Appliances In Class Research Articles

Treatment effects of "PowerScope" fixed functional appliance - a clinical study.

To study the skeletal, dental effects and evaluate the soft tissue changes with PowerScope-fixed functional appliance in class II malocclusion. This clinical study was carried out where a total of 10 growing (CVMS 3 and 4) Class II Division 1 malocclusion patients, indicated for treatment with fixed functional appliance were allocated based on specific inclusion criteria. PowerScope (American Orthodontics) was used as the fixed functional appliance. Skeletal, dental and soft tissue effects of the appliance with various angular and linear parameters on a digital lateral cephalogram were evaluated for all 10 participants. Records were collected before the insertion of PowerScope appliance (T0) and after 5 months, during the appliance removal (T1). All participants were treated with 0.018"×0.025" MBT (3M Unitek) prescription. Statistical analysis was performed using a paired t-test to compare individual mean changes for each treatment category. Statistically significant changes were seen in skeletal parameters such as forward positioning of the mandible with an increase in SNB angle and N perpendicular-Pogonion distance, the class II jaw base relationship improved with reduction in ANB angle and Wits appraisal. Significant changes were observed in dental parameters such as forward positioning of mandibular incisors, maxillary molar distalization and intrusion with reduction in overbite and overjet respectively. In the soft tissue, a significant improvement in facial profile was seen due to an increase in labiomental angle. The results of this study have shown that statistically significant changes in skeletal, dental and soft tissue parameters.

Sagittal, rotational and transverse changes with three intraoral distalization force systems: Jones jig, distal jet and first class.

BackgroundTo compare the maxillary dentoalveolar changes of patients treated with three distalization force systems: Jones Jig, Distal Jet and First Class appliances, using digitized models. Material and MethodsThe retrospective sample comprised 118 digitized models of 59 patients with Class II malocclusion divided into three groups: Group 1 consisted of 22 patients treated with the Jones Jig appliance; Group 2 consisted of 20 patients treated with the Distal Jet, and Group 3 comprised 17 patients treated with the First Class appliance. Pretreatment and post-distalization plaster models of all patients were digitized and evaluated with OrthoAnalyzerTM software. The pretreatment and post-distalization variables regarding sagittal, rotational and transverse changes were compared by the One-way Analysis of Variance (ANOVA) and Kruskal-Wallis tests, depending on normality. ResultsAll appliances presented similar amounts of distalization. The Distal Jet appliance promoted significantly smaller mesial displacement of premolars and greater expansion of posterior teeth. The First Class presented the smallest rotation of the maxillary molars and treatment time. ConclusionsThe distalizers were effective in correcting Class II molar relationship, however, a palatal force seems to provide fewer undesirable effects. Additionally, the degree of rotation and expansion was associated with the side of force application. Key words:Malocclusion, Angle Class II, Orthodontics, Corrective, Distalizers.

Outcome quality of Class II division 1 Herbst-multibracket appliance treatment: influence of pretreatment Class II severity and skeletal maturity.

No reliable predictive factors for treatment (Tx) success and outcome quality in Class II:1 Tx have been identified yet. To assess the influence of pre-Tx Class II severity and skeletal maturity on outcome quality after Herbst-multibracket appliance (MBA) Tx. All Class II:1 patients who completed Herbst-MBA Tx between 1986 and 2014 at University of Giessen, Germany. Pre-Tx (T0), post-Tx (T1), and (if available) post-retention (≥24 months; T2) study casts were evaluated using the Peer Assessment Rating (PAR) index and the Ahlgren scale. Three occlusal severity (mild, moderate, and severe) and four skeletal maturity (pre-peak, peak, post-peak, and adult) subgroup categories were defined. Four hundred eight-five patients (age at T0: 14.4 ± 3.2 years) could be evaluated; post-retention (T3) data were available for 230 patients. For the total sample, the median PAR score was 32.4 ± 8.85 at T0, 8.0 ± 4.52 at T1, and 8.8 ± 5.11 at T2. Very low correlations between the subgroup categories (occlusal severity/skeletal maturity) and PAR-score reduction were detected both during Tx (r = 0.12/r = 0.05) and the total observation period (r = 0.17/r = 0.03). The overall outcome quality according to Ahlgren was: 17.0% excellent, 34.8% good, 43.8% acceptable, 2.2% unacceptable, and 2.2% not assessable. The association with the subgroup categories was: p = 0.019 (occlusal severity)/p = 0.820 (skeletal maturity). Retrospective study design with follow-up data was not available from all subjects and no data from untreated controls. Tx was performed by several physicians using different kind of MBAs. Class II:1 Herbst-MBA Tx is an effective and successful Tx approach irrespective of pre-Tx skeletal maturity but dependent-to a certain extent-on Class II severity. Thus, when considering a Herbst appliance for Class II correction, neither of the two variables should considerably limit the indication.

