog') to 2.02 mm (B_B'), and only lower lip thickened overtime for the POS group (L1_LL = 0.99 mm). Soft and hard tissue pogonion displaced anteriorly, but only the soft tissue showed differences among groups; PRE group presented more anterior displacement than POS group (3.61 mm and 1.39 mm, respectively). Hard and soft tissue facial convexity decreased more in the PRE and CIR groups than in the POS group. Mentolabial sulcus depth reduced more in the PRE (1.07 mm) and CIR (1.29 mm) groups than in the POS (0.55 mm) group. Horizontal movement of the skeletal and soft pogonion presented a moderate-high positive correlation (r = 0.783), and hard and soft facial convexity showed a moderate-low positive correlation (r = 0.403). CONCLUSIONS Herbst appliance therapy produces soft tissue improvements in the three phases of craniofacial growth, being greater in patients in the PRE and CIR phases.
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Affiliation(s)
- Juan Francisco Mariscal
- Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil.
| | - Dirceu Barnabé Ravelli
- Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Ary Dos Santos Pinto
- Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | | | | | - Helder B Jacob
- Department of Orthodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
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Cattaneo PM, Holm A, Yung AKC, Isidor S, Cornelis MA. A Three-Dimensional Evaluation of Skeletal and Dentoalveolar Changes in Growing Class II Patients after Functional Appliance Therapy: A Retrospective Case-Control Study. J Clin Med 2024; 13:1315. [PMID: 38592176 PMCID: PMC10932136 DOI: 10.3390/jcm13051315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/02/2024] [Accepted: 02/19/2024] [Indexed: 04/10/2024] Open
Abstract
Background: The aim was to assess three-dimensionally mandibular and maxillary changes in growing Class II patients treated with removable functional appliances followed by fixed appliances. Methods: Twenty-four Class II patients (age range: 9 to 14, mean: 12.1 ± 1.1 years) treated with removable functional appliances followed by fixed appliances (functional appliance group-FAG) were retrospectively selected and compared to an age-matched control group (CG) treated with fixed appliances only. To be included in the study, pre- and post-treatment CBCT scans had to be available. The CBCTs were used to analyze, in 3D, the changes following treatment and growth. Results: Before treatment, overjet (FAG: 9 mm ± 2.8 (mean ± standard deviation); CG: 4 mm ± 1.7), ANB (FAG: 5.7° ± 2.0; CG: 3.2° ± 1.4), and effective mandibular length (FAG: 113.0 mm ± 4.1; CG: 116.6 mm ± 5.9) were statistically significantly different between the two groups. After treatment, overjet (FAG: -6.8 mm ± 2.8; CG: -1.8 mm ± 1.8) and effective mandibular length (FAG: 6.3 mm ± 2.6; CG: 3.9 mm ± 2.6) statistically significantly changed. There was a significant difference in the treatment effect between the FAG and the CG in overjet, ANB, and effective mandibular length. Conclusions: The results indicate that functional appliances are effective in correcting Class II malocclusions. The growth modification in the FAG resulted in an increase in mandibular length. Yet, the final length of the mandible in the FAG was smaller when compared to the CG.
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Affiliation(s)
- Paolo M. Cattaneo
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, 720 Swanston Street, Carlton, Melbourne, VIC 3053, Australia;
| | - Annemarie Holm
- Private Practice, Fisketorvet 4-6, 7.sal, 5000 Odense, Denmark
| | | | | | - Marie A. Cornelis
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, 720 Swanston Street, Carlton, Melbourne, VIC 3053, Australia;
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Shi Y, Luo S, Wang H, Yao Q, Shi Y, Cheng J. Three-dimensional bone remodelling of glenoid fossa in patients with skeletal Class III malocclusion after bimaxillary orthognathic surgery. Int J Oral Maxillofac Surg 2024; 53:133-140. [PMID: 37442687 DOI: 10.1016/j.ijom.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
This study aimed to characterize three-dimensional quantitative morphological changes of glenoid fossa in patients with skeletal Class III malocclusion treated with bimaxillary orthognathic surgery. Ninety-five eligible patients (50 male, 45 female; mean age 22.09 years) were enrolled retrospectively. Cone beam computed tomography obtained at 1 week preoperatively (T0), immediately after surgery (T1), and at ≥ 12 months postoperatively (T2) were registered based on cranial base using voxel-based registration in 3D Slicer. Glenoid fossa surface was divided spatially into four regions, and bone modelling in these regions was visualized with color maps. Our data revealed that the mean surface variations of glenoid fossa were small, with modest bone formation as a whole. No significant associations between anteroposterior or vertical mandibular displacement and overall glenoid fossa remodeling were found (P > 0.05). Moreover, bone deposition was frequently observed in the anterior-lateral region of glenoid fossa in patients with a larger mandibular movement during T0-T1 (P < 0.001). Paired bone formation in the anterior-lateral region of glenoid fossa and bone resorption in the anterior-lateral region of condylar head was frequently observed. Collectively, our results revealed that glenoid fossa underwent complex but modest bone remodeling after bimaxillary surgery in skeletal Class III patients.
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Affiliation(s)
- Y Shi
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China
| | - S Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, PR China
| | - H Wang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China
| | - Q Yao
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China
| | - Y Shi
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China
| | - J Cheng
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China.
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Zhang Y, Zheng J, Wu Q, Jiang T, Xiao H, Du Y, Qi Y, Jin Z, Li F. Three-dimensional spatial analysis of temporomandibular joint in adolescent Class II division 1 malocclusion patients: comparison of Twin-Block and clear functional aligner. Head Face Med 2024; 20:4. [PMID: 38184631 PMCID: PMC10770962 DOI: 10.1186/s13005-023-00404-y] [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: 09/20/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Our study aimed to use three-dimensional (3D) spatial morphological measurement methods to compare the influence of Twin-Block and clear functional aligners on the temporomandibular joint (TMJ) of adolescent Class II division 1 malocclusion mandibular retraction patients. We also aimed to explore the similarities and differences in the effects on the TMJ upon using Twin-Block and clear functional aligner. METHODS Cone-beam computed tomography (CBCT) data of 49 patients with Class II division 1 malocclusion (Twin-Block group: 24; clear functional aligner group: 25) were collected before and after functional orthodontic treatment, and a 3D model of the TMJ was reconstructed using MIMICS 21.0 software. Eighteen measurement parameters, including the anterior, superior, and posterior joint spaces, were measured and compared using the 3D model. RESULTS After the two groups underwent functional appliance treatment, the height, volume, and surface area of the condyle, length of the mandibular ramus and mandibular length increased; The retro-displaced condyle moved to the middle position of the articular fossa, while the rest of the condylar position did not change significantly. Remodeling of the articular fossa after treatment was not evident. The superior joint space of the clear functional aligner group increased, but there was no significant change after Twin-Block appliances treatment. CONCLUSIONS Both appliances promote condylar growth and sagittal and vertical development of the mandible in adolescent Class II division 1 malocclusion mandibular retraction patients. The length of the mandibular ramus showed a more significant increase following treatment with the Twin-Block appliances than with clear function aligners.
