ABSTRACT
The purpose of this study was to analyze whether pronounced orthodontic advancement of the mandibular incisors during Class II correction in the mixed dentition results in gingival recession. Through mandibular superimposition of the pretreatment and posttreatment cephalograms of 67 Class II patients who were treated with reverse headgear to the mandibular dentition, 45 patients with a minimum of a 1-mm advancement of the cementoenamel junction (CEJ; mean, 2.18 +/- 0.87) and a minimum of a 2-mm advancement of the incisal edge (mean, 3.87 +/- 1.34) were identified. Using the same protocol in Class II patients, 30 individuals who finished treatment at a similar time and age, but without reverse headgear and with no advancement of the CEJ (mean -0.43, SD 0.53) and a maximum of 1-mm advancement of the incisal edge (mean -0.26, SD 1.15) were identified. Before treatment, the mandibular incisors were more retruded, relative to the line from point A to pogonion and relative to the mandibular plane in the patients with pronounced advancement than in those with no advancement of the mandibular incisors; no differences were found at the time of appliance removal. A total of 30 patients with pronounced advancement and 21 patients with no advancement could meet for a follow-up examination a mean period of 7.83 years (SD, 4.44) and 9.38 years (SD, 4.39) after treatment, respectively. Clinical examinations at the time of follow-up revealed no differences in the amount of recession, the width of attached gingiva, the length of supracrestal connective tissue attachment, the probing pocket depth, and gingival bleeding index or visible plaque index of the mandibular incisors between the patients in the 2 groups. An examination of color slides demonstrated no differences in the number of mandibular incisors that developed recession from before treatment to after treatment and from after treatment to follow-up. Measurement of mandibular incisor crown height on the study models demonstrated no difference in the increase in clinical crown height from after treatment to follow-up between the patients in the 2 groups. It was concluded that pronounced advancement of the mandibular incisors may be performed in adolescent patients with dentoalveolar retrusion without increasing the risk of recession.
Subject(s)
Incisor/pathology , Mandible/pathology , Periodontal Diseases/etiology , Tooth Movement Techniques/adverse effects , Adolescent , Cephalometry , Connective Tissue/pathology , Dental Plaque Index , Dentition, Mixed , Extraoral Traction Appliances/adverse effects , Female , Follow-Up Studies , Gingiva/pathology , Gingival Hemorrhage/etiology , Gingival Recession/etiology , Humans , Male , Malocclusion, Angle Class II/therapy , Models, Dental , Odontometry , Periodontal Pocket/etiology , Photography, Dental , Reproducibility of Results , Statistics as Topic , Tooth Cervix/pathology , Tooth Crown/pathologyABSTRACT
Profound knowledge of craniofacial growth is of utmost importance to the clinician in order to establish a treatment plan which respects the growth type of each patient. Different growth processes and possible etiological factors leading to a skeletal Class II are discussed. Only a comprehensive analysis in all three dimensions will allow adequate choice of treatment procedure.
Subject(s)
Malocclusion, Angle Class II/embryology , Malocclusion/embryology , Mandible/embryology , Adolescent , Adult , Cephalometry , Child , Humans , Odontometry , OsteogenesisABSTRACT
The vertical dimension and its implication in the etiology of the class II are described. This dimension is analysed at the level of the cranial base, the maxillary and mandibular bones and alveolar processes. Then, the facial architecture as a whole is considered and particularly the key position of the upper molar. The dorsal and low position of these teeth in the hyperdivergent cases is fundamentally different from the one they occupy in the hypodivergent cases. The therapeutic approach is completely different in both cases and is illustrated by means of three deep overbite and three open bite cases.
Subject(s)
Malocclusion, Angle Class II/etiology , Skull/growth & development , Vertical Dimension , Alveolar Process/growth & development , Cephalometry , Humans , Maxillofacial Development , Orthodontics, Corrective , Tooth/growth & developmentABSTRACT
Normal facial growth displaces maxilla and mandible forward and downward. The result is the skeletal and facial equilibrium described by Angle. In classe-II and class-III cases, growth patterns are modified as well as sagittal and vertical dento-facial dimensions. Development and differential diagnosis of skeletal and dental class-II cases are presented, in relation to their sagittal parameters only. The evolution of a class-II can be predicted with the help of several cephalometric measurements, so that the adequate therapy can be used in time to reestablish proper growth.
Subject(s)
Malocclusion, Angle Class II/etiology , Adolescent , Cephalometry , Child , Humans , Tooth EruptionSubject(s)
Models, Dental , Orthodontics, Corrective , Dental Impression Technique , Humans , Malocclusion/therapyABSTRACT
The importance of an exact differential diagnosis of the Class II malocclusion and its indications for treatment with activators, extraoral forces, and fixed appliances has been shown. Four schematized malocclusions with their cephalometric characteristics and their individualized orthopedic therapeutics have been presented. Special attention has been given to the subsequent fixed mechanotherapy showing the limited need for fixed appliances. This approach is attractive, for it reduces considerably the stress imposed on the patient and the orthodontist, it bypasses the iatrogenic hazards entailed in extensive and prolonged mechanotherapy, and it consistently increases chances for long-term stability.
