Dental, skeletal and soft tissue effects of the Distal Jet appliance: A prospective clinical study

ABSTRACT Objective: This study evaluated the dental, skeletal and soft tissue effects in Class II malocclusion patients treated with Distal Jet appliance, compared to an untreated control group. Methods: 44 patients with Class II malocclusion were divided into two groups: Group 1 (experimental) - 22 patients, mean age of 12.7 years, treated with the Distal Jet appliance for a mean period of 1.2 years; Group 2 (control) - 22 untreated patients, mean age of 12.2 years, followed by a mean period of 1.2 years. Lateral cephalograms were obtained before treatment (T0) and at the end of the distalization (T1).Independent t test was used to identify intergroup differences. Results: When compared to control group, the Distal Jet produced a significant increase in mandibular plane angle (0.7 ± 2.0o). The maxillary second molars presented distal inclination (6.6 ± 3.8o), distalization (1.1 ± 1.1 mm) and extrusion (1.3 ± 2.1 mm). The maxillary first molars distalized by 1.2 ± 1.4 mm. The maxillary first premolars mesialized by 3.4 ± 1.1 mm. The maxillary incisors showed slight labial tipping of 4.3 ± 4.7o and were protruded by 2.4 ± 1.7 mm. There were no significant changes in the facial profile. The overjet increased 1.5 ± 1.1 mm and overbite had no significant changes. Conclusion: The Distal Jet appliance is effective to distalize the maxillary first molars, but promotes increase in mandibular plane angle, distal inclination, extrusion and distalization of maxillary second molars, mesialization of maxillary first premolars, proclination and protrusion of maxillary incisors, and increase in overjet, when compared to a control group.

RESUMO Objetivo: o presente estudo avaliou os efeitos dentoesqueléticos e tegumentares em pacientes com má oclusão de Classe II tratados com aparelho Distal Jet, comparando-os com um grupo controle não tratado. Métodos: 44 pacientes com má oclusão de Classe II foram divididos em dois grupos: Grupo 1 (experimental) - 22 pacientes, idade média de 12,7 anos, tratados com o aparelho Distal Jet por um período médio de 1,2 anos; Grupo 2 (controle) - 22 pacientes não tratados, idade média de 12,2 anos, acompanhados por um período médio de 1,2 anos. Telerradiografias laterais foram obtidas antes do tratamento (T0) e no final da distalização (T1). O teste t independente foi usado para identificar as diferenças entre os grupos. Resultados: quando comparado ao grupo controle, o Distal Jet produziu um aumento significativo no ângulo do plano mandibular (0,7 ± 2,0o). Os segundos molares superiores apresentaram inclinação distal (6,6 ± 3,8o), distalização (1,1 ± 1,1 mm) e extrusão (1,3 ± 2,1 mm). Os primeiros molares superiores foram distalizados por 1,2 ± 1,4 mm. Os primeiros pré-molares superiores, mesializados por 3,4 ± 1,1 mm. Os incisivos superiores mostraram leve inclinação labial de 4,3 ± 4,7o e foram protruídos por 2,4 ± 1,7 mm. Não existiram alterações significativas no perfil facial. O overjet aumentou 1,5 ± 1,1 mm, e o overbite não sofreu alterações significativas. Conclusão: o aparelho Distal Jet é eficaz para distalizar os primeiros molares superiores, mas promove aumento no ângulo do plano mandibular, inclinação distal, extrusão e distalização dos segundos molares superiores, mesialização dos primeiros pré-molares superiores, vestibularização e protrusão dos incisivos superiores e aumento do overjet, quando comparado a um grupo de controle.

Dental, skeletal and soft tissue effects of the Distal Jet appliance: A prospective clinical study.