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Affiliation(s)
- Yueying Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Jiajing Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Qiuyue Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Tianlu Jiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Hua Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yusen Du
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yizhe Qi
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Zuolin Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
| | - Feifei Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
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Halapanavar B, Padmini MN, Deshmukh S, Tirupathi S, Waremani AS, Kasodekar A. Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study. Int J Clin Pediatr Dent 2024; 17:7-14. [PMID: 38559857 PMCID: PMC10978514 DOI: 10.5005/jp-journals-10005-2727] [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] [Indexed: 04/04/2024] Open
Abstract
Aim This current study evaluated and compared the skeletal changes in the head of the condyle, glenoid fossa, and articular space between the twin block appliance and PowerScope™ a fixed functional appliance. Materials and methods This study was a pilot, randomized, single-blinded, assessing the skeletal changes in the components of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT). The study was conducted in 20 subjects in the age range of 11-14 years with class II division 1 malocclusion. These subjects were distributed randomly between two groups with an allocation ratio of 1:1 (group I-twin block and group I-PowerScope™). Follow-ups of both groups were done till desirable skeletal correction was attained (clinical edge-to-edge incisor relation). Results Condylar parameters such as position, height, and length were evaluated bilaterally in the CBCT scans. After using both devices, there was an increase in all condylar qualities; however, the twin block appliance showed a more noticeable difference, which has been determined to be statistically significant. In the twin block group, there was an average decrease of 0.56 mm in the anterior articular space and an increase of 1.2 and 2.64 mm in the middle and posterior articular spaces, respectively. In the PowerScope™ group, there was an average decrease of 0.23 mm in the anterior articular space and an increase of 2.55 and 1.85 mm in the middle and posterior articular spaces, respectively. In the case of the twin block device, the change in glenoid fossa angle was observed to be 6.1 mm on both sides and a mean difference of 1.25 mm on the right-side and 1.75 mm on the left-side was observed in the case of PowerScope™. The difference was established to be significant with a p < 0.05 in all cases. Conclusion Condylar attributes increased after the application of both devices but the difference was more pronounced in the case of twin block appliances. The difference in articular space (middle and posterior) between the twin block group and PowerScope™ group, was not significant statistically. In the present study, the remodeling in the glenoid fossa was greater in the twin block group compared to the PowerScope™ group. How to cite this article Halapanavar B, MN P, Deshmukh S, et al. Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study. Int J Clin Pediatr Dent 2024;17(1):7-14.
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Affiliation(s)
- Bhakti Halapanavar
- Department of Orthodontics & Dentofacial Orthopedics, Dr DY Patil Dental College and Hospital, Dr DY Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - MN Padmini
- Department of Orthodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Sonali Deshmukh
- Department of Orthodontics & Dentofacial Orthopedics, Dr DY Patil Dental College and Hospital, Dr DY Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Sunnypriyatham Tirupathi
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - Afshan S Waremani
- Department of Orthodontics, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka, India
| | - Aniket Kasodekar
- Department of Orthodontics, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences & Research Centre, Belagavi, Karnataka, India
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Biggs EV, Benavides E, McNamara JA, Cevidanes LHS, Copello F, Lints RR, Lints JP, Ruellas ACO. Three-dimensional Evaluation of the Carriere Motion 3D Appliance in the treatment of Class II malocclusion. Am J Orthod Dentofacial Orthop 2023; 164:824-836. [PMID: 37598337 DOI: 10.1016/j.ajodo.2023.05.031] [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: 11/01/2021] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 08/21/2023]
Abstract
INTRODUCTION This study aimed to quantify the outcomes of adolescent patients with Class II malocclusion treated with the Carriere Motion 3D Appliance (CMA) combined with full fixed appliances. METHODS Cone-beam computed tomography scans of 22 patients were available before orthodontic treatment (T1), at removal of the CMA (T2), and posttreatment (T3). The average age of the patients was 13.5 ± 1.6 years at T1, 14.1 ± 0.2 years at T2, and 15.6 ± 0.5 years at T3. The 3-dimensional image analysis procedures were performed using ITK-SNAP (version 3.6.0; www.itksnap.org, Hatfield, Pa) and SlicerCMF (version 4.11.0; http://www.slicer.org, Cambridge, Mass); skeletal and dentoalveolar changes relative to cranial base, maxillary, and mandibular regional superimpositions were evaluated. RESULTS Changes were analyzed with 1 sample t tests using the mean differences during the CMA phase (T1 to T2) and total treatment time (T1 to T3). Significant skeletal changes included a slight reduction of ANB from T1 to T3, mandibular growth (Co-Gn increment of 1.2 mm and 3.3 mm from T1 to T2 and T1 to T3, respectively), inferior displacement of point A, and anterior and inferior displacement of point B. The mandibular plane did not change significantly during treatment. During the CMA treatment, posterior tipping and distal rotation of the maxillary molars, tip back and inferior displacement of the maxillary canines, significant mesial rotation, and superior displacement of the mandibular molars were observed. These movements rebounded during the full fixed appliance phase except for the molar and canine vertical displacements. Clinically significant dental changes during treatment included a reduction in overjet and overbite, Class II correction of the molar and canine relationship, and proclination of the mandibular incisors. CONCLUSIONS The CMA is an effective treatment modality for Class II correction in growing patients because of a combination of mesial movement of the mandibular molar, distal rotation of the maxillary molar, and anterior displacement of the mandible.
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Affiliation(s)
- Elizabeth V Biggs
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich; Private practice, Novi, Mich
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Flavio Copello
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Maryland, Baltimore, Md
| | | | | | - Antonio C O Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich; Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
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Duggal I, Singh N, Tripathi T. Queries regarding clinical finite element analysis of mandibular displacement model treated with Twin-block appliance. Am J Orthod Dentofacial Orthop 2023; 164:461-462. [PMID: 37758397 DOI: 10.1016/j.ajodo.2023.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/29/2023] [Indexed: 10/03/2023]
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Sabbagh H, Sabbagh A, Rankovic MJ, Huber C, Wichelhaus A, Hoffmann L. Influence of the force magnitude of fixed functional appliances for class II subdivision 1 treatment-a cephalometric study. J Orofac Orthop 2023:10.1007/s00056-023-00455-5. [PMID: 36877253 DOI: 10.1007/s00056-023-00455-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/08/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE To investigate the skeletal and dental effects of a hybrid fixed functional appliance (FFA) used with different force magnitudes for class II subdivision 1 treatment. METHODS Treatment records from 70 patients were evaluated: 35 patients were treated with a FFA with standard activation (SUS group) and 35 with a FFA with an additional force-generating spring (TSUS group). Two control groups were matched from the American Association of Orthodontists Foundation (AAOF) Craniofacial Growth Legacy Collection for comparison with the two treatment groups to determine skeletal and dental treatment effects. The cephalometric parameters at T0 (before treatment) and T1 (before debonding) were assessed using the Munich standard cephalometric analysis and by the sagittal occlusal analysis (SO) according to Pancherz. Data were analyzed statistically using SPSS. RESULTS No statistically significant difference for any cephalometric parameter was observed between the SUS and TSUS groups concerning the measurements at T0 and T1. Both treatment groups exhibited an effective class II therapy mainly due to a significant reduction in SNA, and ANB and an increase in SNB. In contrast to the control group, as the result of treatment a skeletal class I was achieved. CONCLUSION No significant statistical differences were observed between the patient group treated with the FFA with standard activation (SUS) and those treated with an additional spring (TSUS) regarding the cephalometric parameters investigated. Both variants were equally effective in treating class II division 1 malocclusions.
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Affiliation(s)
- Hisham Sabbagh
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestr. 70, 80336, Munich, Germany.
| | | | - Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestr. 70, 80336, Munich, Germany
| | | | - Andrea Wichelhaus
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestr. 70, 80336, Munich, Germany
| | - Lea Hoffmann
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestr. 70, 80336, Munich, Germany
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A Semi-Automatic Approach for Holistic 3D Assessment of Temporomandibular Joint Changes. J Pers Med 2023; 13:jpm13020343. [PMID: 36836577 PMCID: PMC9959062 DOI: 10.3390/jpm13020343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
The literature lacks a reliable holistic approach for the three-dimensional (3D) assessment of the temporomandibular joint (TMJ) including all three adaptive processes, which are believed to contribute to the position of the mandible: (1) adaptive condylar changes, (2) glenoid fossa changes, and (3) condylar positional changes within the fossa. Hence, the purpose of the present study was to propose and assess the reliability of a semi-automatic approach for a 3D assessment of the TMJ from cone-beam computed tomography (CBCT) following orthognathic surgery. The TMJs were 3D reconstructed from a pair of superimposed pre- and postoperative (two years) CBCT scans, and spatially divided into sub-regions. The changes in the TMJ were calculated and quantified by morphovolumetrical measurements. To evaluate the reliability, intra-class correlation coefficients (ICC) were calculated at a 95% confidence interval on the measurements of two observers. The approach was deemed reliable if the ICC was good (>0.60). Pre- and postoperative CBCT scans of ten subjects (nine female; one male; mean age 25.6 years) with class II malocclusion and maxillomandibular retrognathia, who underwent bimaxillary surgery, were assessed. The inter-observer reliability of the measurements on the sample of the twenty TMJs was good to excellent, ICC range (0.71-1.00). The range of the mean absolute difference of the repeated inter-observer condylar volumetric and distance measurements, glenoid fossa surface distance measurements, and change in minimum joint space distance measurements were (1.68% (1.58)-5.01% (3.85)), (0.09 mm (0.12)-0.25 mm (0.46)), (0.05 mm (0.05)-0.08 mm (0.06)) and (0.12 mm (0.09)-0.19 mm (0.18)), respectively. The proposed semi-automatic approach demonstrated good to excellent reliability for the holistic 3D assessment of the TMJ including all three adaptive processes.
