Appliance Treatment Research Articles

Class I treatment with severe dental crowding and mandibular protrusion: a case report

The use of Corrective Orthodontics to modifying dental aesthetics, has been increasingly effective in modifying and improving the profile of patients. Objective: Review the literature on the treatment of Cl I malocclusions with severe dental crowding and to report a clinical case performed in the dental clinic of a private educational institution. Methodology: After dental extraction and fixed orthodontic appliance treatment, the facial and dental aesthetics patient evolution with the diastema presence between dental elements 11 and 21 and supernumerary elements. The case was treated in two phases, with the aim of correcting the dental crowding. In the first phase, the first premolars and a supernumerary tooth were extracted, to initiate the isolated canine retraction and, later, the space closures by means of the retraction of the incisors. In the second phase, after the closure of spaces, the intrusion and molarization verticalization phase was started. For the subject review in case, articles were searched in the Pubmed databases, Lilacs and Scielo and selected 8 articles between the years 2010 and 2019.Results and Conclusions: It was observed that the exodontia provided the necessary spaces for the alignment and leveling of the teeth and the intrusion and mandibular rotation of the molars allowed the mandible to rotate counter clockwise, reducing the convex profile of the patient. At the end of the treatment, a facial response was observed according to the mechanics employed and significant improvement in the dental, facial aesthetics and, consequently, social improvement of the patient.

A comparison of three different modalities in improving oral hygiene in adult orthodontic patients – An open label randomized controlled trial

The objective of the study was to compare outcomes in terms of Bleeding index (BI), Gingival Index (GI) and Orthodontic Plaque Index (OPI) with videographic and plaque disclosing tablets (PDT) versus verbal instructions in adult orthodontic patients undergoing fixed appliance treatment (FAT). Adult orthodontic patients were recruited form outpatient orthodontic clinic who fulfilled the inclusion criteria and were randomly allocated to three groups i.e., video, PDT AND VERBAL GROUPS: Subjects who had gingivitis as assessed by the Bleeding Index (BI), Gingival Index (GI) and Orthodontic Plaque Index (OPI) were recruited. Pre- and post-interventional measurements were taken at two intervals only for BI, GI and OPI. The primary outcome was to evaluate mean change in the BI, GI and OPI in the three study groups after six weeks. A computer-generated randomization list was used to allocate subjects to one of the three study groups using a random permuted block sampling of 6 and 9 to randomize the samples. A total of 99 subjects were assessed for eligibility out of which 96 participants were randomized as three of the participants declined to be part of this trial. The mean change in the oral hygiene indices score were assessed and we found no statistically significant difference among the three interventional groups. Pre- and postinterventional results showed statistically significant improvement in the oral hygiene indices for video and PDT group. No statistically significant difference for age, gender and education level on oral hygiene indices. Simple linear regression showed that video group produced significantly higher mean OPI change as compared to other groups. Visual aids performed better than verbal instructions. Gender, age, and education level did not have a statistically significant impact on oral hygiene indices.

Pharyngeal site of collapse and collapsibility estimated from airflow predict oral appliance treatment efficacy

Pharyngeal site of collapse and collapsibility estimated from airflow predict oral appliance treatment efficacy

Biomimetic Oral Appliance Therapy (BOAT): Novel Oral Appliance Treatment for Obstructive Sleep Apnea Administered by Dentists

Biomimetic Oral Appliance Therapy (BOAT): Novel Oral Appliance Treatment for Obstructive Sleep Apnea Administered by Dentists

Does Mint have Antifungal and Antibacterial effect

Introduction: Patients undergoing fixed appliance treatment have many attachments on their teeth that act as an active site as plague retention sites for the attachment of food particles and subsequently microorganisms which later cause caries and periodontal diseases Orthodontic patients have an increase in the microorganisms because of the active sites for the plaque accumulation. Almost all conventional mouth freshners contain alcohol and fluoride, which are toxic (even lethal) if used in large amounts. This is often not the case with natural herbal mouth rinses. Mouth rinse comes into direct contact together with your mucosa and may be absorbed directly into your bloodstream. Mint which is a perennial plant has antimicrobial property and can be used as a mouth wash for these patients. Aim: To evaluate the efficacy of aqueous extracts of Mint on Candida albicans and Streptococcus mutans by evaluating their zone of inhibition. Methodology: Cell suspension with 108 cells were prepared using candida albicans and Streptococcus mutans. Using sterile micro tip, wells were made which was about 8mm in diameter. Lawn culture was made on appropriate media.

