Skip to main content
Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 1/2021

23.06.2020 | Original Article

Management of skeletal class II malocclusion using bimaxillary skeletal anchorage supported fixed functional appliances

A novel technique

verfasst von: Gagan Deep Kochar, SM Londhe, Anubhav Shivpuri, SS Chopra, Rajat Mitra, Munish Verma

Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Aim

To evaluate the treatment effects in growing skeletal class II patients subjected to a novel treatment technique, i.e., bimaxillary miniplates supported fixed functional appliance. The null hypothesis was that there is no statistically significant difference in skeletal changes of patients with class II malocclusion treated with bimaxillary skeletal anchorage supported fixed functional appliance and those who were not provided any intervention.

Methods

The sample comprised 32 skeletal class II subjects (17 males and 15 females) with a Cervical Vertebrae Maturity Index (CVMI) demonstrating peak of pubertal growth spurt. Sixteen patients (12.37 ±1.09 years of age) were treated with bimaxillary skeletal anchorage supported fixed function appliance, while 16 well-matched subjects (12.06 ± 1.34 years of age) were included as controls. For both groups, cephalograms (T1, T2) were taken with a matched observational interval of about 7.5 months; 17 linear and 10 angular measurements were recorded. The intraclass correlation coefficient (ICC) was used to determine reliability of measurements recorded. Student t test was carried out to determine the changes produced by the treatment relative to control.

Results

When compared with the control group, the treatment group demonstrated significant maxillary retrusion. No significant changes were seen in mandibular growth pattern, whereas mandibular length increased significantly more than in the control group (B-VP: 3.05 mm; Co-Gn: 2.65 mm). Treatment mechanics had minimal effects on maxillary dentition. Mandibular incisors proclined by an average of 3.06°. Maxilla–mandibular relation improved significantly (ANB: −4.29°; NA-Pog: −3.76°).

