Retroclination Of Incisors Research Articles

Conservative treatment of a Class I malocclusion with 12 mm overjet, overbite and severe mandibular crowding

INTRODUCTION: A female patient aged 12 years and 2 months had molars and canines in Class II relationship, severe overjet (12 mm), deep overbite (100%), excessive retroclination and extrusion of the lower incisors, upper incisor proclination, with mild midline diastema. Both dental arches appeared constricted and a lower arch discrepancy of less than -6.5 mm. Facially, she had a significant upper incisors display at rest, interposition and eversion of the lower lip, acute nasolabial angle and convex profile. OBJECTIVE: To report a clinical case consisting of Angle Class I malocclusion with deep overbite and overjet in addition to severe crowding treated with a conservative approach. METHODS: Treatment consisted of slight retraction of the upper incisors and intrusion and protrusion of the lower incisors until all crowding was eliminated. RESULTS: Adequate overbite and overjet were achieved while maintaining the Angle Class I canine and molar relationships and coincident midlines. The facial features were improved, with the emergence of a slightly convex profile and lip competence, achieved through a slight retraction of the upper lip and protrusion of the lower lip, while improving the nasolabial and mentolabial sulcus. CONCLUSIONS: This conservative approach with no extractions proved effective and resulted in a significant improvement of the occlusal relationship as well as in the patient's dental and facial aesthetics.

Dentofacial effects of two facemask therapies for maxillary protraction

To compare the dentofacial effects of maxillary protraction with two facemask therapies in growing Class III patients: facemask in association with miniscrew implants (MSI/FM) and facemask with rapid maxillary expanders (RME/FM). Forty-three Chinese patients with Class III malocclusion and maxillary deficiency were randomly assigned to a MSI/FM sample of 20 patients and a RME/FM sample of 23 subjects. The changes in dentofacial cephalometric variables from the beginning (T1) to the end of treatment (T2) were compared with t-test for paired samples in both groups and for independent samples between the two groups. No significant cephalometric differences were observed between the two groups in active treatment effects except for maxillary dental variables. However, significant favorable changes in both maxillary and mandibular skeletal components were noted in two groups after treatment. Sagittal measurements showed the maxilla was advanced, mandibular projection was reduced, and the relative sagittal intermaxillary discrepancy improved. Patients experienced additional unfavorable outcomes of clockwise rotation of the mandible as well as retroclination of the lower incisors. The soft tissue profile was improved remarkably in both groups. Proclination of the maxillary incisors and mesialization of the maxillary dentition were significantly different between the two groups. The increases in U1-SN, U1-VR, and U6-VR were 6.41°, 2.78 mm, and 1.24 mm less in the MSI/FM group than in the RME/FM group, respectively. Compared with the RME/FM therapy, the MSI/FM protocol using a smaller magnitude of protraction force improves skeletal relationships and soft tissue profile and reduces the undesired dentoalveolar effects.

Soft and hard tissue changes in Class II division 1 patients treated with Tip-Edge plus appliance

To investigate the soft and hard tissue changes in Class II division 1 patients treated with Tip-Edge plus technique. Sixteen Class II division 1 patients (7 boys and 9 girls) with mandibular retrusion in permanent dentition were selected and treated with Tip-Edge plus appliance. Lateral cephalometric films were analyzed before and after treatment. The effects were evaluated with Holdaway soft tissues analysis and routine cephalometric analysis methods. The arithmetic mean and standard deviation were calculated for each variable. Paired t-test was performed. The average treatment time was 16 months. Normal overjet and overbite were established with retroclination of upper incisors and proclination of lower incisors. U1-NA(°) and U1-NA (mm) decreaed by (15.40 ± 5.31)° and (4.16 ± 1.82) mm (P < 0.01). NLA showed an average increase of (-16.60 ± 5.29)° (P < 0.01). Remarkable soft tissue change was noted after the treatment. The profile in Class II division 1 patients could be quickly and efficiently improved after treatment with Tip-Edge plus technique.