Effect of Twin-block Appliance on Pharyngeal Airway, Sleep Patterns, and Lung Volume in Children with Class II Malocclusion

In this study, we sought to evaluate the effect of the twin-block appliance on pharyngeal airway dimensions, sleep patterns, and lung volumes in growing children with class II malocclusion with a retrognathic mandible. Twenty children aged 9-12 years with class II malocclusion with a retrognathic mandible participated in the study. A validated sleep questionnaire assessed the sleep patterns and the sleep problems of the children. The pre-treatment cephalometric variables and the pharyngeal airway passage (PAP) dimensions were analyzed. Spirometry tests were performed to evaluate lung volumes. A custom-made twin-block appliance was fabricated, and children were instructed to wear it for a minimum of 10 months. All variables including sleep problems, cephalometric variables, and pharyngeal airway measurements were evaluated post-treatment. Spirometry tests were re-evaluated at the end of the twin-block treatment. All data were statistically analyzed. Post-twin-block appliance treatment, there was a definite decrease in snoring, noisy breathing, and sleeping with mouth open. The sella-nasion to B point angle (SNB), mandibular length, the depths of oropharynx, nasopharynx, and hypopharynx as well as the height of nasopharynx (HNP) were significantly increased post-treatment (p <0.001). The length and thickness of soft palate (SPI) increased significantly (p <0.001), while its inclination decreased significantly (p <0.001). We found improvements in forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1); however, the changes were statistically not significant (p = 0.88 and p = 0.78). Twin-block appliance significantly increased the pharyngeal airway dimensions and improved the length and thickness of the soft palate in children with class II malocclusion. Post-twin-block treatment showed a considerable reduction in the sleep problems of the children. The lung volume measurements showed improvement; however, it was not statistically significant. Twin block may be used not only to correct the facial disharmony of children with a retrognathic mandible but also to improve the airway dimensions and lung volume as well as to reduce the sleep-disordered symptoms.

Cost-effectiveness of orthodontics: a systematic review.

Health economic evaluation is a methodology to maximize health benefits and minimize opportunity costs and is of increasing importance in informing resource allocation decisions in healthcare. This systematic review aims to assess the availability and quality of economic evaluations of any orthodontic interventions and summarize the conclusions of these studies. A thorough search of the literature was carried out including terms related to orthodontic interventions and economic evaluation between January 2000 and February 2022. MEDLINE, EMBASE, SCOPUS, Web of Science, NHS Economic Evaluation Database, and Cochrane were searched. Grey literature was searched and further hand-searching was performed on the reference lists of relevant systematic reviews. Studies on cleft lip and palate surgery and sleep apnoea were excluded due to the multi-disciplinary nature of these conditions which might alter the applicability of the result to orthodontic interventions. Two independent reviewers selected studies for inclusion. Data extraction was carried out through full text analysis of included studies by two authors. The quality of each study was assessed according to the Drummond 10-point Checklist and the National Institute for Health and Care Excellence (NICE) Quality Appraisal Checklist for Economic Evaluations. Characteristics and conclusions of included articles were descriptively summarized. Sixteen articles met inclusion criteria. Most of the included articles were trial-based studies, with only one model-based study. Orthodontic interventions assessed included crossbite correction, functional appliance treatment and orthognathic surgery. Most studies were carried out in Europe and specifically in Sweden. The quality of included studies was generally low with 69% of studies reported as having serious limitations according to the NICE Checklist. This review highlighted a lack of economic evaluations for orthodontic interventions, and limitations of existing economic evaluations. Recommendations on future research are provided. The protocol for the systematic review was registered on the NIHR Database (www.crd.york.ac.uk/prospero, CRD42021220419).

Improving Nasal Airflow with a Novel Nasal Breathing Stent.

