Fixed-functional appliance treatment combined with growth hormone therapy

Effects of nutrition and hormones on functional appliance treatment outcome in patients with skeletal Class II malocclusion

BACKGROUND

Functional appliances has been used for treatment of skeletal Class II malocclusion for a long time; however, the real skeletal effects, mandibular growth particularly, remain insufficient. Several auxiliary approaches have been attempted with the hope of enhancing treatment effects. In this review, we summarize and discuss the use of additional nutrition and hormones to assist the functional appliance treatment on patients with skeletal Class II malocclusion.

METHODS

Relevant articles were identified by electronic research in MEDLINE Ovid using keywords such as "nutrition," "hormone," "functional appliance," "orthodontics," "maxillofacial development," and "maxillofacial abnormalities." References of related articles were assessed for relevant studies to identify additional published references.

RESULTS

The literature search yielded 239 studies. According to the current literature, use of additional nutrition and hormones, including growth hormones, sex hormones, insulin, and insulin-like growth factor I, seem to improve the effects of functional appliance treatment on patients with skeletal Class II malocclusion.

CONCLUSIONS

The current evidence indicates that additional nutrition or hormones might improve the treatment effects on mandibular hypoplasia compared with the functional appliance alone, which is a promising approach and calls for further studies.

Craniofacial Morphology in Children with Growth Hormone Deficiency and Turner Syndrome

The review aims to collect and demonstrate recent knowledge about craniofacial morphology in growth hormone (GH)-deficient children and children with Turner syndrome. The review describes also the effects of growth hormone treatment on craniofacial morphology of children with growth hormone deficiency and Turner syndrome. Regardless of the disorder it accompanies, short stature is associated with similar craniofacial features characteristic of all short-statured children. Characteristic craniofacial features involve lesser dimensions of the cranial base and mandibular length, proportionately smaller posterior than anterior facial height, retrognathic face, and posterior rotation of the mandible. We also analyze orthodontic treatment in children affected by disorders associated with GH deficiency or provided with growth hormone treatment in the aspect of craniofacial growth. Recent publications show also the connection between growth hormone receptor polymorphism and craniofacial growth. Specialists and orthodontists treating short-statured children must be aware of the results of studies on craniofacial morphology and educate themselves on the topic of craniofacial growth in children with short stature. Moreover, knowledge of the influence of GH therapy on growth of craniofacial structures is necessary to decide the proper timing and planning of orthodontic treatment.

[Cephalometric analysis of influence of the Frankel-2 appliance in the treatment of distal malocclusion]

AIM

To analyze the effect of the Frankel-2 activator on the sagital maxillomandibular ratio during the treatment of distal malocclusion.

MATERIAL AND METHODS

51 patients with skeletal distal malocclusion were examined. 24 patients belong to the main group treated with Frankel-2 activator, and 27 belong to the control group that did not receive treatment. Patients age 10-14, the duration of treatment was 1.5-2 years. To estimate changes of the maxillomandibular ratio in patients before and after treatment, in the control group were analyzed lateral cephalometric X-rays with interval of two years.

RESULTS

The growth of the maxilla (ANS-PNS) in the main group was less than in the control group. The SNA angle showed similar changes in both groups. Co-Gn distance indexes were also close in both groups. In the SNB angle, the jaw in the main group was moved forward. The angle of ANB and the size of WITS in the control group are not changed, and in the main group were decreased and normalized. In contradistinction to the control group, in the main group in the upper incisors occurred retrusion and this affects the upper lip. The overjet distance in the control group was not changed, while in the main group decreased and normalized.

CONCLUSION

During the treatment of distal malocclusion by the Frankel-2 activator there is a delay in the growth of the maxilla in the saggital direction, movement of the mandibula forward, and improvement in the sagittal ratio between the maxilla and the mandibula.