Alterações dentoesqueléticas decorrentes do tratamento com aparelho ortopédico funcional Twin Block em pacientes portadores de má oclusão de Classe II esquelética

OBJETIVO: este estudo clínico prospectivo avaliou as alterações dentoesqueléticas em pacientes portadores de más oclusões de Classe II esquelética e dentária, tratados com o aparelho ortopédico funcional Twin Block (TB). MÉTODOS: a amostra foi dividida em dois grupos de 19 indivíduos cada: o grupo TB, com idade média de 9 anos e 6 meses (d.p. = 10 meses); e o grupo controle, com idade média de 9 anos e 9 meses (d.p. = 13 meses), ambos situados na fase de pré-surto de crescimento puberal. O teste t de Student não paramétrico mostrou que a amostra era homogênea para os valores cefalométricos ao início do estudo. Radiografias cefalométricas ao início do estudo (T1) e ao final dos 12 meses (T2) foram obtidas de todos os pacientes. Os testes de Wilcoxon e Mann-Whitney foram utilizados para avaliar as mudanças intragrupos e intergrupos em T1 e T2. RESULTADOS: a relação molar de Classe I foi obtida em 15 indivíduos do grupo tratado, enquanto nenhuma modificação ocorreu no grupo controle. Não foram observadas alterações na maxila e no padrão vertical de crescimento facial. Um aumento significativo do comprimento total mandibular e um deslocamento anterior da mandíbula ocorreram no grupo tratado (p&lt;0,05), assim como a redução do overjet, influenciado pela significativa retroinclinação do incisivo superior e vestibularização do incisivo inferior (p&lt;0,05). CONCLUSÕES: o tratamento da Classe II em pacientes brasileiros apresentou efeitos esqueléticos e dentários, incluindo aumento do comprimento mandibular e compensação dos incisivos, respectivamente.

Use of the Clark Twin Block functional appliance with and without an upper labial bow: a randomized controlled trial

To compare dentoalveolar and skeletal changes in two groups of Class II division 1 patients treated with different designs of Clark's Twin Block (CTB), with (Group 1) or without (Group 2) an upper labial bow. A randomized controlled trial was conducted in the Department of Orthodontics at the East Kent Hospitals University NHS Foundation Trust, UK. Sixty-two white subjects (aged 10-14 years at the start of treatment, minimum overjet > 6 mm, molar relationship at least ½ unit Class II) were recruited. Subjects were divided into age- and sex-matched pairs, were randomly allocated to treatment with either appliance design, and were treated for 12 months, at which time additional data were collected. Sixty participants were available for final data collection. The two groups were well matched with respect to age (mean 12.5 years in Group 1; 12.3 years in Group 2). No statistical difference was noted between groups for any dentoalveolar or skeletal variables measured. Both groups experienced a reduction in overjet as a result of maxillary incisor retroclination, mandibular incisor proclination, and forward positioning of the pogonion. Maxillary molar distalization, mandibular molar mesialization, and ANB reduction also occurred in both groups. The addition of a maxillary labial bow to the CTB has no influence on dentoalveolar or skeletal changes, or on rate of overjet reduction, in relation to appliance therapy.

A comparison of two different techniques for early correction of Class III malocclusion

To compare the effectiveness of Reverse Twin-Block therapy (RTB) and protraction face mask treatment (PFM) with respect to an untreated control in the correction of developing Class III malocclusion. A retrospective comparative study of subjects treated cases with either PFM (n = 9) or RTB (n = 13) and untreated matched controls (n = 10) was performed. Both the PFM and control group samples were derived from a previously conducted clinical trial, and the RTB group was formed of consecutively treated cases. The main outcome variables assessed were skeletal and dental changes. Lateral cephalograms were taken at the start and end of treatment or during the observation period. Analysis of variance was used to compare changes in cephalometric variables arising during the study period in the lateral group. Linear regression analysis and an unpaired t-test were used to determine the impacts of treatment duration and gender, respectively. Significantly greater skeletal changes arose with PFM therapy than with RTB therapy or in the control group (SNA, SNB, and ANB; P < .001). The dentoalveolar effects of RTB therapy exceeded those of PFM treatment, with significantly more maxillary incisor proclination (P < .001) and mandibular incisor retroclination (P < .006) arising with treatment. Both appliances are capable of correction of Class III dental relationships; however, the relative skeletal and dental contributions differ. Skeletal effects, chiefly anterior maxillary translation, predominated with PFM therapy. The RTB appliance induced Class III correction, primarily as a result of dentoalveolar effects.