Treatment Effects of the Herbst Appliance in Class II Malocclusion Patients after the Growth Peak.

Objective The aim of this study was to evaluate dentoskeletal changes in the treatment of Class II malocclusion with the Herbst Cantilever Bite Jumper (CBJ) appliance, associated with multibracket appliances after the growth peak, at pretreatment. Materials and Methods A sample of 37 individuals was divided into two groups: the experimental group comprised 16 patients treated consecutively for a mean period of 2.52 years with the Herbst CBJ appliance associated with multibracket appliances. A total of 21 subjects (10 males and 11 females) with Class II malocclusion and mean age at T1 of 16.08 years were followed for a mean period of 2.12 years composed the control group. Comparisons between the two groups were performed using initial and final lateral cephalograms. Comparisons between experimental and control groups at pretreatment and of the treatment changes were performed by Mann–Whitney or independent t -tests. Results Experimental group exhibited a significantly greater labial inclination of the mandibular incisors in comparison to the control group. Additionally, significantly greater corrections in overbite, overjet, and molar relationship were observed in the experimental than in the control groups. Conclusion The effects of the Herbst CBJ appliance, associated with fixed appliances after the growth peak in Class II malocclusion treatment are correction in molar relationship toward a Class I relationship, decrease of the overjet, decrease of the overbite, and mandibular incisors labial inclination.

The Herbst appliance combined with a completely customized lingual appliance: A retrospective cohort study of clinical outcomes using the American Board of Orthodontics Objective Grading System

In this retrospective study we aimed to evaluate the quality of treatment outcomes using the American Board of Orthodontics (ABO) scoring system with a completely customized lingual appliance used in combination with a Herbst appliance for Class II correction. Patient selection criteria for this study were Class II division 1, II/2 or subdivision treated with a WIN® lingual appliance combined with an L-pin Herbst device. Thirty-two consecutively debonded cases were included in this retrospective case series. Pre- and post- treatment dental casts, dental set-ups, panoramic X-rays, cephalometric analysis, photographs and clinical files were available for data collection. The primary outcome was the ABO score based on the Discrepancy Index (ABO DI) including: overjet, overbite, anterior open bite, lateral open bite, crowding, occlusion (Angle class), lingual posterior crossbite, buccal posterior crossbite, ANB, IMPA and SN-GoGN angles and the Cast-Radiograph Evaluation (ABO CR-Eval) comprising of alignment/rotations, marginal ridges, buccolingual inclination, overjet, occlusal contacts, occlusal relationship (Angle class), interproximal contacts and root angulation. In addition, overjet, overbite and Class II correction were also evaluated on pre- and post-treatment models. The secondary outcome was bracket failure and complications related to the Herbst device. The study cohort included 18 female and 12 male patients with a mean age of 15.8 (range 12, 6- 18, 5). Twenty patients were Class II division 1 and ten were Class II division 2. The mean pre-treatment value of ABO DI was 20.8 (range 10-39); more than two-thirds of the sample were rated as being either of moderate difficulty (ABO DI: 16-24) or severe (ABO DI: over 25). The average post-treatment ABO Cast-Radiograph Evaluation score was 15.0 (SD=4.4), which is considered a passing score. Twenty-six patients had a score equal or lower than 20 (undisputed passing score). The Class II discrepancy was effectively corrected from a score of 16.83 penalty points (SD: 3.65) pre-treatment to a score of 1.57 (SD: 1.70) post-treatment. No association was found between initial and final Class II occlusal relationships (P=0.42), indicating that regardless of the initial discrepancy, no difference in the success of Class II correction was observed. The mean bracket failure rate was 3.8 per patient. Herbst related complications were few: 1.6 per patient, with the majority of complications being of little consequence and with 43% of the patients having no breakages. The completely customized lingual appliance assessed in this study combined with an L-pin Herbst led to effective Class II correction regardless of the initial severity of the sagittal discrepancy. The average ABO CR-Eval score for this sample was well below the undisputed passing score indicating a high quality of treatment outcomes.