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Muacevic A, Adler JR, Hajeer MY, Nawaya FR, Sahtout GF. Evaluation of Local Application of Glucosamine Sulfate and Chondroitin Sulfate on Temporomandibular Joint Response and Alleviation of Pain and Tension During the Functional Treatment of Skeletal Class II Patients: A Randomized Control Clinical Trial. Cureus 2023; 15:e34608. [PMID: 36751570 PMCID: PMC9897954 DOI: 10.7759/cureus.34608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE This study was conducted to assess the effects of applying a gel of combined glucosamine sulfate and chondroitin sulfate on the temporomandibular joint (TMJ) area in patients with skeletal Class II malocclusion treated by removable functional appliances in terms of TMJ internal proportions, levels of pain, and tension. MATERIALS AND METHODS The study included 36 patients aged 10-13 years with skeletal Class II malocclusion due to retrusion of the mandible characterized by: 4-8 degrees of the sagittal skeletal discrepancy (ANB) angle, 4-7 mm of overjet, 72-76 degrees of the sagittal mandibular positioning (SNB) angle, and a bone maturity stage located at pubertal growth spurt. Patients were distributed to the experimental group (Twin-Block appliance + Jointance® gel) or the control group (conventional treatment with the Twin-Block appliance). An allocation ratio of 1:1 was employed. Pre- and post-treatment digital lateral cephalometric radiograms were taken, and the TMJ joint spaces were measured using the Viewbox software (dHAL Software, Kifissia, Greece). The pain and discomfort levels were evaluated using a questionnaire with a four-point Likert scale at three assessment times. RESULTS The anterior and posterior glenoid and anterior condylar distances to the pterygoid vertical (PTV) reference plane significantly decreased after treatment (p<.001), and the anterior joint space decreased significantly (p<.001). In contrast, the superior distance of the condyle to the Frankfort horizontal reference plane increased significantly after treatment, and the same results were found for the posterior and superior joint spaces (p<.05). There were no significant differences between the two groups in the evaluated linear variables. No significant differences were found when comparing pain and tension levels between the two groups at each assessment time. A gradual decrease in pain and tension levels was observed between the three evaluation times in both groups. CONCLUSIONS A combination of glucosamine sulfate and chondroitin sulfate did not affect the temporomandibular joint spaces, pain, and tension levels in patients with skeletal Class II malocclusions treated by removable functional appliances.
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Matthaios S, Tsolakis AI, Haidich AB, Galanis I, Tsolakis IA. Dental and Skeletal Effects of Herbst Appliance, Forsus Fatigue Resistance Device, and Class II Elastics-A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11236995. [PMID: 36498570 PMCID: PMC9741176 DOI: 10.3390/jcm11236995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/13/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Our study aimed to systematically summarize the dentoskeletal effects of Herbst appliance; Forsus fatigue resistance device; and Class II elastics in adolescent Class II malocclusion. Methods: Five databases; unpublished literature; and reference lists were last searched in August 2022. Randomized clinical trials and observational studies of at least 10 Class II growing patients that assessed dentoskeletal effects through cephalometric/CBCT superimpositions were eligible. The included studies quality was assessed with the RoB 2 and ROBINS-I tools. A random-effects model meta-analysis was performed. Heterogeneity was explored with subgroup and sensitivity analyses. Results: Among nine studies (298 patients); two-to-three studies were included in each meta-analysis. Less post-treatment upper incisor retroclination (<2) and no overbite; overjet; SNA; SNB; and lower incisor inclination differences were found between Herbst/Forsus and Class II elastics. No differences in maxilla; condyle; glenoid fossa; and most mandibular changes were found between Herbst and Class II elastics; except for a greater 1.5 mm increase in mandibular length and right mandibular ramus height (1.6 mm) with Herbst. Conclusions: Herbst and Class II elastics corrected the molar relationship; but Herbst moved the lower molars more mesially. Apart from an additional mandibular length increase; no other dental and anteroposterior skeletal difference was found. Forsus was more effective in molar correction; overjet reduction; and upper incisor control than Class II elastics. Trial registration number OSF: 10.17605/OSF.IO/8TK3R.
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Affiliation(s)
- Stefanos Matthaios
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Correspondence:
| | - Apostolos I. Tsolakis
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioannis Galanis
- 2nd Propaedeutic Department of Surgery, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioannis A. Tsolakis
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Bates WR, Cevidanes LS, Larson BE, Adams D, De Oliveira Ruellas AC. Three-dimensional cone-beam computed technology evaluation of skeletal and dental changes in growing patients with Class II malocclusion treated with the cervical pull face-bow headgear appliance. Am J Orthod Dentofacial Orthop 2022; 162:491-501. [DOI: 10.1016/j.ajodo.2021.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 05/05/2021] [Accepted: 05/05/2021] [Indexed: 11/01/2022]
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Sangalli KL, Dutra-Horstmann KL, Correr GM, Topolski F, Flores-Mir C, Lagravère MO, Moro A. Three-dimensional skeletal and dentoalveolar sagittal and vertical changes associated with cantilever Herbst appliance in prepubertal patients with Class II malocclusion. Am J Orthod Dentofacial Orthop 2022; 161:638-651.e1. [PMID: 35016812 DOI: 10.1016/j.ajodo.2020.11.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 11/01/2022]
Abstract
INTRODUCTION This study aimed to assess sagittal and vertical skeletal and dentoalveolar changes through the use of 3-dimensional imaging in prepubertal Class II malocclusion patients treated with a cantilever Herbst appliance (HA). Condyle-glenoid fossa positional changes were also quantified. METHODS This retrospective cohort study assessed 22 children (11.2 years ± 1.2) consecutively treated with a cantilever HA for 12 months and 11 untreated children (aged 9.3 ± 0.30 years) that served as controls. Cone-beam computed tomography was performed at baseline (T1) and at the end of the observation period (T2). Movements in the regions of interest were measured as linear displacements from cone-beam computed tomography images through algebraic calculations. A Student t test for independent samples was used for group equivalence testing at T1, and the treatment differences between T2 and T1 were evaluated by 2 analyses of covariance, one considering the expected growth unit as a covariate and the other with an annualized factor. RESULTS The largest dental movement was a mesial movement of mandibular molars (3.70 mm), whereas the largest skeletal changes consisted of a larger relative length of the mandible (difference of 1.2 mm) in the HA group than in the control group. CONCLUSIONS Within the study limitations (retrospective cohort, historical control group, and sample size), 3-dimensional imaging suggests that HA corrected Class II malocclusion in a predominantly prepubertal sample through more dental than skeletal changes. The changes were more significant in the sagittal than in the vertical direction. In addition, relative stability in the condyle-fossa relationship was noted.
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Affiliation(s)
- Kamilla Leonardo Sangalli
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | | | - Gisele Maria Correr
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Francielle Topolski
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Manuel O Lagravère
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Alexandre Moro
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Department of Orthodontics, Federal University of Paraná, Curitiba, Paraná, Brazil.
