Esthetic perception of facial profile changes after extraction and nonextraction Class II treatment

Andréa Damasceno Rocha,Marcio Rodrigues Almeida,Renata Rodrigues Almeida-Pedrin,Ana Claudia Conti,Fernando Pedrin Carvalho Ferreira,Cleomária Evelyn Vieira Freire Casteluci

doi:10.1590/1807-3107bor-2020.vol34.0003

Andréa Damasceno Rocha, Marcio Rodrigues Almeida + Show 4 more

Open Access

https://doi.org/10.1590/1807-3107bor-2020.vol34.0003

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Abstract

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.

Highlights

Class II malocclusion is the most frequent sagittal discrepancy in orthodontic offices, presenting high prevalence (38%) early in childhood, without presenting self-correction.[1]
For more than one century, Class II division 1 malocclusion has been treated with different types of functional appliances for mandibular
The study sample comprised 60 patients treated by corrective orthodontics; one group of 30 patients was treated by extraction of maxillary first premolars, and the other group of 30 patients was treated with the Forsus appliance (3M Unitek, Monrovia, CA, USA)

Summary

Introduction

Class II malocclusion is the most frequent sagittal discrepancy in orthodontic offices, presenting high prevalence (38%) early in childhood, without presenting self-correction.[1] Maxillary protrusion and/or mandibular retrusion are the etiologic factors involved in this discrepancy, leading to maxillomandibular sagittal step, increased overjet and convex facial profile. Advancement, considering the predominance of retrognathism in this malocclusion. For this reason, several mandibular anterior repositioning appliances are available in the market (Bionator, Herbst, Forsus, Twin-Force, etc.).[6,7,8] The Forsus FRD appliance is a semi-rigid device that provides greater flexibility in mandibular positioning, making it better accepted by patients. The improvement in the facial profile is evidenced by changes in soft tissue cephalometric measurements with retrusion of the upper lip and protrusion of the lower lip.[9]

Methods

Discussion

Conclusion