Comparison of the dentoskeletal and soft tissue changes with the cervical headgear and Jones Jig followed by fixed appliances in Class II malocclusion patients: A retrospective study

To retrospectively compare the dentoskeletal and soft tissue changes of patients with Class II malocclusion treated with cervical headgear and Jones Jig appliances, followed by fixed appliances. The sample comprised 46 Class II malocclusion patients divided into two groups. Patients with Class II malocclusion based on the ANB angle and plaster model analyses, needing non-extraction orthodontic treatment, absence of mandibular crowding and no previous orthodontic treatment were eligible to be selected. Group 1 consisted of 25 patients treated with cervical headgear (CH) followed by fixed appliances for a mean period of 3.26 years and group 2 consisted of 21 patients treated with the Jones Jig (JJ) appliance for a mean of 4.29 years. Lateral cephalograms were evaluated at the beginning and at the end of orthodontic treatment. For intergroup comparisons, t and Mann-Whitney tests were performed. The cervical headgear group produced significantly greater maxillary anterior displacement restriction (SNA; CH: -0.97°±1.33; JJ: 0.07°±1.73; P=0.025), apical base discrepancy improvement (ANB; CH: -1.52°±1.25; JJ: 0.36°±1.46; P=0.006), FMA reduction (CH: -0.78°±2.68; JJ: 1.07°±2.84; P=0.028) and distal mandibular molar angulation (Md6.PM; CH: 6.97°±3.66; JJ: 2.77°±6.87; P=0.013) than the Jones Jig group. Both distalizers followed by fixed appliances were effective to correct Class II malocclusion. The cervical headgear group presented skeletal effects with less treatment time and there were no significant intergroup differences regarding soft tissue changes.

Comparison of 2 treatment protocols using fixed functional appliances in Class II malocclusion: Treatment results and stability

The objective of this research was to compare the 2 treatment protocols including a functional mandibular advancer (FMA; Forestadent, Pforzheim, Germany) followed by multibracket appliances (MBAs) vs a Forsus device (3M Unitek, Monrovia, Calif) in combination with MBA concerning treatment outcomes and posttreatment stability. This study was conducted using lateral cephalograms of patients who were treated with MBA, which was used either after an FMA or concurrently with a Forsus device, and of patients who had untreated Class II malocclusion (control group). Each group consisted of 19 subjects in cervical stage 2 or cervical stage 3 stages according to the cervical vertebral maturation index. Cephalograms were taken for the treated groups at T1 (pretreatment), T2 (completion of the MBA treatment), and T3 (at least 2years after T2). Significant intergroup differences at the T1-T2 period were observed in favor of the FMA concerning mandibular advancement, intermaxillary relationship, and mandibular elongation. With Forsus treatment, restrained maxillary growth and a slightly improved intermaxillary relationship rebounded after treatment (P<0.05). At the end of treatment, mandibular incisor protrusion and occlusal plane rotation were greater in the Forsus group than in the FMA group (P<0.05), and maxillary incisor retroclination was significant in the Forsus group. During the posttreatment period, although no significant changes were present in the incisors' inclination, relapses of the T1-T2 improvements in overjet and overbite and the recidive of the occlusal plane rotation were significantly higher in the Forsus group. Treatment protocol including an FMA was found to be more effective with mandibular skeletal effects and was more stable with a lesser degree of relapse in overjet and overbite than the Forsus protocol.

