Three-Dimensional Assessment of Mandibular Condylar Volume and Position Subsequent to Twin Block Functional Therapy of Skeletal Class II Malocclusion Accompanied by Low-Level Laser Therapy.

Mahmoud Abdel Hameed Mohamed,Farouk Ahmed Hussein,Khaled Farouk Abdallah

doi:10.3390/dj8040115

Abstract

This study aimed to evaluate and compare the effect of low-level laser therapy (LLLT) on mandibular condylar volume and position following treatment of a Class II malocclusion with a twin block (TB) appliance employing cone beam computed tomography (CBCT). Twenty-four growing patients, aged 9–12 years, were randomly allocated into control and laser groups. All patients were treated with a TB appliance. The patients in the laser group were treated weekly with a gallium–aluminum–arsenide (GaAlAs) diode laser around the temporomandibular joint (TMJ) region for three months. CBCT images were obtained before and after TB therapy and the changes in TMJ and skeletal variables were evaluated and compared among and between the groups. In the laser group, the condylar volume of the right and left sides significantly increased by 213.3 mm3 and 231.2 mm3, respectively (p < 0.05), whereas in the control group it significantly increased by 225.2 mm3, and 244.2 mm3, respectively (p < 0.05), with forward and lateral positioning of both sides. Furthermore, effective mandibular, ramus, and corpus lengths were increased, which were not significant between the groups. Low-Level Laser therapy accomplished no considerable effect on mandibular condylar volume and position following the functional orthopedic treatment of skeletal Class II malocclusions using a TB appliance.

Highlights

Class II malocclusions are seen as the most frequent skeletal problems in the orthodontic community and constitute a significant proportion of orthodontic patients ranging from 18% up to approximately 32%
It has been claimed that these malocclusions are often due to a mandibular deficiency or retrognathism
The study was conducted according to the principles of the Declaration of Helsinki and the study protocol was approved by the Research Ethics Committee of Al-Azhar University, Cairo, Egypt, on 29/01/2017, with Registration No orthod._10 Med.Research._LLLT.temporomandibular joint (TMJ), Class II, _0000010

Summary

Introduction

Class II malocclusions are seen as the most frequent skeletal problems in the orthodontic community and constitute a significant proportion of orthodontic patients ranging from 18% up to approximately 32%. It has been claimed that these malocclusions are often due to a mandibular deficiency or retrognathism. In the management of growing patients, different removable or fixed functional appliances have been recommended to stimulate or redirect the mandibular growth to improve this skeletal disparity [1,2]. The effect of these appliances on mandibular and/or condylar growth is debatable, and the methods by which the probable changes are triggered is still not clearly understood [2,3,4,5]. The efficacy of mandibular orthopedic management relies on the ultimate synergy between treatment and growth, in patients who are in their pubertal growth spurt [6].

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Conclusion