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14
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Holte MB, Nielsen TW, Sæderup H, Pinholt EM. Does the Glenoid Fossa Change following Orthognathic Surgery? J Oral Maxillofac Surg 2022; 80:1007-1017. [DOI: 10.1016/j.joms.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
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15
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Three-Dimensional Evaluation of Condyle-Glenoid Fossa Complex Following Treatment with Herbst Appliance. J Clin Med 2021; 10:jcm10204730. [PMID: 34682852 PMCID: PMC8538158 DOI: 10.3390/jcm10204730] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
The purpose of the present retrospective observational study was to compare the effects of treatment with Herbst appliance and fixed therapy with elastics on the condyle and glenoid fossa complex. Thirty patients aged between twelve and sixteen years with skeletal Class II malocclusion who met the inclusion criteria were included in the study: fifteen patients treated with Herbst appliance (Group 1), and fifteen patients treated with orthodontic camouflage using MBT prescription (MBTTM Versatile+ Appliance System) (Group 2). For Group 2, patients had CBCT scans taken before treatment either after Herbst appliance removal or at the end of treatment. CBCT scans were evaluated for changes in condyle-glenoid fossa complex using the In Vivo Dental 5.1 software. Statistical significance was set at p ≤ 0.05. On inter-group comparison, the Herbst group showed statistically significant increases in the condylar height of 1.35 mm (p ≤ 0.001) on the right and 1.21 mm (p ≤ 0.01) on the left side, and a condylar volume of 111.03 mm3 (p ≤ 0.01) on the right and 127.80 mm3 (p ≤ 0.001) on the left side. The Herbst group showed anterior remodelling on the postero-superior aspect of glenoid fossa. Herbst appliance treatment induced growth at the condylar head and anterior remodelling of glenoid fossa, thereby improving the maxilla-mandibular relationship in growing skeletal Class II patients.
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16
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Wei RY, Atresh A, Ruellas A, Cevidanes LHS, Nguyen T, Larson BE, Mangum JE, Manton DJ, Schneider PM. Three-dimensional condylar changes from Herbst appliance and multibracket treatment: A comparison with matched Class II elastics. Am J Orthod Dentofacial Orthop 2020; 158:505-517.e6. [PMID: 32828608 DOI: 10.1016/j.ajodo.2019.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/01/2019] [Accepted: 09/01/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this study was to quantify and qualify the 3-dimensional (3D) condylar changes using mandibular 3D regional superimposition techniques in adolescent patients with Class II Division 1 malocclusions treated with either a 2-phase or single-phase approach. METHODS Twenty patients with Herbst appliances who met the inclusion criteria and had cone-beam computed tomography (CBCT) images taken before, 8 weeks after Herbst removal, and after the completion of multibracket appliance treatment constituted the Herbst group. They were compared with 11 subjects with Class II malocclusion who were treated with elastics and multibracket appliances and who had CBCT images taken before and after treatment. Three-dimensional models generated from the CBCT images were registered on the mandible using 3D voxel-based superimposition techniques and analyzed using semitransparent overlays and point-to-point measurements. RESULTS The magnitude of lateral condylar growth during the orthodontic phase (T2-T3) was greater than that during the orthopedic phase (T1-T2) for all condylar fiducials with the exception of the superior condyle (P <0.05). Conversely, posterior condylar growth was greater during the orthopedic phase than the subsequent orthodontic phase for all condylar fiducials (P <0.05). The magnitude of vertical condylar development was similar during both the orthopedic (T1-T2) and orthodontic phases (T2-T3) across all condylar fiducials (P <0.05). Posterior condylar growth during the orthodontic phase (T2-T3) of the 2-phase approach decreased for all condylar fiducials with the exception of the posterior condylar fiducial (P <0.05) when compared with the single-phase approach. CONCLUSIONS Two-phase treatment using a Herbst appliance accelerates condylar growth when compared with a single-phase regime with Class II elastics. Whereas the posterior condylar growth manifested primarily during the orthopedic phase, the vertical condylar gains occurred in equal magnitude throughout both phases of the 2-phase treatment regime.
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Affiliation(s)
- Robert Y Wei
- Growth and Development, Melbourne Dental School, University of Melbourne, Melbourne, Australia.
| | - Arjun Atresh
- Growth and Development, Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Antonio Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Tung Nguyen
- Department of Orthodontics, University of North Carolina, Chapel Hill, NC
| | - Brent E Larson
- Division of Orthodontics, University of Minnesota, Minneapolis, Minn
| | - Jonathan E Mangum
- Growth and Development, Melbourne Dental School, University of Melbourne, Melbourne, Australia; Department of Pharmacology and Therapeutics, University of Melbourne, Melbourne, Australia
| | - David J Manton
- Growth and Development, Melbourne Dental School, University of Melbourne, Melbourne, Australia; Centrum voor Tandheelkunde en Mondzorgkunde UMCG, University of Groningen, Groningen, The Netherlands
| | - Paul M Schneider
- Growth and Development, Melbourne Dental School, University of Melbourne, Melbourne, Australia
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17
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Rodríguez-Cárdenas YA, Arriola-Guillén LE, Ruíz-Mora GA, Aliaga-Del Castillo A, Boessio-Vizzotto M, Dias-Da Silveira HL. Root changes in buccal versus palatal maxillary impacted canines of adults: A longitudinal and retrospective 3-dimensional study before and after orthodontic traction. Int Orthod 2020; 18:490-502. [PMID: 32513608 DOI: 10.1016/j.ortho.2020.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/14/2020] [Accepted: 05/17/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Maxillary impacted canines (MIC) could suffer root changes after canine traction. The aim of this study was to evaluate the 3-dimensional root changes in buccal versus palatal MIC after orthodontic traction. MATERIALS AND METHODS This longitudinal and retrospective study included pre-treatment and after traction cone beam computed tomography scans (CBCTs) of 30 subjects with unilateral/bilateral MIC. A total of 43 MIC were divided into 2 groups: buccal (n=17) or palatal (n=26). Root changes in length and area after orthodontic traction were measured at sagittal, coronal and axial sections. Intergroup comparison was carried out by t or U Mann-Whitney tests, depending on normality. Multiple linear regression analysis was used to evaluate the influence of all predictor variables on root changes (P<0.05). RESULTS Significant difference between groups was found for root area changes in the upper limit of the cervical third at axial section that showed greater appositional values for the palatal impacted canine group (-1.18mm2) and resorptive values for the buccal impacted canine group (0.62mm2) (P=0.024). Position of impaction palatal influenced the increase of root area in the coronal section and in the upper limit of the cervical third at axial section. Age directly influenced the decrease of total length and root area in sagittal and coronal sections, respectively. CONCLUSION Orthodontic traction of MIC produced an important appositional root change in the palatal impaction group in the axial root area of the upper limit of the cervical third. Impaction position and age influenced the increase and decrease of root area and length of some specific radicular regions.
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Affiliation(s)
| | - Luis Ernesto Arriola-Guillén
- Division of Orthodontics and Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Peru.
| | - Gustavo Armando Ruíz-Mora
- Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
| | - Aron Aliaga-Del Castillo
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Mariana Boessio-Vizzotto
- Division of Oral Radiology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Heraldo Luis Dias-Da Silveira
- Division of Oral Radiology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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18
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Güven BA, Ciğer S. Evaluation of the Effect of Fixed Anterior Biteplane Treatment on Temporomandibular Joint in Patients with Deep Bite. Turk J Orthod 2020; 33:8-12. [PMID: 32284893 PMCID: PMC7138230 DOI: 10.5152/turkjorthod.2020.19108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/17/2020] [Indexed: 07/20/2023]
Abstract
OBJECTIVE To investigate the effects of fixed anterior biteplane treatment on temporomandibular joint in deep bite patients. METHODS The sample comprised 17 Class II patients with deep bite and decreased lower anterior facial height. The average patient age was 9.9±0.9 years. Transcranial temporomandibular joint radiographs were obtained from the subjects before (T0) and after fixed anterior biteplane treatment (T1). Anterior joint space, posterior joint space, superior joint space, anteroposterior thickness of the condylar head, vertical height of the articular fossa, and the articular fossa slope were measured on temporomandibular joint radiographs to evaluate the position of the mandibular condyles in the glenoid fossa. RESULTS The average treatment duration was 8.5±2.1 months. Slope of the articular fossa, vertical height of the articular fossa, anteroposterior thickness of the condyle, posterior joint space, superior joint space, and anterior joint space showed no statistically significant difference between T0 and T1 (p>0.05). CONCLUSION Fixed anterior biteplane appliance treatment did not change the condyle fossa relationship in Class II deep bite patients at the time of appliance removal.