Correction of Unintended Aftermath of Fixed Functional Appliance in Class II Division 1 Malocclusion – A Case Report

Correction of Unintended Aftermath of Fixed Functional Appliance in Class II Division 1 Malocclusion – A Case Report

Class II Correction with Forsus Fixed Functional Appliance in Class II Division 2 Malocclusion: A Case Report

Class II Correction with Forsus Fixed Functional Appliance in Class II Division 2 Malocclusion: A Case Report

Long-term dentoskeletal changes of class II growing patients' treatment with the propulseur universal light appliance. A prospective controlled study.

Class II is one of the most common malocclusions. The prevailing aspect in Class II patients is a mandibular deficiency. Various removable and fixed functional therapies are used in order to enhance the mandibular growth or position. The aim of this prospectively controlled study was to evaluate long-term dentoskeletal changes obtained by a functional appliance for Class II. Prospective controlled study, based on a sample size calculation. 26 Class II Division 1 patients (11.8±1.5 years) were consecutively treated with the propulseur universal light (PUL) appliance and a multi bracket appliance (PG), they were compared to a sample of 26 Class II untreated patients (11.5±0.8 years) (CG). Lateral cephalograms were taken before and after the PUL therapy, and after multibracket treatment. Interaction analysis was carried out to test whether the PUL parameters in treatment groups were different according to the acquisition times, using the Linear Mixed-Effects Model. Significant ANB, Overjet and WITS differences existed in treatment groups according to the time. In particular, comparing to T1 vs. T0, the relative difference (RD) means in the control group were -0.34, -0.31 and 0.17 for ANB, Overjet and WITS, respectively. The corresponding RD means in the treated group PG were -1.58, -4.27 and -2.38. Comparing to T2 vs. T0, the RD means in the control group were -0.36, -0.51 and 0.63 for ANB, Overjet and WITS, respectively. While the corresponding RD means in the treated group were -2.08, -5.12 and -2.50. The PUL appliance successfully corrected class II malocclusion. The long term correction was mainly due to dentoalveolar effects: therapy success was 91% for overjet correction and 76% for ANB correction. During the post functional appliance period, overjet was stable in 77% of the treated subjects, and ANB in 74% of the treated subjects.

Comparison of skeletal anchorage and tooth-borne maxillary protraction followed by fixed appliance in Class III malocclusion.

The purpose of this study was to compare the results of skeletal anchorage (SAMP) and tooth- borne (TBMP) maxillary protraction followed by fixed appliance in growing skeletal Class III patients. Patients treated with maxillary protraction were selected and classified into two groups (SAMP: n = 19, mean age = 11.19 years; TBMP: n = 27, mean age = 11.21 years). Lateral cephalograms taken before treatment (T0), after the maxillary protraction (T1), and after the fixed appliance treatment (T2) were analysed and all variables were statistically tested to find difference between the two groups. Compared to the TBMP, the SAMP showed significant forward growth of maxilla (Co-A point and SN-Orbitale) and improvement in intermaxillary relationship (ANB, AB to mandible plane, and APDI) after the overall treatment (T0-T2), with no significant sagittal changes in maxilla or mandible throughout the fixed appliance treatment (T1-T2). In maxillary protraction, effects of skeletal anchorage were retrospectively compared with those of dental anchorage, not with Class I or III control. After maxillary protraction, skeletal and tooth-borne anchorage did not cause significant differences in the residual growth of maxilla throughout the phase II treatment. Orthopaedic effects with skeletal anchorage showed appropriate stability in maxilla and intermaxillary relationship even after fixed appliance treatment.