Nasal obstruction requires close attention, as it is a risk factor for obstructive sleep apnea (OSA). This study evaluated airflow rates of our newly designed nasal breathing stent (NBS) compared with those of existing nasal dilators in 10 adult men. We hypothesized that the NBS would expand the nasal passage more than the other nasal dilators by means of airflow measurements. We compared airflow measurements between the NBS and three existing appliances and no appliance. Velocity measurements were recorded by analyzing 499 videographic images when each appliance was placed next to a steam generator at 0, 5, and 10 mm from the outlet port for airflow visualization. The peak nasal inspiratory flow (PNIF) rate was measured using an inspiratory flow meter. The NBS resulted in significantly higher airflow velocity measurements at all distances from the outlet port and a higher PNIF rate than the other appliances. Thus, the NBS offers a significantly decreased resistance to air movement compared with other appliances. Future in-depth investigations are required to demonstrate the use of NBS as a nasal dilator in conjunction with continuous positive airway pressure/oral appliance treatments in patients with OSA.

The outcome of oral appliance therapy on position-dependent obstructive sleep apnea: A multicenter randomized controlled trial

<h3>Introduction</h3> This multicenter trial on patients with obstructive sleep apnea (OSA) treated with an oral appliance aimed to determine the effect of sleeping positions. <h3>Methods</h3> A cohort of 314 patients with OSA were enrolled and evaluated at 8 weeks and 1 year, focusing on treatment effects. At baseline and the 2 follow-ups, new polygraphic registration comparing the proportion of treatment responders without position-dependent OSA (non–position-dependent OSA [non-POSA]) and with POSA was used. <h3>Results</h3> At the 8-week and 1-year follow-up, 205 and 139 patients were included, respectively. The proportion of responders (apnea-hypopnea index [AHI] <10 and/or ≥50% reduction in AHI) was 56% for the non-POSA group and 69% for the POSA group (not significant [NS]). The responders increased at the 1-year follow-up: 68% and 77% for the non-POSA and POSA groups (NS), respectively. The absolute change in AHI in all sleeping positions at 8 weeks was –12.9 (interquartile range, –25.0 to –0.5) in the non-POSA group and –10.5 (interquartile range, –19.9 to –5.3; NS) in the POSA group. However, the decrease in supine AHI was significantly greater among subjects with POSA. In contrast, the decrease in nonsupine AHI was significantly greater in the non-POSA group, an effect that remained at the 1-year follow-up. <h3>Conclusions</h3> Our hypothesis that subjects with POSA at baseline would have a higher treatment response rate after oral appliance treatment compared with subjects without POSA was rejected. However, those with POSA had a significantly higher supine AHI decrease, and those without POSA had significantly less nonsupine AHI.

Correction of skeletal class 2 malocclusion with Carriere Motion appliance: case report

The article considers nonsurgical and nonextraction method of treatment of patient with skeletal class 2 malocclusion.Aim. To evaluate the treatment effectiveness of Carrier Distalize, determing the short-term skeletal and dental effects occur as a result of Class II malocclusion correction utilizing the Carrière Overall, the Carriere Distalizer appears to be effective in early results in the treatment of Class II malocclusion.Materials and methods: A 25 years old male patient presented for treatment exhibition a class 2 malocclusion with a severely retrusive mandible was treated with Carrier motion class 2 appliance , after previous orthodontic unsuccessful treatment with extraction of the lower right premolar by brace system. the appliance was used for 5 month fool time. This systematic review was conducted and changes were analyzed from dental photo protocol, lateral cephalograms taken at the start and after and study model measurements from pre and post treatment Results: the time of skeletal class two correction in class one for Carriere motion appliance was significantly shorter. great mesial mandibular movement and improvement in sagittal skeletal relation were shown after carrier motion appliance treatment for five month.Conclusions. Treatment resulted that carrier motion appliance is simple to apply, comfortable for patient and affective in correcting class 2 malocclusion.

Coronal Resorption in Unerupted Anterior Permanent Teeth: Cases with Different Aetiologies? A Review

Two case reports are described along with differential diagnoses and management strategies from the literature for teeth discovered with intra-coronal resorption prior to their eruption. Our cases feature impacted maxillary anterior teeth. In both instances, significant coronal resorption presented itself mid-way through fixed appliance treatment, prior to full eruption of the involved teeth. This was detected radiographically and not through patient-reported symptoms. Once sufficiently erupted, root canal therapy was carried out in both cases and orthodontic treatment was successfully completed. CPD/Clinical Relevance: Orthodontists are often first to identify pathological lesions in unerupted teeth and should be equipped with differential diagnoses in order to manage and refer patients appropriately.

Disparities in oxygen saturation and hypoxic burden levels in obstructive sleep apnoea patient's response to oral appliance treatment.