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Affiliation(s)
- Bengisu Akarsu Güven
- Department of Orthodontics, Hacettepe University School of Dentistry, Ankara, Turkey
| | - Semra Ciğer
- Department of Orthodontics, Hacettepe University School of Dentistry, Ankara, Turkey
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19
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Cheib Vilefort PL, Farah LO, Gontijo HP, Moro A, Ruellas ACDO, Cevidanes LHS, Nguyen T, Franchi L, McNamara JA, Souki BQ. Condyle-glenoid fossa relationship after Herbst appliance treatment during two stages of craniofacial skeletal maturation: A retrospective study. Orthod Craniofac Res 2019; 22:345-353. [PMID: 31419375 DOI: 10.1111/ocr.12338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/08/2019] [Accepted: 08/10/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To perform a three-dimensional evaluation of the position of the condyles in patients treated with Herbst appliance (HA) in two stages of cervical vertebral maturation. SETTING AND SAMPLE POPULATION Retrospective case-control study. Pubertal Herbst group (PHG; n = 24, mean age 14.5 years, CS 3 and CS 4) and pre-pubertal Herbst group (PPHG; n = 17, mean age 9.9 years, CS 1 and CS 2) were contrasted with comparison groups of non-orthopaedically treated Class II patients in pubertal (PCG; n = 17, mean age 13.9 years) and pre-pubertal maturational stages (PPCG; n = 18, mean age 10.6 years). MATERIALS AND METHODS Cone-beam computer tomography scans were taken before treatment (T0) and at T1 after 8 to 12 months. Point-to-point measurements of the displacement of the condyles between T0 and T1, relative to the glenoid fossae, were performed in the X, Y, Z and 3D perspectives. Qualitative assessments using semi-transparent overlays and colour mapping also were produced. RESULTS The displacement of the condyles within the glenoid fossae in the treated groups was small (<0.75 mm; P > .05). Relative to the glenoid fossa, condylar position at T1 was similar to T0 in pre-pubertal and pubertal groups (P > .05). Similar condylar rotations from T0 to T1 were observed in Herbst and comparison groups, and no significant difference was found between pre-pubertal and pubertal patients. CONCLUSIONS Regardless the stage of skeletal maturation, HA treatment did not change the condyle-glenoid fossa relationship.
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Affiliation(s)
| | | | - Henrique Pársia Gontijo
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Alexandre Moro
- Graduate Program in Dentistry, University Positivo, Curitiba, Brazil
| | | | | | - Tung Nguyen
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Lorenzo Franchi
- School of Dentistry, University of Florence, Florence, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Bernardo Quiroga Souki
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
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20
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Gandedkar NH, Shrikantaiah S, Patil AK, Baseer MA, Chng CK, Ganeshkar SV, Kambalyal P. Influence of conventional and skeletal anchorage system supported fixed functional appliance on maxillo-mandibular complex and temporomandibular joint: A preliminary comparative cone beam computed tomography study. Int Orthod 2019; 17:256-268. [DOI: 10.1016/j.ortho.2019.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Moro A, Borges SW, Spada PP, Morais ND, Correr GM, Chaves CM, Cevidanes LHS. Twenty-year clinical experience with fixed functional appliances. Dental Press J Orthod 2018; 23:87-109. [PMID: 29898162 PMCID: PMC6018450 DOI: 10.1590/2177-6709.23.2.087-109.sar] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 02/23/2018] [Indexed: 12/04/2022] Open
Abstract
Introduction: Considering the large number of fixed functional appliances, choosing the best device for your patient is not an easy task. Objective: To describe the development of fixed functional appliances as well as our 20-year experience working with them. Methods: Fixed functional appliances are grouped into flexible, rigid and hybrid. They are different appliances, whose action is described here. Four clinical cases will be reported with a view to illustrating the different appliances. Conclusions: Rigid fixed functional appliances provide better skeletal results than flexible and hybrid ones. Flexible and hybrid appliances have similar effects to those produced by Class II elastics. They ultimately correct Class II with dentoalveolar changes. From a biomechanical standpoint, fixed functional appliances are more recommended to treat Class II in dolichofacial patients, in comparison to Class II elastics.
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Affiliation(s)
- Alexandre Moro
- Universidade Federal do Paraná, Programa de Pós-graduação em Ortodontia (Curitiba/PR, Brazil).,Universidade Positivo, Programa de Mestrado e Doutorado em Odontologia Clínica (Curitiba/PR, Brazil)
| | - Suellen W Borges
- Mestre em Odontologia Clínica, Universidade Positivo (Curitiba/PR, Brazil)
| | - Paula Porto Spada
- Universidade Positivo, Programa de Mestrado e Doutorado em Odontologia Clínica (Curitiba/PR, Brazil).,Mestre em Odontologia Clínica, Universidade Positivo (Curitiba/PR, Brazil)
| | - Nathaly D Morais
- Universidade Positivo, Programa de Mestrado e Doutorado em Odontologia Clínica (Curitiba/PR, Brazil).,Mestre em Odontologia Clínica, Universidade Positivo (Curitiba/PR, Brazil)
| | - Gisele Maria Correr
- Universidade Positivo, Programa de Mestrado e Doutorado em Odontologia Clínica (Curitiba/PR, Brazil)
| | - Cauby M Chaves
- Universidade Federal do Ceará, Faculdade de Farmácia, Odontologia e Enfermagem (Fortaleza/CE, Brazil)
| | - Lucia H S Cevidanes
- University of Michigan, School of Dentistry, Orthodontics and Pediatric Dentistry (Ann Arbor, EUA)
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Gerszewski C, Topolski F, Correr GM, Gomes RAP, Morais ND, Moro A. Dentoalveolar Evaluation of Lower Incisors by CBCT after Treatment with Herbst Appliance. Braz Dent J 2018; 29:562-568. [DOI: 10.1590/0103-6440201802382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 10/10/2018] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to evaluate the effects of the Herbst appliance on the proclination and protrusion of the lower incisors, and to verify if the device causes alveolar bone loss in the anterior region of the mandible. This is a retrospective study. The sample consisted of 35 individuals. The treatment group consisted of 22 individuals (8 girls and 14 boys; initial mean age of 8.2 years) who used the Cantilever Herbst appliance for a period of 12 months. The control group consisted of 13 individuals (3 girls and 10 boys; initial mean age of 8.9 years) who received no treatment and were followed up for a period of approximately 18 months. Cone-beam computed tomography scans were performed at the beginning and at the end of the observational period. The medullary bone thickness (MT), buccal cortical bone thickness (BCT), lingual cortical bone thickness (LCT), and lower incisors proclination and protrusion were evaluated. Data were submitted to statistical analysis (ANCOVA and Student’s t-test) with a significance level of 5%. There was no significant difference in MT, BCT, LCT and incisor proclination between groups. Incisor proclination increased in the treated group with no statistical significance. The treatment group showed a significant increase in the protrusion of the incisors (p = 0.02). The Herbst appliance promoted a small proclination and protrusion of the lower incisors, without relevant clinical implications. The Herbst appliance did not cause bone loss in the anterior region of the mandible during Class II treatment.