Cephalometric outcomes of a new orthopaedic appliance for Class III malocclusion treatment.

To evaluate dental and skeletal effects of a new orthopaedic appliance for the treatment of Class III malocclusion in growing patients. This retrospective cephalometric study was performed on a sample of 18 patients with a skeletal Class III malocclusion (4 males; 14 females; mean age 8.8 ± 1.5 years) treated with the Pushing Splints 3 (PS3) protocol. The control group consisted of 18 subjects (5 males; 13 females; mean age 9.1 ± 1.8 years) selected from a database of subjects with untreated Class III malocclusion. The cephalometric analysis was performed at the beginning (T0) and the end of the orthopaedic therapy (T1). Significant differences between the treated and control groups were assessed with independent samples t-test (P < 0.05). In the PS3 group, the post-treatment cephalometric values showed a forward displacement of the maxilla, resulting in a statistically significant increase of the SNA angle. ANPg and Wits appraisal improved significantly compared with the control group. Lingual inclination of mandibular incisors and buccal inclination of the upper incisors were significantly increased in comparison with the control group. No significant differences were recorded for backward mandibular rotation. This study presents a short-term evaluation of the treatment and the use of a historical control group. The PS3 was effective for the treatment of Class III malocclusion in growing patients, with favourable maxillary advancement and control of the vertical skeletal relationships.

Effects of wear time differences of removable functional appliances in class II patients: prospective MRI study of TMJ and masticatory muscle changes.

The aim of this prospective study was to evaluate the short-term effects of full-time and night-time wear of functional appliances on the temporomandibular joint (TMJ) and masticatory muscles and to compare the differences in craniofacial structures, TMJ, and masticatory muscles with magnetic resonance imaging (MRI). The study was carried out using cephalometric radiographs and MRI of 20 Class II patients who were treated with monoblock/twin-block appliances. The patients were divided into 2 groups: ten patients in Group 1 used their appliances all day, while ten patients in Group 2 were instructed to wear the appliances during sleep. After at least 6 months of uninterrupted treatment, post-treatment cephalograms and MRI were obtained for patients whose molar relationship improved by at least a half cusp width. Signal intensity ratios (SIR) of TMJ structures and morphological evaluations of masticatory muscles were done for all patients. It was found a significant increase in SIR values of the condylar process, articular disc, retrodiscal tissue, and masticatory muscles for all treatment groups. Length of the masseter and medial pterygoid muscles increased to varying degrees which left side of Group 2 was significantly increased (P < 0.05). The volume of all muscles also increased to varying degrees. The cephalometric and MRI findings of this study show that the treatment effects were similar for both wear schedules.

Cephalometric Changes Produced by the Distal Jet and Pendulum Appliances in Class II Malocclusion Treatment

This study aimed to compare the dentoskeletal and soft tissue changes promoted by the Distal Jet and Pendulum, followed by fixed appliances, in class II malocclusion treatment, evaluated in relation to an untreated control group. Group 1 comprised 20 patients (15 female; 5 male) with class II malocclusion, at an initial mean age of 12.77 years. These patients were treated with the Distal Jet followed by fixed appliances for a mean period of 4.15 years. Group 2 consisted of 15 patients (10 female; 5 male) with class II malocclusion, at an initial mean age of 13.42 years, treated with the Pendulum followed by fixed appliances for a mean period of 4.41 years. Group 3 comprised 16 subjects (8 female; 8 male), with class II malocclusion, not submitted to any orthodontic treatment. This group had an initial mean age of 12.25 years. The mean observation period was 3.73 years. Comparison of the three groups was performed by one-way ANOVA followed by Tukey tests. The Distal Jet appliance showed more palatal tipping of the maxillary incisors than the Pendulum. The treated groups showed more overjet reduction and improvement of molar relationship than the control group. It was concluded that the effects of these two appliances in Class II malocclusion correction are very similar. Both Distal Jet and Pendulum appliances corrected the class II malocclusion with similar cephalometric treatment changes.