Conclusion

The new bimaxillary skeletal anchorage supported fixed functional appliance technique was found to be highly effective in the treatment of class II malocclusion with significant skeletal changes.
Literatur
1.
Zurück zum Zitat Garner LD, Butt MH (1985) Malocclusion in black Americans and Nyeri Kenyans. An epidemiologic study. Angle Orthod 55:139–146PubMed Garner LD, Butt MH (1985) Malocclusion in black Americans and Nyeri Kenyans. An epidemiologic study. Angle Orthod 55:139–146PubMed
2.
Zurück zum Zitat Proffit WR, Fields HW Jr, Moray LJ (1998) Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg 13:97–106PubMed Proffit WR, Fields HW Jr, Moray LJ (1998) Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg 13:97–106PubMed
3.
Zurück zum Zitat McNamara JA Jr (1981) Components of class II malocclusion in children 8–10 years of age. Angle Orthod 51:177–202PubMed McNamara JA Jr (1981) Components of class II malocclusion in children 8–10 years of age. Angle Orthod 51:177–202PubMed
4.
Zurück zum Zitat Stahl F, Baccetti T, Franchi L, McNamara JA Jr (2008) Longitudinal growth changes in untreated subjects with Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop 134:125–137CrossRef Stahl F, Baccetti T, Franchi L, McNamara JA Jr (2008) Longitudinal growth changes in untreated subjects with Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop 134:125–137CrossRef
5.
Zurück zum Zitat Al-Khateeb EA, Al-Khateeb SN (2009) Anteroposterior and vertical components of class II division 1 and division 2 malocclusion. Angle Orthod 79:859–866CrossRef Al-Khateeb EA, Al-Khateeb SN (2009) Anteroposterior and vertical components of class II division 1 and division 2 malocclusion. Angle Orthod 79:859–866CrossRef
6.
Zurück zum Zitat Trauner R, Obwegeser H (1957) The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 10:677–689CrossRef Trauner R, Obwegeser H (1957) The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 10:677–689CrossRef
7.
Zurück zum Zitat De Almeida MR, Henriques JF, Ursi W (2002) Comparative study of the Fränkel (FR-2) and bionator appliances in the treatment of Class II malocclusion. Am J Orthod Dentofacial Orthop 121:458–466CrossRef De Almeida MR, Henriques JF, Ursi W (2002) Comparative study of the Fränkel (FR-2) and bionator appliances in the treatment of Class II malocclusion. Am J Orthod Dentofacial Orthop 121:458–466CrossRef
8.
Zurück zum Zitat Toth LR, McNamara JA Jr (1999) Treatment effects produced by the twin-block appliance and the FR‑2 appliance of Fränkel compared with an untreated Class II sample. Am J Orthod Dentofacial Orthop 116:597–609CrossRef Toth LR, McNamara JA Jr (1999) Treatment effects produced by the twin-block appliance and the FR‑2 appliance of Fränkel compared with an untreated Class II sample. Am J Orthod Dentofacial Orthop 116:597–609CrossRef
9.
Zurück zum Zitat Baltromejus S, Ruf S, Pancherz H (2002) Effective temporomandibular joint growth and chin position changes: Activator versus Herbst treatment. A cephalometric roentgenographic study. Eur J Orthod 24:627–637CrossRef Baltromejus S, Ruf S, Pancherz H (2002) Effective temporomandibular joint growth and chin position changes: Activator versus Herbst treatment. A cephalometric roentgenographic study. Eur J Orthod 24:627–637CrossRef
10.
Zurück zum Zitat Koretsi V, Zymperdikas VF, Papageorgiou SN, Papadopoulos MA (2015) Treatment effects of removable functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis. Eur J Orthod 37:418–434CrossRef Koretsi V, Zymperdikas VF, Papageorgiou SN, Papadopoulos MA (2015) Treatment effects of removable functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis. Eur J Orthod 37:418–434CrossRef
11.
Zurück zum Zitat Vaid NR, Doshi VM, Vandekar MJ (2014) Class II treatment with functional appliances: A meta-analysis of short-term treatment effects. Semin Orthod 20:324–338CrossRef Vaid NR, Doshi VM, Vandekar MJ (2014) Class II treatment with functional appliances: A meta-analysis of short-term treatment effects. Semin Orthod 20:324–338CrossRef
12.
Zurück zum Zitat Küçükkeleş N, Ilhan I, Orgun IA (2007) Treatment efficiency in skeletal Class II patients treated with the jasper jumper. Angle Orthod 77:449–456CrossRef Küçükkeleş N, Ilhan I, Orgun IA (2007) Treatment efficiency in skeletal Class II patients treated with the jasper jumper. Angle Orthod 77:449–456CrossRef
