Abstract
ObjectiveThis prospective study assessed the stability of Class II treatment with the Bionator, followed by fixed appliances, 10 years after treatment. Material and MethodsThe experimental group comprised 23 patients of both sexes (10 boys, 13 girls) at a mean initial age of 11.74 years (late mixed or early permanent dentitions), treated for a mean period of 3.55 years who were evaluated at three stages: initial (T1), final (T2) and long-term posttreatment (T3). A total of 69 lateral cephalograms were evaluated and 69 dental casts were measured using the PAR index. The difference between initial and final PAR indexes, the percentage of occlusal improvement obtained with therapy and the percentage of relapse were calculated, using the PAR index. The variables were compared by repeated measures analysis of variance (ANOVA) followed by Tukey tests. ResultsThe significant improvement in apical base relationship, the palatal inclination of the maxillary incisors and the labial inclination of the mandibular incisors, and the significant improvement in molar relationship and reduction of overjet and overbite, obtained with treatment, remained stable in the long-term posttreatment period. There was also significant improvement in the occlusal relationships which remained stable in the long-term posttreatment period. The percentage of occlusal improvement obtained was of 81.78% and the percentage of relapse was of 4.90%. ConclusionsTreatment of Class II division 1 malocclusions with the Bionator associated with fixed appliances showed to be stable in the long-term posttreatment period.
Highlights
The combined use of functional and fixed appliances for treatment of certain malocclusions, LQ GHWHUPLQHG SHULRGV RI WKH JURZWK FDQ JHQHUDWH greater outcomes than that achieved by the XVH RI IXQFWLRQDO RU ¿[HG DSSOLDQFHV VHSDUDWHO\ Orthodontists should, consider this SRVVLELOLW\ ZKHQ GHDOLQJ ZLWK PXOWLSOH IDFWRUV WKDW determine a malocclusion[19]
After its introduction in 1964, the Bionator has been the object of several investigations aimed to identify both the dentoalveolar and skeletal effects RI WKLV DSSOLDQFH 0RVW VWXGLHV GHDOW ZLWK VKRUWWHUP outcomes of Bionator therapy by using various types of control groups[1,3,14]
3 (SN.GoGn, S-Go and 6-PP) of the 16 HYDOXDWHG YDULDEOHV VKRZHG VWDWLVWLFDOO\ VLJQL¿FDQW V\VWHPDWLF HUURUV DQG QR YDULDEOH VKRZHG FDVXDO errors greater than 1.0 mm or 1.5°
Summary
The combined use of functional and fixed appliances for treatment of certain malocclusions, LQ GHWHUPLQHG SHULRGV RI WKH JURZWK FDQ JHQHUDWH greater outcomes than that achieved by the XVH RI IXQFWLRQDO RU ¿[HG DSSOLDQFHV VHSDUDWHO\ Orthodontists should, consider this SRVVLELOLW\ ZKHQ GHDOLQJ ZLWK PXOWLSOH IDFWRUV WKDW determine a malocclusion[19].After its introduction in 1964, the Bionator has been the object of several investigations aimed to identify both the dentoalveolar and skeletal effects RI WKLV DSSOLDQFH 0RVW VWXGLHV GHDOW ZLWK VKRUWWHUP outcomes of Bionator therapy by using various types of control groups (untreated Class I or Class II subjects)[1,3,14].In general, correction of Class II, division 1 by combined orthopedic-orthodontic therapy is related to skeletal and dental factors. The combined use of functional and fixed appliances for treatment of certain malocclusions, LQ GHWHUPLQHG SHULRGV RI WKH JURZWK FDQ JHQHUDWH greater outcomes than that achieved by the XVH RI IXQFWLRQDO RU ¿[HG DSSOLDQFHV VHSDUDWHO\ Orthodontists should, consider this SRVVLELOLW\ ZKHQ GHDOLQJ ZLWK PXOWLSOH IDFWRUV WKDW determine a malocclusion[19]. Retraction and XSULJKWLQJ RI WKH PD[LOODU\ LQFLVRUV DVVRFLDWHG ZLWK proclination of the mandibular incisors; increase in PDQGLEXODU PRODU HUXSWLRQ QR VNHOHWDO PRGL¿FDWLRQ of the maxilla and favorable increase in total mandibular length have been consistently described LQ FDVHV WUHDWHG ZLWK WKH %LRQDWRU16 +RZHYHU WKHVH changes can be considered satisfactory only if WKH\ UHPDLQ VWDEOH /RQJLWXGLQDO VWXGLHV VKRZ WKDW FKDQJHV DFKLHYHG ZLWK DFWLYH WUHDWPHQW WHQG WR XQGHUJR UHODSVH WRZDUG WKH RULJLQDO PDORFFOXVLRQ LQ WKH \HDUV IROORZLQJ WKH HQG RI RUWKRGRQWLF treatment27 7KH UHODWLRQVKLS EHWZHHQ WHHWK DQG bone bases does not necessarily remain constant over the years, but can often be changed during. Many orthodontists believe that is possible to prevent relapse by positioning WHHWK LQ KDUPRQ\ ZLWK WKH OLSV FKHHNV DQG WRQJXH eliminating harmful habits, using appropriate retention and establishing a favorable occlusion[11]
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