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Affiliation(s)
| | | | | | | | | | - Alexandre Moro
- Universidade Positivo, Brazil; Universidade Federal do Paraná, Brazil
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23
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Kinzinger GSM, Lisson JA, Booth D, Hourfar J. Are morphologic and topographic alterations of the mandibular fossa after fixed functional treatment detectable on tomograms? Visual classification and morphometric analysis. J Orofac Orthop 2018; 79:427-439. [PMID: 30203326 DOI: 10.1007/s00056-018-0156-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 08/08/2018] [Indexed: 11/25/2022]
Abstract
AIM The goal was to evaluate if changes in morphology and topography of the mandibular fossa after Functional Mandibular Advancer (FMA) treatment are detectable on tomograms. Furthermore, the suitability of digital tomograms (DT) over magnetic resonance imaging (MRI) for this particular question was investigated. MATERIALS AND METHODS In all, 25 patients (14 female, 11 male) with a skeletal class II malocclusion received treatment with a FMA. DTs were available prior to (T1) and after (T2) FMA treatment. A total of 50 temporomandibular joints were investigated. The mandibular fossae were evaluated metrically and visually regarding treatment-induced alterations. A p < 0.05 was set as the level for statistical significance for all tests. Results were compared to the results of a recent MRI study. RESULTS Visual inspection of all 50 joints in the DT at T1 and T2 revealed no alterations of the fossa shape in the sagittal plane; 24 patients showed identical morphology of right and left joints. The metrical analysis revealed no significant changes regarding width, depth and ratio thereof between T1 and T2. There also were no bilateral differences. Another 18 different distance measurements between porion, mandibular fossa, articular eminence and pterygoid fossa showed no significant changes. There was no detectable proof of a fossa shift. CONCLUSIONS No changes in the sagittal plane, mandibular fossa, the articular tubercle, or a possible fossa shift were found in the DT of class II patients after FMA treatment. DT and MRI measurements and the visual inspection revealed identical findings; thus, DT appears to be a valuable research tool for sagittal analysis of mandibular fossa changes.
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Affiliation(s)
- Gero Stefan Michael Kinzinger
- Department of Orthodontics, Saarland University, Universitätskliniken 56, 66421, Homburg/Saar, Germany
- Private Orthodontic Practice, Toenisvorst, Germany
| | - Jörg Alexander Lisson
- Department of Orthodontics, Saarland University, Universitätskliniken 56, 66421, Homburg/Saar, Germany.
| | - Dania Booth
- Department of Orthodontics, Saarland University, Universitätskliniken 56, 66421, Homburg/Saar, Germany
- Private Orthodontic Practice, Rheinberg, Germany
| | - Jan Hourfar
- Department of Orthodontics, Saarland University, Universitätskliniken 56, 66421, Homburg/Saar, Germany
- Private Orthodontic Practice, Michelstadt, Germany
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Cruz IDS, Pereira HSG, Jacob HB. Use of miniscrew implant to control lower incisor proclination during Herbst therapy: A case report. J World Fed Orthod 2018. [DOI: 10.1016/j.ejwf.2018.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Atresh A, Cevidanes LHS, Yatabe M, Muniz L, Nguyen T, Larson B, Manton DJ, Schneider PM. Three-dimensional treatment outcomes in Class II patients with different vertical facial patterns treated with the Herbst appliance. Am J Orthod Dentofacial Orthop 2018; 154:238-248.e1. [PMID: 30075926 PMCID: PMC6151354 DOI: 10.1016/j.ajodo.2017.11.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 11/01/2017] [Accepted: 11/01/2017] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate, using 3-dimensional superimposition techniques, the skeletal changes in Class II subjects with different vertical facial patterns treated with the Herbst appliance and to compare these skeletal changes to those of Class II controls treated with elastics. METHODS Sixteen Herbst patients who met the inclusion criteria were divided into 2 equal groups based on vertical facial pattern as determined by the Frankfort mandibular plane angle (brachyfacial, ≤22°; mesofacial, 23°-29°) and had cone-beam computed tomographs taken before treatment, 8 weeks after Herbst appliance removal, and after subsequent fixed appliance treatment. Eleven Class II control patients treated with fixed appliances and elastics had cone-beam computed tomographs taken before and after treatment. Three-dimensional models were generated from the cone-beam computed tomography images, registered on the anterior cranial bases, and analyzed using color maps and point-to-point measurements. RESULTS There were minimal differences in treatment response between the 2 Herbst groups across all skeletal parameters measured. The Herbst subjects showed a greater inferior displacement of anterior nasal spine compared with the Class II controls (Herbst brachyfacial, -1.44 mm; Herbst mesofacial, -1.95 mm) with other maxillary changes being clinically insignificant. The Herbst subjects showed greater inferior displacement of B-point compared with the Class II controls (Herbst brachyfacial, -2.59 mm; Herbst mesofacial, -2.75 mm). There were no statistically significant differences in mean linear mandibular measurements. All groups showed a trend toward posterior displacement of the condyles and glenoid fossae from the start to the end of treatment, with no significant differences across the 3 groups. There were minimal differences in the changes in gonial angle and Frankfort mandibular plane angle across all groups. CONCLUSION Approximately 2 years after Herbst treatment, the Herbst subjects with different vertical facial patterns showed similar patterns of skeletal change compared with the Class II controls treated with elastics.
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Affiliation(s)
- Arjun Atresh
- Department of Orthodontics, University of Melbourne, Melbourne, Australia
| | | | - Marilia Yatabe
- Department of Orthodontics, University of Michigan, Ann Arbor, Mich
| | - Luciana Muniz
- Department of Orthodontics, University of Michigan, Ann Arbor, Mich
| | - Tung Nguyen
- Department of Orthodontics, University of North Carolina, Chapel Hill, NC
| | - Brent Larson
- Department of Orthodontics, University of Minnesota, Minneapolis, Minn
| | - David J Manton
- Department of Orthodontics, University of Melbourne, Melbourne, Australia
| | - Paul M Schneider
- Department of Orthodontics, University of Melbourne, Melbourne, Australia.
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3D Comparison of Mandibular Response to Functional Appliances: Balters Bionator versus Sander Bite Jumping. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2568235. [PMID: 29854734 PMCID: PMC5941721 DOI: 10.1155/2018/2568235] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/18/2018] [Indexed: 11/24/2022]
Abstract
Aim To assess the three-dimensional (3D) maxillomandibular and dental response to Balters Bionator (BB) and the Sander Bite Jumping Appliance (SBJA) in growing patients. Materials and Methods Twenty-seven Class II division 1 patients (13 males, 14 females), consecutively treated with either the BB (9 females, 7 males; 10.1 ± 1.6 years) or SBJA (5 females, 6 males; 11 ± 1.9 years), were collected from a single orthodontic practice. All patients presented overjet ≥5 mm, full Class II or end-to-end molar relationship, mandibular retrusion. CBCT scans were available at T1 and after removal of the functional appliances (T2) with a mean interval of 18 months. The 3D location and direction of skeletal and dental changes with growth and treatment were quantitatively assessed. Statistical analysis was performed by means of Mann–Whitney U test (p < 0.05). Results Patients treated with the SBJA and BB orthopedic appliances presented, respectively, 4.7 mm and 4.5 mm of 3D displacement of the chin, with marked ramus growth of, respectively, 3.7 mm and 2.3 mm. While the mandible and maxilla grew downward and forward, no opening of the mandible plane was observed. Both appliances adequately controlled labial inclination of lower incisors (1.3° and 0.3°, for the SBJA and BB groups, resp.). No significant between-group differences were found for the T2−T1 changes for any of the variables, with the exception of molar displacements (significantly greater in the SBJA group than in the BB group, 1.2 mm and 0.9 mm, resp.). Conclusions The maxillomandibular and dental growth responses to BB and SBJA therapies are characterized by vertical ramus growth and elongation of mandible that improve the maxillomandibular relationship with adequate control of lower incisor position.