13.
Zurück zum Zitat Ritto AK, Ferreira AP (2000) Fixed functional appliances—a classification. Funct Orthod 17:12–32PubMed Ritto AK, Ferreira AP (2000) Fixed functional appliances—a classification. Funct Orthod 17:12–32PubMed
14.
Zurück zum Zitat Aslan BI, Kucukkaraca E, Turkoz C, Dincer M (2014) Treatment effects of the Forsus Fatigue Resistant Device used with miniscrew anchorage. Angle Orthod 84:76–87CrossRef Aslan BI, Kucukkaraca E, Turkoz C, Dincer M (2014) Treatment effects of the Forsus Fatigue Resistant Device used with miniscrew anchorage. Angle Orthod 84:76–87CrossRef
15.
Zurück zum Zitat Celikoglu M, Unal T, Bayram M, Candirli C (2014) Treatment of a skeletal Class II malocclusion using fixed functional appliance with miniplate anchorage. Eur J Dent 8:276–280CrossRef Celikoglu M, Unal T, Bayram M, Candirli C (2014) Treatment of a skeletal Class II malocclusion using fixed functional appliance with miniplate anchorage. Eur J Dent 8:276–280CrossRef
16.
Zurück zum Zitat Elkordy SA, Abouelezz AM, Fayed MM, Attia KH, Ishaq RA, Mostafa YA (2016) Three-dimensional effects of the mini-implant-anchored Forsus Fatigue Resistant Device: a randomized controlled trial. Angle Orthod 86:292–305CrossRef Elkordy SA, Abouelezz AM, Fayed MM, Attia KH, Ishaq RA, Mostafa YA (2016) Three-dimensional effects of the mini-implant-anchored Forsus Fatigue Resistant Device: a randomized controlled trial. Angle Orthod 86:292–305CrossRef
17.
Zurück zum Zitat Baccetti T, Franchi L, McNamara JA Jr (2005) The cervical vertebral maturation (CVM) method for the assessment of optimal treatment timing in dentofacial orthopedics. Semin Orthod 11:119–129CrossRef Baccetti T, Franchi L, McNamara JA Jr (2005) The cervical vertebral maturation (CVM) method for the assessment of optimal treatment timing in dentofacial orthopedics. Semin Orthod 11:119–129CrossRef
18.
Zurück zum Zitat Celikoglu M, Oktay H (2014) Effects of maxillary protraction for early correction of Class III malocclusion. Eur J Orthod 36:86–92CrossRef Celikoglu M, Oktay H (2014) Effects of maxillary protraction for early correction of Class III malocclusion. Eur J Orthod 36:86–92CrossRef
19.
Zurück zum Zitat Baccetti T, Franchi L, Toth LR, McNamara JA Jr (2000) Treatment timing for twin-block therapy. Am J Orthod Dentofacial Orthop 118:159–170CrossRef Baccetti T, Franchi L, Toth LR, McNamara JA Jr (2000) Treatment timing for twin-block therapy. Am J Orthod Dentofacial Orthop 118:159–170CrossRef
20.
Zurück zum Zitat O’Brien K, Wright J, Conboy F, Sanjie Y, Mandall N, Chadwick S et al (2003) Effectiveness of early orthodontic treatment with the Twin-block appliance: a multicenter, randomized, controlled trial. Part 1: Dental and skeletal effects. Am J Orthod Dentofacial Orthop 124:234–243CrossRef O’Brien K, Wright J, Conboy F, Sanjie Y, Mandall N, Chadwick S et al (2003) Effectiveness of early orthodontic treatment with the Twin-block appliance: a multicenter, randomized, controlled trial. Part 1: Dental and skeletal effects. Am J Orthod Dentofacial Orthop 124:234–243CrossRef
21.
Zurück zum Zitat Al-Dumaini AA, Halboub E, Alhammadi MS, Ishaq RAR, Youssef M (2018) A novel approach for treatment of skeletal Class II malocclusion: miniplates-based skeletal anchorage. Am J Orthod Dentofacial Orthop 153:239–247CrossRef Al-Dumaini AA, Halboub E, Alhammadi MS, Ishaq RAR, Youssef M (2018) A novel approach for treatment of skeletal Class II malocclusion: miniplates-based skeletal anchorage. Am J Orthod Dentofacial Orthop 153:239–247CrossRef
22.
Zurück zum Zitat Unal T, Celikoglu M, Candirli C (2015) Evaluation of the effects of skeletal anchoraged Forsus FRD using miniplates inserted on mandibular symphysis: a new approach for the treatment of Class II malocclusion. Angle Orthod 85:413–419CrossRef Unal T, Celikoglu M, Candirli C (2015) Evaluation of the effects of skeletal anchoraged Forsus FRD using miniplates inserted on mandibular symphysis: a new approach for the treatment of Class II malocclusion. Angle Orthod 85:413–419CrossRef
23.