Twin block appliance: Effect on pharyngeal airway

Background: Mandibular retrusion is the main cause of Skeletal Class II malocclusion characterized by skeletal retrusion of mandible with skeletal or dentoalveolar protrusion of maxillary.&#x0D; Objectives: This study was conducted to evaluate effect of treatment with twin-block appliances on pharyngeal dimensions.&#x0D; Methodology: This study was conducted in in the Department of Orthodontics &amp; Dentofacial Orthopedics in Kathmandu Medical College. Twenty patients of age group 7 to 14 years with skeletal class II malocclusion with mandibular retrusion were selected. Variables evaluated were depth of nasopharynx; height of nasopharynx; depth of oropharynx; depth of hypopharynx; soft palate length; soft palate thickness and soft palate inclination. The lateral cephalograms were obtained for all subjects before the start of treatment and after a follow-up period of approximately three months in treatment.&#x0D; Results: Results showed that depth of nasopharynx increased by 1 mm, height of nasopharynx increased by 0.78 mm, depth of nasopharynx increased by 1.97 mm, depth of hypopharynx increased by 0.79 mm, soft palate length decreased by 4 mm, soft palate thickness increased by 2 mm and soft palate inclination decreased by 7.01 mm. The results for depth of pharynx and soft palate thickness were statistically significant.&#x0D; Conclusion: This study concluded that the use of twin block appliance for class II patients corrects sagittal dimension of oropharynx and hypopharynx. Early intervention for mandibular retrognathism in class II malocclusion helps enlarge the airway dimensions and decrease potential risk of obstructive sleep apnea syndrome for growing patients in the future.

ANALISIS PENGGUNAAN TWIN BLOCK PADA PERAWATAN MALOKLUSI DENTOSKELETAL KELAS II DIVISI 1 DISERTAI RETROGNATI MANDIBULA BERDASARKAN CERVICAL VERTEBRAL MATURATION STAGE

Background:Class II division 1 dentoskeletal malocclusion with mandibularretrognatic can be treated with twin block appliance. The objectives of this studyare to analyse twin block appliance based on mandibular dimension and anteriorfacial height changes, and to determined the most effective time base on CVMSto begin the treatment.Method: The type of research was a retrospective analysis study usingsecondary data. The sample was 14 lateral cephalometric radiographs beforeand after treatment with twin block appliance. It was taken in IKGA RSGM FKGUNPAD 2010 to 2016. Statistic analysis used paired t-test.Results: Study shows that there is a significant change (p&lt;0.05) in mandibulardimension and anterior facial height after treatment with twin block appliance.Changes in mandibular dimension including total mandibular length, mandibularbody length, ramus height, and gonial angle. Changes in anterior facial heightincluding lower anterior facial height and total anterior facial height. The CVMSIII group showed statistically significant result with the biggest improvement.Conclusion: The use of twin block appliance in Class II division 1 dentoskeletalmalocclusion with mandibular retrognatic could change mandibular dimensionand anterior facial height. Apart from that, CVMS III was found to be the mosteffective time to start the treatment with twin block appliance

Cephalometric Evaluation of Dentoskeletal and Soft-tissue Changes with Powerscope Class II Corrector

Objectives: The objective of the study is to assess the skeletal, dental, and soft-tissue effects of PowerScope fixed functional appliance in Class II malocclusion. Materials and Methods: Fifteen late adolescent Class II subjects (CVMI Stages 5 and 6) were treated with fixed mechanotherapy and PowerScope fixed functional appliance. Student t -test was used to compare the cephalometric changes produced before insertion of appliance (T1) and 6 months after the treatment with this appliance (T2). Results: Maxillomandibular relationship improved with significant lengthening of the mandible. There was retroclination of maxillary incisors, proclination of mandibular incisors, extrusion, and sagittal displacement of mandibular molars and clockwise rotation of occlusal plane. Conclusion: PowerScope is effective in correcting Class II malocclusion with a combination of dentoalveolar (primarily) and skeletal changes.