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Three-dimensional skeletal, dentoalveolar and temporomandibular joint changes produced by Twin Block functional appliance. J Orofac Orthop 2018; 79:245-258. [DOI: 10.1007/s00056-018-0137-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/26/2018] [Indexed: 12/20/2022]
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Al-Jewair T, Stellrecht E, Lewandowski L, Chakaki R. American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection in the orthodontic literature—use and trends: A systematic review. Am J Orthod Dentofacial Orthop 2018; 153:15-25.e10. [DOI: 10.1016/j.ajodo.2017.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/01/2017] [Accepted: 07/01/2017] [Indexed: 10/18/2022]
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Rogers K, Campbell PM, Tadlock L, Schneiderman E, Buschang PH. Treatment changes of hypo- and hyperdivergent Class II Herbst patients. Angle Orthod 2017; 88:3-9. [PMID: 29016191 DOI: 10.2319/060117-369.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To determine the relative effects of Herbst appliance therapy in hypo- and hyperdivergent patients. MATERIALS AND METHODS The treated group included 45 growing Class II, division 1, patients treated with stainless steel crown Herbst appliances, followed by fixed edgewise appliances. The untreated control group consisted of 45 Class II, division 1, subjects, matched to the treated sample based on Angle classification, age, sex, and pretreatment mandibular plane angle (MPA). Subjects were categorized as hypo- or hyperdivergent based on their MPAs. Pre- and posttreatment cephalograms were traced and superimposed on cranial base and mandibular structures. RESULTS The primary effect of the Herbst in terms of maxillomandibular correction was in the maxilla. It significantly restricted maxillary growth, producing a "headgear effect." Mandibular treatment changes depended on divergence. Hyperdivergent patients experienced a deleterious backward true mandibular rotation with Herbst treatment. Hypodivergent patients, as well as untreated hypo- and hyperdivergent controls, underwent forward true mandibular rotation. However, hypodivergent chins did not advance any more than expected for untreated hypodivergent Class II patients. CONCLUSIONS Hypo- and hyperdivergent patients benefit from the Herbst's headgear effect. While the mandibular growth of hypodivergent patients overcomes the negative rotational effects, hyperdivergent patients undergo a deleterious backward mandibular rotation and increases in facial height.
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Common 3-dimensional coordinate system for assessment of directional changes. Am J Orthod Dentofacial Orthop 2017; 149:645-56. [PMID: 27131246 DOI: 10.1016/j.ajodo.2015.10.021] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 10/01/2015] [Accepted: 10/01/2015] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate how head orientation interferes with the amounts of directional change in 3-dimensional (3D) space and to propose a method to obtain a common coordinate system using 3D surface models. METHODS Three-dimensional volumetric label maps were built for pretreatment (T1) and posttreatment (T2) from cone-beam computed tomography images of 30 growing subjects. Seven landmarks were labeled in all T1 and T2 volumetric label maps. Registrations of T1 and T2 images relative to the cranial base were performed, and 3D surface models were generated. All T1 surface models were moved by orienting the Frankfort horizontal, midsagittal, and transporionic planes to match the axial, sagittal, and coronal planes, respectively, at a common coordinate system in the Slicer software (open-source, version 4.3.1; http://www.slicer.org). The matrix generated for each T1 model was applied to each corresponding registered T2 surface model, obtaining a common head orientation. The 3D differences between the T1 and registered T2 models, and the amounts of directional change in each plane of the 3D space, were quantified for before and after head orientation. Two assessments were performed: (1) at 1 time point (mandibular width and length), and (2) for longitudinal changes (maxillary and mandibular differences). The differences between measurements before and after head orientation were quantified. Statistical analysis was performed by evaluating the means and standard deviations with paired t tests (mandibular width and length) and Wilcoxon tests (longitudinal changes). For 16 subjects, 2 observers working independently performed the head orientations twice with a 1-week interval between them. Intraclass correlation coefficients and the Bland-Altman method tested intraobserver and interobserver agreements of the x, y, and z coordinates for 7 landmarks. RESULTS The 3D differences were not affected by the head orientation. The amounts of directional change in each plane of 3D space at 1 time point were strongly influenced by head orientation. The longitudinal changes in each plane of 3D space showed differences smaller than 0.5 mm. Excellent intraobserver and interobserver repeatability and reproducibility (>99%) were observed. CONCLUSIONS The amount of directional change in each plane of 3D space is strongly influenced by head orientation. The proposed method of head orientation to obtain a common 3D coordinate system is reproducible.
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Xinqi H, Xiao C, Jun L. [Meta-analysis of the condylar position changes produced by functional appliances in class Ⅱ malocclusion]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2016; 34:589-593. [PMID: 28318159 DOI: 10.7518/hxkq.2016.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aimed to analyze the condylar position changes produced by functional appliances in class Ⅱ malocclusion by systematic review. METHODS Electronic search was conducted using Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Medline, Embase, Pubmed, and Cochrane Central Register of Controlled Trials. Studies on condylar position changes produced by functional appliances in class Ⅱ malocclusion were included. Risk of bias assessment and data extraction of included studies were conducted by two reviewers independently. The meta-analysis was carried out using Revman 5.1. RESULTS Six studies were included (five high quality and one low quality). The condylar position showed no changes after Herbst treatment. The condylar posterior space after Twin-block treatment averagely increased by 0.31 mm (P<0.000 01), whereas the condylar anterior space averagely reduced by 0.32 mm (P<0.000 01). CONCLUSIONS Twin-block appliance enables forward movement of the condylar position. This result contributes to the correction of class Ⅱ malocclusion.
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Affiliation(s)
- Huang Xinqi
- State Key Laboratory of Oral Diseases, Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Cen Xiao
- State Key Laboratory of Oral Diseases, Dept. of Oral and Maxillo-facial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Liu Jun
- State Key Laboratory of Oral Diseases, Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Ivorra-Carbonell L, Montiel-Company JM, Almerich-Silla JM, Paredes-Gallardo V, Bellot-Arcís C. Impact of functional mandibular advancement appliances on the temporomandibular joint - a systematic review. Med Oral Patol Oral Cir Bucal 2016; 21:e565-72. [PMID: 27475694 PMCID: PMC5005093 DOI: 10.4317/medoral.21180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/02/2016] [Indexed: 12/26/2022] Open
Abstract
Background Although many orthodontists have no doubts about the effectiveness of functional appliances for mandibular advancement, the impact on the temporomandibular joint (TMJ) is still in dispute. The objective of this systematic review is to examine the main effects on the TMJ of using functional appliances, both in healthy patients and in patients with a pre-existing disorder. Material and Methods A systematic review of the literature was conducted in accordance with the PRISMA guidelines. Only systematic reviews, meta-analyses, randomized clinical trials (RCTs), case-control studies and cohort studies were included. A detailed language-independent electronic search was conducted in the Pubmed, Scopus, Cochrane Library and Embase databases. All studies published between 2000 and 2015 were included. Results A total of 401 articles were identified. Of these, 159 were duplicates and were excluded. On reading the title and abstract, 213 articles were excluded because they did not answer the research question, leaving a total of 29 articles. These articles were read and assessed. Following critical reading of the full text, eight articles were excluded: seven because they were considered of low quality and one because it published redundant data. As a result, 21 articles were included. Conclusions After treatment with functional appliances, the condyle was found to be in a more advanced position, with remodelling of the condyle and adaptation of the morphology of the glenoid fossa. No significant adverse effects on the TMJ were observed in healthy patients and the appliances could improve joints that initially presented forward dislocation of the disk. Key words:Temporomandibular joint, TMJ, orthodontic appliances, functional, mandibular advancement, herbst appliance, bionator.
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Affiliation(s)
- L Ivorra-Carbonell
- Departamento de Estomatología, Unidad Docente de Ortodoncia, Clínica Odontológica, C/ Gascó Oliag n 1, 46010, Valencia, Spain,
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Ruellas ACDO, Huanca Ghislanzoni LT, Gomes MR, Danesi C, Lione R, Nguyen T, McNamara JA, Cozza P, Franchi L, Cevidanes LHS. Comparison and reproducibility of 2 regions of reference for maxillary regional registration with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2016; 149:533-42. [PMID: 27021458 DOI: 10.1016/j.ajodo.2015.09.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate the differences between 2 regions of maxillary voxel-based registration and to test the reproducibility of the registration. METHODS Three-dimensional models were built for before-treatment (T1) and after-treatment (T2) based on cone-beam computed tomography images from 16 growing subjects. Landmarks were labeled in all T2 models of the maxilla, and voxel-based registrations were performed independently by 2 observers at 2 times using 2 reference regions. The first region, the maxillary region, included the maxillary bone clipped inferiorly at the dentoalveolar processes, superiorly at the plane passing through the right and left orbitale points, laterally at the zygomatic processes through the orbitale point, and posteriorly at a plane passing through the distal surface of the second molars. In the second region, the palate and infrazygomatic region had different posterior and anterior limits (at the plane passing through the distal aspects of the first molars and the canines, respectively). The differences between the registration regions were measured by comparing the distances between corresponding landmarks in the T2 registered models and comparing the corresponding x, y, and z coordinates from corresponding landmarks. Statistical analysis of the differences between the T2 surface models was performed by evaluating the means and standard deviations of the distances between landmarks and by testing the agreement between coordinates from corresponding landmarks (intraclass correlation coefficient and Bland-Altman method). RESULTS The means of the differences between landmarks from the palate and infrazygomatic region to the maxillary region 3-dimensional surface models at T2 for all regions of reference, times of registrations, and observer combinations were smaller than 0.5 mm. The intraclass correlation coefficient and the Bland-Altman plots indicated adequate concordance. CONCLUSIONS The 2 regions of regional maxillary registration showed similar results and adequate intraobserver and interobserver reproducibility values.