Prevalence and severity of vestibular recession in mandibular incisors after orthodontic treatment

To assess the prevalence and severity of vestibular gingival recession of mandibular incisors after orthodontic treatment and to evaluate possible contributing factors. From the record pool of patients who completed orthodontic treatment from 1999-2006 at the Department of Orthodontics, University of Oslo, Norway, 588 patients fulfilled the inclusion criteria. Intraoral color slides were used for the evaluation of gingival recessions (based on Miller classification), presence of visible plaque, and gingival inflammation. Cephalometric radiographs were used to assess the sagittal intermaxillary relation, mandibular and intermaxillary angles, and the position of the lower incisors. A control group was drawn from the same pool of 588 patients. All statistical analyses were performed using SPSS. The prevalence of gingival recessions after orthodontic treatment was 10.3%. Most (8.6%) were classified as Miller Class I, and 1.7% were classified as Miller Class II. Gingival recession was predominantly found on central incisors. Reduction of the sagittal intermaxillary angle and retroclination of the lower incisors was correlated with the development of a more severe gingival recession. The present study indicates that vestibular gingival recession of mandibular incisors after orthodontic treatment is of minor prevalence and severity. The presence of gingival recession or retroclination of the incisors with mesial basal relations increases the risk of more severe gingival recession.

Orthodontic Considerations in Restorative Management of Hypodontia Patients With Endosseous Implants

The use of implant-supported restorations in patients with hypodontia remains challenging and requires a multistage treatment that begins in late mixed dentition and continues into late adolescence. The aim of this article is to review the role of orthodontics in endosseous implant rehabilitation of patients with hypodontia. The MEDLINE, Web of Science, Scopus, Cochrane databases, and necessary scientific textbooks were searched for relevant studies and reviews, and as far as possible, they were only included if they had been cited at least once in the literature. Dental implants are susceptible to overloading as the periodontal ligament is absent and the proprioceptive nerve endings are either lacking or very limited. Patients with hypodontia may present with skeletal features such as short and retrognathic maxilla, prognathic mandible, and shorter lower anterior facial height, and they sometimes need orthognathic correction as part of their overall treatment. Dental problems vary and include bimaxillary retroclination of incisors, spacing, centerline discrepancies, microdontia, hypoplastic enamels, ankylosis of the retained primary teeth, overeruptions, and volume deficiencies of alveolar ridges. The challenges mentioned, as well as bone volume deficiencies, compromise the successful placement of implants. Orthodontic strategies and techniques, such as uprighting mechanics, extrusion/intrusion, delayed space opening, and orthodontic implant site-switching, can be used to create, preserve, or augment the implant site. After orthodontic site development, the final planned position of the teeth should be maintained with a rigid bonded retainer; overlooking this stage may compromise the implant site and require orthodontic retreatment.

Skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances and lower premolar extractions

Abstract Background: Mild Class III malocclusions can be treated by upper incisor proclination and lower incisor retroclination following extraction of the lower first premolars. Aims: To compare the skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances, Class III traction and lower first premolar extractions with the changes in a group of untreated Class III patients. Methods: The Treatment group consisted of 30 Class III patients (Mean age 13.69 ± 1.48 years) who were treated by upper and lower fixed appliances, Class III intermaxillary traction and lower first premolar extractions for 2.88 ± 1.12 years. The Control group consisted of 20 untreated Class III patients (Mean age 13.51 ± 0.95) matched for age and gender. The T1 to T2 changes in the treated and untreated groups were compared using a paired t-test while differences between the two groups were compared with an independent t-test. Results: During treatment, the upper incisors were proclined about 1 degree and the lower incisors were retroclined 8 degrees. Small, but statistically significant changes in SNB, Wits and the overlying soft tissues accompanied the changes in incisor inclination. At the end of treatment a positive overbite and overjet were achieved. The increase in lower facial height in the Treatment group was comparable with the change in the Control group. Conclusions: A range of mild to moderate Class III malocclusions can be treated by dentoalveolar compensation.

Treatment effects of the R-appliance and twin block in Class II division 1 malocclusion

The purpose of this study was to compare the effects of a differently designed functional appliance (the R-appliance) with a twin-block (TB)-treated group. Thirty patients (18 girls and 12 boys) with a mean age of 10.5±0.7 years were treated with the R-appliance for 16.2±0.3 months and 25 (11 boys and 14 girls) with a mean age of 11.2±1.3 years with a TB for 16.1±1.4 months (control). All had a Class II division 1 malocclusion due to mandibular deficiency. Lateral cephalograms obtained at the beginning (T1) and end (T2) of the study were analysed. Paired t-tests showed that SNB significantly increased in both groups. The incisor mandibular plane angle (IMPA) was reduced in the R-appliance group by 1.9±4.9 degrees (P<0.04) but increased by 0.5±5.1 degrees (P<0.6) in the TB group. SNA in the R-appliance group showed an increase of 0.2±1.8 degrees (P<0.5), while it was decreased by 0.2±1.3 degrees (P<0.3) in the TB group. Both treatment modalities were successful in moving the mandible forward. However, with the R-appliance, this was achieved without retroclination of the lower incisors.

Craniofacial Changes After 2 Years of Nasal Continuous Positive Airway Pressure Use in Patients With Obstructive Sleep Apnea

Many patients with obstructive sleep apnea (OSA) use nasal continuous positive airway pressure (nCPAP) as a first-line therapy. Previous studies have reported midfacial hypoplasia in children using nCPAP. The aim of this study is to assess the craniofacial changes in adult subjects with OSA after nCPAP use. Forty-six Japanese subjects who used nCPAP for a minimum of 2 years had both a baseline and a follow-up cephalometric radiograph taken. These two radiographs were analyzed, and changes in craniofacial structures were assessed. The cephalometric measurements evaluated were related to face height, interarch relationship, and tooth position. Most of the patients with OSA were men (89.1%), and the mean baseline values for age, BMI, and apnea-hypopnea index (AHI) were 56.3 ± 13.4 years, 26.8 ± 5.6 kg/m(2), and 42.0 ± 18.6/h. The average duration of nCPAP use was 35.0 ± 6.7 months. After nCPAP use, cephalometric variables demonstrated a significant retrusion of the anterior maxilla, a decrease in maxillary-mandibular discrepancy, a setback of the supramentale and chin positions, a retroclination of maxillary incisors, and a decrease of convexity. However, significant correlations between the craniofacial changes, demographic variables, or the duration of nCPAP use could not be identified. None of the patients self-reported any permanent change of occlusion or facial profile. The use of an nCPAP machine for > 2 years may change craniofacial form by reducing maxillary and mandibular prominence and/or by altering the relationship between the dental arches.