Maxillary molar distalization with miniscrew-supported appliances in Class II malocclusion: A systematic review.

To evaluate the quantitative effects of miniscrew supported appliances for maxillary molar distalization in Class II malocclusion. The systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles. The date of the last search was January 30, 2017. Methodological quality of the retrospective studies was graded by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP) and prospective studies by means of Newcastle-Ottawa Scale. In total, 298 studies were identified for screening, and 14 studies were eligible. The Quality Assessment Tool for Quantitative Studies rated all of the four included retrospective studies as moderate. The Newcastle-Ottawa Scale rated seven studies as high quality and three studies as low quality. The mean molar distalization values varied from 1.8 mm to 6.4 mm. Mean distal tipping of molars varied from 1.65° to 11.3°. The mean distal movement of premolars and incisors varied from 1.75 mm to 5.4 mm and 0.1 mm to 2.7 mm, respectively. Miniscrew-supported appliances are effective in molar distalization with distal movement of premolars with minimal anchorage loss and distal tipping of the molar teeth.

Effects of three types of functional appliances in class II malocclusions treatment - sagittal and vertical changes

Introduction/Objective. Class II malocclusions are sagittal malocclusions characterized by a distal relationship of posterior teeth. Depending on the underlying problem, class II can be skeletal or dentoalveolar. Class II treatment modality will depend on the cause, severity and age. Growth modification is the best treatment option in skeletal Class II growing patients. The aim of this study was to establish and compare sagittal and vertical skeletal and dental changes in patients treated with the ?M block? appliance, the Fr?nkel functional regulator and the Balters? Bionator. Methods. The sample consisted of 70 patients diagnosed with skeletal class II (ANB &gt; 4?) and mandibular retrognathism (SNB &lt; 80?). Patients were divided into 3 groups according to the type of appliance. All patients went through the standard diagnostic procedure (anamnesis, clinical and functional analysis, study model, panoramic radiograph and cephalometric analysis) and dental and skeletal age was determined. Treatment effects were analyzed on study models and cephalograms at the end of treatment. Results. All appliances led to significant mandibular anterior movement and sagittal growth, which reduced ANB values. All three groups of patients presented with neutral growth pattern, upper incisor retrusion and lower incisor protrusion at the end of treatment. Conclusion. Results of this study indicate efficacy of all three appliances in skeletal class II treatment.

Soft tissue profile changes after Functional Mandibular Advancer or Herbst appliance treatment in class II patients.

The objective of the present study is to compare the effects on soft tissue profile in class II patients after treatment with either "Functional Mandibular Advancer" (FMA) or Herbst appliance. The study included n=42 patients treated with either FMA (n=21) or Herbst appliance (n=21) by the same experienced orthodontist. The treatment followed a single-step advancement protocol. Lateral cephalograms were analyzed through a set of customized measurements. The actual therapeutic effect was calculated using data from a growth survey. After testing for normal distribution and homogeneity of variance, data were analyzed by one-sample Student's t tests and independent Student's t tests. Statistical significance was set at p<0.05. For both FFAs, significant upper lip retrusion, increase in lower lip's thickness, and length of the lower face occurred. Additionally, significant lower lip retrusion and straightening of the profile were found in FMA and Herbst appliance patients. All remaining variables revealed no significant differences. Treatment-related changes on the facial soft tissue profile could be regarded similar in class II patients treated with FMA or Herbst appliance. No treatment-related changes that were specific for FMA or Herbst appliance could be identified. Only moderate changes were noted comparing pre- and posttreatment soft tissue profiles. Despite proven differences in skeletal and dental treatment effects, the facial profile has not to be taken into consideration when choosing between FMA and Herbst appliance for class II treatment.