Zurück zum Zitat Aras A, Ada E, Saracoglu H, Gezer NS, Aras I (2011) Comparison of treatments with the Forsus fatigue resistant device in relation to skeletal maturity: a cephalometric and magnetic resonance imaging study. Am J Orthod Dentofacial Orthop 140:616–625CrossRef Aras A, Ada E, Saracoglu H, Gezer NS, Aras I (2011) Comparison of treatments with the Forsus fatigue resistant device in relation to skeletal maturity: a cephalometric and magnetic resonance imaging study. Am J Orthod Dentofacial Orthop 140:616–625CrossRef
24.
Zurück zum Zitat Papageorgiou SN, Zogakis IP, Papadopoulos MA (2012) Failure rates and associated risk factors of orthodontic miniscrew implants: a meta-analysis. Am J Orthod Dentofacial Orthop 142:577–595CrossRef Papageorgiou SN, Zogakis IP, Papadopoulos MA (2012) Failure rates and associated risk factors of orthodontic miniscrew implants: a meta-analysis. Am J Orthod Dentofacial Orthop 142:577–595CrossRef
25.
Zurück zum Zitat Celikoglu M, Buyuk SK, Ekizer A, Unal T (2016) Treatment effects of skeletally anchored Forsus FRD EZ and Herbst appliances: a retrospective clinical study. Angle Orthod 86:306–314CrossRef Celikoglu M, Buyuk SK, Ekizer A, Unal T (2016) Treatment effects of skeletally anchored Forsus FRD EZ and Herbst appliances: a retrospective clinical study. Angle Orthod 86:306–314CrossRef
26.
Zurück zum Zitat von Bremen J, Ludwig B, Ruf S (2015) Anchorage loss due to Herbst mechanics-preventable through miniscrews? Eur J Orthod 37:462–466CrossRef von Bremen J, Ludwig B, Ruf S (2015) Anchorage loss due to Herbst mechanics-preventable through miniscrews? Eur J Orthod 37:462–466CrossRef
27.
Zurück zum Zitat Bowman AC, Saltaji H, Flores-Mir C, Preston B, Tabbaa S (2013) Patient experiences with the Forsus Fatigue Resistant Device. Angle Orthod 83:437–446CrossRef Bowman AC, Saltaji H, Flores-Mir C, Preston B, Tabbaa S (2013) Patient experiences with the Forsus Fatigue Resistant Device. Angle Orthod 83:437–446CrossRef
28.
Zurück zum Zitat Cornelis MA, Scheffler NR, Mahy P, Siciliano S, De Clerck HJ, Tulloch JF (2008) Modified miniplates for temporary skeletal anchorage in orthodontics: placement and removal surgeries. J Oral Maxillofac Surg 66:1439–1445CrossRef Cornelis MA, Scheffler NR, Mahy P, Siciliano S, De Clerck HJ, Tulloch JF (2008) Modified miniplates for temporary skeletal anchorage in orthodontics: placement and removal surgeries. J Oral Maxillofac Surg 66:1439–1445CrossRef
29.
Zurück zum Zitat Cacciatore G, Ghislanzoni LT, Alvetro L, Giuntini V, Franchi L (2014) Treatment and posttreatment effects induced by the Forsus appliance: a controlled clinical study. Angle Orthod 84:1010–1017CrossRef Cacciatore G, Ghislanzoni LT, Alvetro L, Giuntini V, Franchi L (2014) Treatment and posttreatment effects induced by the Forsus appliance: a controlled clinical study. Angle Orthod 84:1010–1017CrossRef
30.
Zurück zum Zitat Zymperdikas VF, Koretsi V, Papageorgiou SN, Papadopoulos MA (2016) Treatment effects of fixed functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis. Eur J Orthod 38:113–126CrossRef Zymperdikas VF, Koretsi V, Papageorgiou SN, Papadopoulos MA (2016) Treatment effects of fixed functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis. Eur J Orthod 38:113–126CrossRef
31.
Zurück zum Zitat Ishaq RA, AlHammadi MS, Fayed MM, El-Ezz AA, Mostafa Y (2016) Fixed functional appliances with multibracket appliances have no skeletal effect on the mandible: a systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 149:612–624CrossRef Ishaq RA, AlHammadi MS, Fayed MM, El-Ezz AA, Mostafa Y (2016) Fixed functional appliances with multibracket appliances have no skeletal effect on the mandible: a systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 149:612–624CrossRef
Metadaten
Titel
Management of skeletal class II malocclusion using bimaxillary skeletal anchorage supported fixed functional appliances
A novel technique
verfasst von
Gagan Deep Kochar
SM Londhe
Anubhav Shivpuri
SS Chopra
Rajat Mitra
Munish Verma
Publikationsdatum
23.06.2020
Verlag
Springer Medizin
Erschienen in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Ausgabe 1/2021
Print ISSN: 1434-5293
Elektronische ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-020-00239-1

Weitere Artikel der Ausgabe 1/2021

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 1/2021 Zur Ausgabe

Mitteilungen der DGKFO

Mitteilungen der DGKFO

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.