Chin cup effects using two different force magnitudes in the management of Class III malocclusions

To evaluate the dental and skeletal effects of chin cup using two different force magnitudes in the management of Class III malocclusion cases. Fifty growing patients (26 males and 24 females) with skeletal Class III and mandibular prognathism were selected. The patients were divided into three groups. Patients in group 1 (n = 20) were treated with a chin cup and occlusal bite plane using 600 g of force per side. Patients in group 2 (n = 20) were subjected to the same treatment as in group 1 but using 300 g of force per side. In group 3 (n = 10) no treatment was performed. For all patients, lateral cephalograms were taken before treatment and after 1 year. Cephalograms were traced and analyzed. The collected data were analyzed statistically using one-way analysis of variance and the Tukey test. In the treatment groups, the SNB angle and ramus height decreased significantly. The ANB angle, Wits appraisal, anterior facial height, mandibular plane angle, and retroclination of the mandibular incisors were significantly increased in comparison to the control group. Utilization of either force showed no significant differences, except that the reduction in the ramus height was significantly greater with the use of higher force. The use of a chin cup improved the maxillomandibular base relationship in growing patients with Class III malocclusion but with little skeletal effect. The utilization of either force had the same effects, except that the higher force had a more pronounced effect in reduction of ramus height.

Terapia ortopedico-funzionale della malocclusione di Classe III

Objectives Early treatment of Class III malocclusion with orthopaedic and functional appliances has been advocated to control and modify the growth's direction and to reduce the need of treatment in the permanent dentition, when camouflage orthodontic treatment or surgery are the only options. Materials and methods The clinical success of early Class III treatment in most patients through growth modification, however, has resulted in the development of several strategies to treat Class III disharmony. Results The removable mandibular retractor produced a more significant anterior morphogenetic rotation of the mandible, due to a more upward and forward direction of condylar growth. Frankel's function regulator led to a downward and backward rotation of the mandible, a decrease in the SNB angle with a subsequent increase of the ANB angle, and the retrusion of the lower incisors. The Balters’ Bionator appliance caused mainly dento-alveolar changes in the growing craniofacial skeleton. Although such skeletal changes are statistically significant, they are less evident from a clinical point of view. The double-plate appliance showed a protrusion of the maxillary incisors and a retrusion of the mandibular incisors, a few sagittal skeletal effects with a satisfying control of vertical dental and skeletal changes. The SEC III caused an improvement of Wits appraisal, ANB angle, and overbite without backward mandibular rotation. The maxillary incisors were protruded. The chincup corrected the incisors relationship with proclination of the upper incisors and retroclination of lower incisors, and caused a redirection of mandibular growth in a downward direction with increase in facial height. Conclusions The early treatment of Classes III has always been and still is a controversial issue. Functional and orthopaedic therapies, if early administered, allow to control and change both the direction of growth and the relationships among osseous bases, whereas the orthodontic therapy is useful only to perform a dental compensation.

Use of a modified anterior inclined plane in the treatment on the dentoskeletal Class II division 2 patient

Class II malocclusions are seen due to the underdevelopment of the mandible in most of the cases. To compensate for the mandible retrusive position, there is flaring of the lower anterior teeth or retroclination of the central incisors as a compensatory mechanism seen in Class II division 2 type of malocclusion. This case report evaluates the skeletal and dental changes when a 12-year-old female patient with Class II div 2 malocclusion was treated with a modified anterior inclined plane. The postreatment data suggested that there were no significant changes in the vertical skeletal parameters. The upper central incisors were significantly realigned by proclination along with retroclination of the lateral incisors. There was significant increase in the mandibular length. The results revealed that the modified anterior inclined plane showed good results in the treatment of a case of Class II div 2 malocclusion.

Oral habits, prevalence and effects on occlusion of 4-15 year old school children in Lagos, Nigeria