BackgroundOxygen saturation indices show a strong correlation with long‐term health outcomes. Nonetheless, evidence on the relationship between reduction in respiratory events and increase in oxygenation levels following oral appliance (OA) treatment is scarce.ObjectivesTo verify the relationship between reduction in the apnoea‐hypopnoea index (AHI) and oxygen saturation levels following OA treatment, we have conducted an evaluation of polysomnography (PSG) and clinical parameters associated with the improvement of oxygen desaturation.MethodsOSA patients (n = 48) who received an OA and had pre‐ and post‐treatment PSG were classified into three responder groups according to the change in AHI and min O2 post‐treatment: responderAHIonly (decrease in AHI of ≥50% but increase in min O2 level of <4% or decrease); responderMinO2only (increase in min O2 level of ≥4% but decrease in AHI <50% or increase) and responderCongruous (decrease in AHI of ≥50% and increase in min O2 level of ≥4%). Various demographic and PSG variables were statistically compared among groups.ResultsThere were 26 (54.17%) responderAHIonly, 9 (18.75%) responderMinO2only and 13 (27.08%) responderCongruous. Pre‐treatment min O2 was significantly lower in responderMinO2only. A higher pre‐treatment min O2 showed a significant correlation with a smaller amount of change in mean O2 (r = −.486) and min O2 (r = −.764) with treatment. Pre‐treatment min O2 showed the strongest ability to predict those who would show a ≥4% min O2 increase following treatment.ConclusionCertain patients do not show sufficient decrease in hypoxaemia in spite of the improvement in AHI. Pre‐treatment min O2 should be considered in OA treatment planning regarding its close relation to improvements in oxygenation levels with treatment.

Extraction Decision and Anchorage Consideration for Fixed Functional Appliance Treatment

Extraction Decision and Anchorage Consideration for Fixed Functional Appliance Treatment

Accuracy of dental arch form in customized fixed labial orthodontic appliances

This study evaluated arch form accuracy with or without premolar extraction in customized fixed labial orthodontic appliance treatment. Setup and posttreatment digital models of 27 samples (15 extractions and 12 nonextractions) were selected and superimposed by best-fit surface-based registration in both the maxilla and the mandible. The facial axis points were identified and converted into Cartesian coordinates. A sixth-order polynomial equation was used to fit dental arches. Arch discrepancies (the mean distance between 2 arch forms) and similarities were compared between extraction and nonextraction groups, maxilla and mandible, and anterior and posterior arches. The arch discrepancy between extraction and nonextraction groups showed no statistically significant difference, but a statistically significant difference in arch similarity was found in the mandible. There were statistically significant differences between anterior and posterior arch discrepancies in the extraction (mandible) and the nonextraction (maxilla and mandible) groups. However, no statistically significant correlation was shown between anterior and posterior arch discrepancies. The arch similarities were 96.18% and 97.38% in the maxilla and 96.01% and 97.49% in the mandible between extraction and nonextraction groups. Arch form discrepancies and similarities showed a moderate correlation but no statistically significant differences between the maxilla and the mandible. In customized fixed labial orthodontic appliance treatment, arch form setup can be accurately achieved with and without premolar extraction. Anterior arch form acquires fewer discrepancies than the posterior arch, and overcorrection should be added to the end of the customized archwire to reduce posterior arch discrepancies. The discrepancy of the maxillary and mandibular arches is interrelated, and adjustments should be made on both maxillary and mandibular archwires to correct single-jaw transverse malposition.

An Extensive Comparison of the Clinical Efficiency of Acidulated Phosphate Fluoride (APF) and Neutral Sodium Fluoride (NaF) Oral Rinses in the Prevention of White Spot Lesions during Fixed Orthodontic Treatment: A Randomized Controlled Trial.