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Affiliation(s)
- Antonio Carlos de Oliveira Ruellas
- Associate professor, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Brazilian National Counsel of Technological and Scientific Development (CNPq) researcher and postdoctoral fellow, School of Dentistry, University of Michigan, Ann Arbor, Mich.
| | | | - Marcelo Regis Gomes
- Postgraduate student, Department of Prosthetics, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Carlotta Danesi
- Postgraduate student, Department of Clinical Sciences and Translational Medicine, University of Rome, Rome, Italy
| | - Roberta Lione
- PhD fellow, Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Rome, Italy
| | - Tung Nguyen
- Assistant professor, Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - James A McNamara
- Thomas M. and Doris Graber Endowed Professor Emeritus, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Paola Cozza
- Professor and department chair, Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Rome, Italy
| | - Lorenzo Franchi
- Research associate, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy; Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Mich
| | - Lucia Helena Soares Cevidanes
- Assistant professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
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Parton AL, Duncan WJ, Oliveira ME, Key O, Farella M. Implant-based three-dimensional superimposition of the growing mandible in a rabbit model. Eur J Orthod 2015; 38:546-52. [PMID: 26609073 DOI: 10.1093/ejo/cjv085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The reliable assessment of craniofacial morphological changes during growth requires invariant regions for image registration. As these regions have not yet been identified in three dimensions, intra-osseous implants are required as fiducial markers for the reliable assessment of three-dimensional (3D) mandibular growth changes. The objective of this study was to develop an animal model for the assessment of the 3D morphological changes of the mandible during growth, using implants as fiducial markers. MATERIALS AND METHODS Titanium implants were placed in the body of the mandible of six New Zealand White rabbits. Cone beam computed tomography (CBCT) scans were taken 1-week following implant placement and after an additional 8-weeks of growth. Segmentations of CBCT images were exported into custom-made scripts, implant centroids were identified, implant stability during growth calculated, and the segmented mandibles were registered on the implant centroids. RESULTS The buccal cortical bone of the body of the mandible was stable during growth and suitable for fiducial marker placement. Bilateral implants resulted in more accurate rigid registration of the growing rabbit mandible than only unilateral implants. 3D mandibular growth changes were visualised by means of semi-transparencies. CONCLUSIONS This animal model appears to be feasible for the assessment of the 3D morphological changes occurring during mandibular growth. To the best of our knowledge this is the first time that the implant superimposition method has been combined with 3D imaging to accurately reveal mandibular growth changes.
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Affiliation(s)
- Andrew L Parton
- *Department of Oral Sciences, University of Otago, Dunedin, New Zealand and
| | - Warwick J Duncan
- *Department of Oral Sciences, University of Otago, Dunedin, New Zealand and
| | - Marcelo E Oliveira
- **Robotic System Laboratory (LSRO), Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Oscar Key
- *Department of Oral Sciences, University of Otago, Dunedin, New Zealand and
| | - Mauro Farella
- *Department of Oral Sciences, University of Otago, Dunedin, New Zealand and
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Al-Saleh MAQ, Alsufyani N, Flores-Mir C, Nebbe B, Major PW. Changes in temporomandibular joint morphology in class II patients treated with fixed mandibular repositioning and evaluated through 3D imaging: a systematic review. Orthod Craniofac Res 2015; 18:185-201. [DOI: 10.1111/ocr.12099] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 11/27/2022]
Affiliation(s)
- M. A. Q. Al-Saleh
- Faculty of Medicine and Dentistry; University of Alberta; Edmonton AB Canada
| | - N. Alsufyani
- Faculty of Medicine and Dentistry; University of Alberta; Edmonton AB Canada
| | - C. Flores-Mir
- Faculty of Medicine and Dentistry; University of Alberta; Edmonton AB Canada
| | | | - P. W. Major
- Faculty of Medicine and Dentistry; University of Alberta; Edmonton AB Canada
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De Clerck HJ, Proffit WR. Growth modification of the face: A current perspective with emphasis on Class III treatment. Am J Orthod Dentofacial Orthop 2015; 148:37-46. [DOI: 10.1016/j.ajodo.2015.04.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 04/01/2015] [Accepted: 04/01/2015] [Indexed: 10/23/2022]
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The validity of using surface meshes for evaluation of three-dimensional maxillary and mandibular surgical changes. Int J Oral Maxillofac Surg 2015; 44:914-20. [PMID: 25752242 DOI: 10.1016/j.ijom.2015.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/21/2014] [Accepted: 02/04/2015] [Indexed: 11/20/2022]
Abstract
The three-dimensional (3D) changes in hard tissue position following orthognathic surgery have been reported using 3D cephalometry, changes in volume, principal component analysis, and changes based on the surface model of the hard tissue. The aim of this study was to determine the validity of using surface models as a method of assessing positional changes of the maxilla and mandible. The actual unidirectional movement of the maxilla (advancement or downgraft) and the mandible (advancement), together with bidirectional movement of the maxilla (simultaneous advancement and downgraft) were simulated on a plastic skull. Following cone beam computed tomography scanning of each surgical simulation, the actual surgical movement was compared to the analysis based on surface model movement using the mean absolute distance of all points, the 90th percentile, and the root mean square (RMS) distance. All three methods of assessment of analysis consistently underestimated the actual amount of surgical movement. The movement was approximately one-third to one-half of the actual surgical movement. The use of surface meshes and point-to-point measurements grossly underestimates the 3D changes in the maxilla and mandible in simulated surgical procedures. Currently there are limitations in fully describing the true positional changes of the maxilla or the mandible in three dimensions.
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Yildirim E, Karacay S, Erkan M. Condylar response to functional therapy with Twin-Block as shown by cone-beam computed tomography. Angle Orthod 2014; 84:1018-25. [PMID: 24713070 DOI: 10.2319/112713-869.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the condylar changes through cone-beam computed tomography (CBCT) images in patients treated with Twin-Block functional appliance. MATERIALS AND METHODS In this retrospective study, CBCT images of 30 patients who were treated with the Twin-Block appliance were used. Mandible was segmented and pretreatment and posttreatment (T0 and T1) condylar volume was compared. The angle between sella-nasion-Point A (SNA), angle between sella-nasion-Point B (SNB), angle between Point A-nasion-Point B (ANB), midfacial length (Co-A), mandibular length (Co-Gn), and the distances from right condylion to left condylion (CoR-CoL) were also measured on three-dimensional images. Differences were analyzed with Wilcoxon signed rank tests, and Mann-Whitney U-tests were used to compare the scores of male and female participants. Significance was set at P < .05. RESULTS In this study, a decrease in SNA and ANB (P < .05 and P < .01, respectively) and an increase in SNB (P < .01) were found. Additionally, CoR-CoL, Co-Gn, and condylar volume increased at both the left and right sides (P < .01). However, increase at Co-A was not statistically significant (P > .05). Comparison of differences by sex was not statistically significant for all measurements (P > .05). CONCLUSION Twin-Block appliance increases condylar volume, mandibular length, and intercondylar distance by stimulating growth of condyle in an upward and backward direction.
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Affiliation(s)
- Ersin Yildirim
- a Assistant Professor, Gülhane Military Medical Academy Haydarpasha Education Hospital, Dental Service, Section of Orthodontics, Istanbul, Turkey
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