To determine the prevalence of oral habits and assess the effects of these habits on the occlusion in a group of Nigerian schoolchildren. A cross-sectional study of 928 children aged 4-15 years from Eti -Osa local government area in Lagos, Nigeria. The sample population was selected from 2 private and 3 public schools. Three hundred and sixteen children (34.1%) of total children examined, exhibited one form of oral habit or another. The most common habit observed was digit sucking which was observed in 17% of the children. Increased overjet was observed in 33% of the habit children. This was significantly higher than findings in children without the habit who recorded an increased overjet of 25.3%. Anterior open bite was observed in 12.5% of habit children and 3.1% of non-habit children. Statistically significant differences in the occurrence of upper incisor proclination, lower incisor retroclination and lip incompetence were also observed occurring more frequently in the oral habit group. Posterior crossbite was observed in 1.9% of the habit group and 1.5% of the non-habit group. This difference was not statistically significant. This study shows an increased prevalence of oral habits when compared to previous studies in this region. Increased overjet and anterior open bite were the most commonly occurring occlusal anomalies associated with oral habits. There is a need to reduce the occurrence of permanent occlusal deformation due to the persistent form of these habits through dental health education among Nigerian children.

Long-term stability of dentoalveolar and skeletal changes after activator-headgear treatment

The aim of this study was to analyze the long-term stability of combined activator-headgear treatment on skeletal and dental structures in Class II patients. The material comprised 26 subjects, 10 girls and 16 boys. All had a molar Class II relationship, overjet > or =6 mm, and overbite > or =5 mm. They were treated in one practice with combined activator and headgear appliances. Lateral cephalometric radiographs and dental study casts were taken before treatment (T0, mean age 11.9 years), at the end of activator-headgear treatment (T1, mean age 15.9 years), and 12-15 years out of retention (T2, mean age 28.6 years). Nineteen cephalometric and nine dental cast variables were evaluated using a paired sample t-test between T0-T1, T1-T2, and T0-T2. At T1, the majority of the cephalometric measurements showed statistically significant changes. ANB was significantly reduced by 2.3 degrees due to a significant increase in SNB, but only small changes were observed in SNA. The interincisal angle increased as a result of significant retroclination of both maxillary and mandibular incisors. All patients achieved a Class I molar relationship and a significant reduction in overjet and overbite. At T2, the results showed only slight relapse from T1. However, the relapse did not compromise the significant improvement in almost all the cephalometric and dental variables. Combined activator-headgear treatment improved the skeletal and dental conditions and the results remained stable in the long term.

Bimaxillary Protrusion: An Overview of the Surgical-Orthodontic Treatment

Bimaxillary protrusion is a commonly seen deformity in Asian populations. This condition is characterized by protrusive and proclined upper and lower incisors and an increased procumbency of the lips. It is usually combined with lip incompetence, gummy smile, mentalis strain, and anterior open bite. Facial aesthetics is the primary concern of these patients. Successful treatment depends on a thorough evaluation and understanding of this dentofacial deformity. Typical orthodontic treatment includes retraction and retroclination of maxillary and mandibular incisors after extraction of the four first premolars. Orthognathic surgery is required to correct significant skeletal problems. Anterior subapical osteotomies and extraction of premolars can correct sagittal excess of the jaw bones and relieve dental crowding. Segmental maxillary osteotomies are performed to treat patients with an associated exaggerated curve of Spee and vertical maxillary excess. Differential intrusion of anterior and posterior maxilla/maxillary segments with clockwise rotation of the occlusal plane is a useful technique for treatment of anterior open bite and creation of a consonant smile arc. Le Fort I osteotomy with setback sometimes provides an alternative to segmental maxillary osteotomies. Meticulous planning and execution of osteotomies in accordance with surgical planning are essential for aesthetic and functional outcome.

Skeletal and dental components of Class II correction with the bionator and removable headgear splint appliances