Background The purpose of this randomized trial is to compare the efficacy of weekly once regime of neutral sodium fluoride (NaF) oral rinse with that of acidulated phosphate (APF) formulated daily mouth rinse in the reduction of white spot lesions (WSLs) associated with fixed orthodontic appliance treatment. Methods The participants (n = 90) of this single-center, two-arm parallel study without a control group were randomly assigned with 1 : 1 distribution to each of the two groups after the bonding of brackets. Group A/test group 1 (n = 45) was given weekly rinse of neutral sodium fluoride (Colgate® PreviDent® Dental Rinse-0.2% NaF), and for group B/test group 2 (n = 45), an APF formulated daily oral rinse (Colgate® Ortho Defense@ PhosFlur® Rinse-0.044% w/v of NaF) was given for six months. The outcome was assessed by the International Caries Detection and Assessment System (ICDAS) index for scoring the demineralization, and for scoring gingivitis, Loe and Silness gingival index (GI) was utilized. Four different time points “T0”immediately before bonding procedures, “T1” after 4weeks, “T2” after 12 weeks, and “T3” after 24 weeks were taken to assess the ICDAS and GI scores. Results The mean ICDAS scores for group A (NaF) were 0.025, 0.051, 0.093, and 0.113 and for group B (APF) were 0.014, 0.022, 0.038, and 0.015 at different points of time. The GI scores for group A were 0.008, 0.22, 0.33, and 0.38 and for group B were 0.003, 0.136, 0.181, and 0.097 at different time points. There was a statistically significant difference (p < 0.05) for both groups in terms of reducing WSL and GI. Conclusion APF formulated daily oral rinse—0.044% w/v of NaF—is more effective than the weekly once regimen of 0.2% NaF oral rinse to prevent white spot lesions.

Evaluation of skeletal and dentoalveolar changes in class II division I pediatric patients receiving myofunctional appliance therapy: A preliminary study

The treatment effect of myofunctional appliance therapy has remained debated. The aim of this study was to evaluate the skeletal and dentoalveolar effects in class II division I pediatric patients receiving Education Fonctionnelle (EF) myofunctional appliance therapy. Thirteen patients undergoing EF appliance treatment (9 boys and 4 girls；average 9.3years old) met the inclusion criteria and 13 untreated patients (9 boys and 4 girls；average 9.9 years old) served as controls. Initial and one-year follow-up lateral cephalometric measurement was used to assess skeletal and dentoalveolar changes. Gender ratio was analyzed using Chi-square test. Age and cephalometric measurement changes within and between the two groups were analyzed using Mann-Whitney U test and Wilcoxon signed rank test and Benjamini - Hochberg procedure. There were no significant differences in age, gender ratio, and initial cephalometric measurement data between the two groups. One-year follow-up skeletal findings revealed no significant differences between the two groups. Regarding the dentoalveolar changes, only the values of the upper incisor angle related parameters revealed significances between the two group (with adjusted p value). In this preliminary small sample size study, the EF group demonstrated significant upper incisor angle decrease, lower incisor angle increase, and lower incisor tip to mandibular plane distance decrease in comparison to the values measured in the control group. However, only the upper incisor angle changes were statistically significant after p-value adjustment. The skeletal effect of the EF appliance could not be verified in one-year follow-up of cephalometric data.

Preferencias de los ortodoncistas en el uso y momento oportuno de uso de aparatos para la corrección de maloclusiones en pacientes en crecimiento

Objective: To evaluate orthodontists’ preferences in the use and timing of appliances for the correction of Class II and Class III malocclusions in growing patients and the sociodemographic factors that influence these preferences. Material and Methods: Active members of the Colombian Orthodontics Society (SCO) were invited to complete a previously validated survey on the use of Class II and Class III correctors in growing patients. Results: 180 orthodontists responded (80 male, 100 female). The appliances used most frequently in the treatment of Class II malocclusion were Planas indirect tracks (32.78%) and Twin-blocks (30.56%). Facemasks (62.22%) and Progenie plates (25%) were the most prevalent appliances used in the treatment of Class III malocclusions. Regarding treatment timing, 52% of the orthodontists stated that Class II malocclusions must be treated during late mixed dentition or early permanent dentition, 42% stated that treatment for Class III malocclusions sho-uld occur during early mixed dentition. Appliance use and treatment timing were significantly associated with sex (p= 0.034), years of practice (p= 0.025), and area of work (private clinics or public institutions), (p= 0.039). Conclusion: Twin-blocks and Facemask appliances were the preferred appliances for Class II and Class III treatment, respectively, in growing patients. Most of the orthodontists believed that Class II malocclusions must be treated during late mixed dentition and that Class III malocclusions must be treated during early mixed dentition. Sociodemographic variables are related factors that influence orthodontists’ preferences in the use of these appliances.

