Localization of mandibular changes in patients with class II division 1 malocclusions treated with twin-block appliances: finite element scaling analysis.

Abstract

Thirty mandibular landmarks were digitized from cephalographs of 46 children (prepubertal, approximately 10 years old) and 53 adolescents (pubertal, approximately 13 years old) to determine mandibular morphological changes in patients with Class II Division 1 malocclusions treated with Twin-block appliances. Procrustes superimposition computed average geometries and an analysis of variance were performed on the cephalographs. Prepubertal pretreatment and approximately 13-month-posttreatment profiles and pubertal pretreatment and approximately 22-month-posttreatment profiles were statistically different (P <.002). In male prepubertal configurations, a color-coded finite element scaling analysis revealed a conspicuous area of positive allometry ( approximately 12%) in the condylar neck and negative allometry ( approximately 17%) at the apex of the coronoid process. For the female prepubertal configuration, local increases in size were discernible in the condylar neck ( approximately 3%) and in the apex of the coronoid process ( approximately 4%). Comparing male pubertal configurations, finite element scaling analysis revealed marked positive allometry ( approximately 27%) in the condylar neck and negative allometry ( approximately 16%) at the apex of the coronoid process. For the female pubertal configurations, local increases in size were noticeable at the condylar neck ( approximately 15%), with negative allometry ( approximately 9%) in the coronoid process. For shape change, all configurations were highly isotropic over the entire mandibular nodal mesh. Therefore, in growing patients treated for Class II Division 1 malocclusions with Twin-block appliances, condylar growth, coronoid process remodeling, and osteogenesis in corpus and dentoalveolar regions may reflect the correction of the underlying skeletal dysmorphology.