The purpose of this study was to differentiate the dentoalveolar and skeletal effects to better understand orthodontic treatment. We evaluated the treatment changes associated with the bionator and the removable headgear splint (RHS). The sample comprised 51 consecutively treated Class II patients from 1 office who had all been successfully treated with either a bionator (n=17) or an RHS appliance (n=17). Class II patients waiting to start treatment later served as controls (n=17). A modified version of the Johnston pitchfork analysis was used to quantify the dentoalveolar and skeletal contributions to the anteroposterior correction at the levels of the molars and the incisors. Both appliances significantly improved anteroposterior molar relationships (2.15 mm for the bionator, 2.27 mm for the RHS), primarily by dentoalveolar modifications (1.49 and 2.36 mm for the bionator and the RHS, respectively), with greater maxillary molar distalization in the RHS group. Overjet relationships also improved significantly compared with the controls (3.11 and 2.12 mm for the bionator and the RHS, respectively), due primarily to retroclination of the maxillary incisors (2.2 and 2.38 mm for the bionator and the RHS, respectively). The differences between overall corrections and dentoalveolar modifications for both molar and overjet relationships were explained by skeletal responses, with the bionator group showing significantly greater anterior mandibular displacement than the RHS group. The bionator and the RHS effectively corrected the molar relationships and overjets of Class II patients primarily by dentoalveolar changes.

Skeletal components of class III malocclusions and compensation mechanisms

The aim of this retrospective study was to assess the skeletal characteristics of sagittal maxillary and mandibular discrepancies resulting in class III malocclusions and compensation mechanisms in one Caucasian European population (Croatian). The study sample included 107 patients (63 females and 44 males), aged between 11 and 18 years of age (mean age 14.6 +/- 2.2), with a class III malocclusion. Forty-three angular and linear measurements were assessed from the pre-treatment lateral cephalographs of each subject. anova, Tukey post hoc and t-test were used for statistical analysis. The most common differential skeletal type was mandibular prognathism with a normal maxilla (43%), followed by maxillary retrognathism with a normal mandibular position (19.6%), while the combination of maxillary retrognathism and mandibular prognathism was found to be rare (<5%). Subjects with maxillary retrognathia, appeared to also have a vertical facial pattern, suggesting a tendency towards vertical growth as a possible compensation mechanism. Those with mandibular prognathia tended to exhibit a horizontal facial growth pattern and typically included more pronounced dento-alveolar compensation, that is, proclination of maxillary and retroclination of mandibular incisors. There were no differences observed in gender, overjet or soft tissue profiles between different sagittal skeletal types. Dominant protrusive mandible in Croatians can be related to European Caucasian ancestry, where this entity is historically described as 'Habsburg jaw'.

Vertical changes in treated and untreated Class II division 1 malocclusions

Abstract Background Treatment-induced increases in the height of the face may be permanent. Aims To determine if appliance-induced increases in the heights of the upper and lower molars in girls with Class II division 1 malocclusion, and the consequential increase in the height of the face are maintained. Methods Ten angles and 10 distances were measured on lateral cephalometric radiographs of 11 year-old girls (Range: 8.5–14.8 years) with treated (N = 9) and untreated (N = 8) Class II division 1 malocclusions. The intervals between the initial and recall records were, on average, 12 years (Range: 7.6–15.7 years) for the girls in the treatment group, and 8 years (Range: 4–13 years) for the girls in the untreated/control group. In the treatment group eight girls were treated with the Begg appliance and Class II elastics. Results Upper and lower molar dentoalveolar heights in both groups increased significantly between the initial and recall visits. There were no significant differences between the molar heights in the groups at the start or at recall. Anterior face height (AFH) also increased significantly in both groups between the initial and recall visits. At recall, AFH in the treatment group was significantly greater than AFH in the control group. This finding is attributed to a similar-sized difference between the groups at the start, to the longer period between the initial and recall records in the treatment group and to lesser variation in both groups at recall. In both groups, posterior face height increased significantly between the initial and recall stages. At the conclusion of the study there were no statistically significant differences between the treated and control groups in either overjet or the inclination of the upper incisors. Relapse of the upper incisors in the treatment group and retroclination of the upper incisors in the control group reduced the initial differences between the groups. These changes are attributed to altered lip posture and increased lip pressures in adolescence. At recall, angles SNA and SNB were significantly smaller in the treatment group. Conclusion The heights of the upper and lower molars and the face increased in both groups. Orthodontic treatment may have no lasting effects on either the height of the face or the heights of the molars in girls with Class II division 1 malocclusion.