Airway changes after fixed functional appliance treatment in children with and without morphologic deviations of the upper spine: A 3-dimensional CBCT study

Functional appliances (FA) have a positive effect on the upper airway volume and minimal cross-sectional area (MCA) in children. An association between morphologic deviations of the upper spine (MDUS) and reduced treatment response was found in appliances used to treat adults with obstructive sleep apnea. This study aimed to: (1) compare airway changes after FA treatment in children with and without MDUS and controls; (2) identify if MDUS causes a smaller upper airway. Pretreatment and posttreatment cone-beam computed tomography scans were included from 21 children with MDUS and 42 without MDUS treated with a fixed FA, along with a pair-matched control group (matched for chronological age, skeletal age, gender, and mandibular inclination) who received orthodontic treatment for minor malocclusions without an FA. The influence of MDUS on changes in upper airway volume and MCA were evaluated with 3-dimensional cone-beam computed tomography scans using standardized, previously validated methods and mixed-effects linear regression. There was a significantly increased volume and MCA in the FA groups with and without MDUS compared with control (P= 0.003 and P= 0.049) and in the FA group without MDUS compared with the MDUS group (P= 0.008 and P= 0.011) after treatment. There was no significant pretreatment difference in airway dimensions between the MDUS and non-MDUS FA groups. The airway response with fixed FA is significantly reduced in MDUS children. MDUS caused no significant pretreatment airway differences in children. However, MDUS may be important in predicting airway changes in FA treatment.

Clinical effectiveness of clear aligner treatment compared to fixed appliance treatment: an overview of systematic reviews.

To evaluate the available evidence regarding clinical effectiveness of clear aligner treatment (CAT). A comprehensive literature search was conducted for systematic reviews investigating effectiveness of CAT published up to July 15, 2021. This was accomplished using different electronic databases. No language restriction was applied. Screening, quality assessment, and data extraction were performed by two authors independently. Information was categorized and narratively synthesized for the key findings from moderate and high-quality reviews. A total of 361 potentially eligible reviews were identified. After excluding the non-relevant/low-quality reviews, 18 systematic reviews were included. CAT was found to be effective for mild to moderate malocclusions, and was associated with inferior outcomes when treating severe cases or with achieving specific tooth movements. There were conflicting results regarding treatment duration; however, CAT may be associated with shorter treatment in mild to moderate cases. Relapse was greater with CAT, while periodontal health was better. The risk of root resorption tended to be lower with CAT. Regarding pain, the results were unclear, although CAT was found to be more comfortable and associated with a reduced impact on eating and chewing. The level of evidence regarding CAT is moderate; hence, further high-quality randomized clinical trials are required. Evidence supports use of aligners as an alternate to fixed appliances in patients with mild-to-moderate malocclusion but not in severe cases. Advancement in technology could enhance the accuracy of CAT in delivering planned outcomes. CAT can be used effectively for selected cases with mild to moderate malocclusion. PROSPERO registration number: CRD42021246855.

Evaluation of architectural changes in mandibular trabecular and cortical bone pattern after functional treatment

Abstract Purpose: To assess the changes in mandibular trabecular and cortical bone following functional appliance treatment through fractal dimension (FD) and cortical thickness (CorT) measurements. Material and methods The study was performed on 45 mandibular retrognathia cases. While the treatment group (T) comprised 30 patients treated using a functional appliance for one year during puberty, the control group (C) consisted of 15 patients who did not receive any orthodontic treatment due to insufficient oral hygiene. FD and CorT analyses were bilaterally evaluated for each mandible. FD measurements were performed on the condylar process, the antegonial notch, and ramus regions on panoramic radiographs. A paired t-test was applied for group analysis, before (T1) and after treatment (T2) and, correspondingly, before (C1) and after (C2) controls. In addition, an independent t-test was used to determine differences between the treatment (∆T = T2−T1) and the control group (∆C = C2−C1). Results Statistically significant differences were found in the treatment group between the initial and post-treatment FD values of the right (p &lt; 0.05) and left condyles (p &lt; 0.05), and the CorT measurements on the right (p &lt; 0.01) and the left sides (p &lt; 0.05). There was no statistically significant difference in FD parameters in the control group and a significant difference was only found in the left CorT (p &lt; 0.05). A comparison of the treatment and control groups revealed that the changes in FD and CorT measurements were not statistically significantly different between the groups (p &gt; 0.05). Conclusion: Mandibular protraction appliances do not produce trabecular bone alteration in the mandibular condyles, the antegonial notch and ramus over a 12-month time period.