OBJECTIVE: This study evaluated the dental, skeletal and soft tissue effects in Class II malocclusion patients treated with Distal Jet appliance, compared to an untreated control group. METHODS: 44 patients with Class II malocclusion were divided into two groups: Group 1 (experimental) - 22 patients, mean age of 12.7 years, treated with the Distal Jet appliance for a mean period of 1.2 years; Group 2 (control) - 22 untreated patients, mean age of 12.2 years, followed by a mean period of 1.2 years. Lateral cephalograms were obtained before treatment (T0) and at the end of the distalization (T1).Independent t test was used to identify intergroup differences. RESULTS: When compared to control group, the Distal Jet produced a significant increase in mandibular plane angle (0.7 ± 2.0o). The maxillary second molars presented distal inclination (6.6 ± 3.8o), distalization (1.1 ± 1.1 mm) and extrusion (1.3 ± 2.1 mm). The maxillary first molars distalized by 1.2 ± 1.4 mm. The maxillary first premolars mesialized by 3.4 ± 1.1 mm. The maxillary incisors showed slight labial tipping of 4.3 ± 4.7o and were protruded by 2.4 ± 1.7 mm. There were no significant changes in the facial profile. The overjet increased 1.5 ± 1.1 mm and overbite had no significant changes. CONCLUSION: The Distal Jet appliance is effective to distalize the maxillary first molars, but promotes increase in mandibular plane angle, distal inclination, extrusion and distalization of maxillary second molars, mesialization of maxillary first premolars, proclination and protrusion of maxillary incisors, and increase in overjet, when compared to a control group.

O aparelho ortopédico funcional Twin Block modificado por Henriques / The Twin Block functional orthopedic appliance modified by Henriques

Objetivo: o objetivo desse trabalho é apresentar o aparelho Twin Block modificado por Henriques, indicado no tratamento de retrognatismo mandibular. Métodos: a não ser no padrão de crescimento vertical excessivo da face, o avanço mandibular é único. Os componentes são: porção acrílica, arco vestibular superior, tornos expansores superior e inferior, grampos de Adams e circunferenciais, planos de mordida anteriores e posteriores encaixados em 70º. As principais modificações em relação ao aparelho Twin Block original de Clark são o parafuso expansor inferior, a cobertura dos incisivos inferiores para evitar a inclinação vestibular ou protrusão desses dentes, 20º de inclinação para dentro (junto aos 70º) no aparelho superior, ou escudo lingual no inferior para evitar deslocamentos laterais da mandíbula. Os parafusos expansores superior e inferior são ativados em » de volta por mês apenas para acompanhar o crescimento maxilomandibular e evitar mordida cruzada. Em casos de mordida profunda, os desgastes seletivos no plano posterior do aparelho superior para a correção da curva de Spee são iniciados quando os contatos oclusais ocorrerem em padrão de fechamento de relação cêntrica. No padrão de crescimento vertical ou casos com altura anteroinferior aumentada (AFAI), os desgastes seletivos não são realizados, para não piorar esses casos. Resultados: mudanças esqueléticas e dentoalveolares são associadas com mudanças significativas no perfil duro e mole. Conclusão: o aparelho Twin Block modificado por Henriques pode ser adequado ao padrão de crescimento facial e tipo de má oclusão inicial, porém, por ser removível, depende totalmente da cooperação do paciente.

Radiographic techniques for medical-dental research with minipigs.

Techniques were developed to obtain standardised intra- and extra-oral radiographs in minipigs for use in medical-dental research. Twelve male minipigs (BR-1 Minipigs) were chosen at random. Two animals each at 3, 5, 7, 9, 12 and 15 months of age were anaesthetised and subjected to radiographic examinations to assess six techniques. Three intra-oral and three extra-oral techniques, standardised for humans, were used with variations of the angle of incidence of the X-ray beams, focus-film distance and exposure time. Two film positioners were developed for the intra-oral techniques. Two examiners then chose the radiographs with the least image distortion, greatest clarity and least superimposition of images. For each technique, the suitable angle of incidence of the X-ray beams, the focus-film distance and exposure time that produced the highest quality radiographs were standardised.

Dental and skeletal characterization of the BR-1 minipig.

This study was designed to characterize the development of oral structures in the BR-1 minipig and to compare these data with literature reports on domestic swine and other minipig lineages. Twelve male minipigs were anesthetized and given physical and radiographic examinations. The presence and chronology of tooth eruption from 3 to 15 months of age were assessed, and the radiographic results were interpreted by two certified researchers, who obtained a high index of agreement (kappa>0.81). The eruption chronology was similar to that reported for domestic swine and other minipig lineages. The results indicate that it is possible to use the BR-1 minipig in dental research.

Anterior open bite treated with a palatal crib and high-pull chin cup therapy. A prospective randomized study.

The aim of this prospective randomized clinical study was to cephalometrically investigate the dentoalveolar and soft tissue changes produced by a removable appliance with a palatal crib associated with high-pull chin cup therapy in children with an Angle Class I anterior open bite (AOB) malocclusion. Thirty children (8 males and 22 females) with an initial mean age of 8.3 years and a mean AOB of 4.1 mm were treated with a removable appliance composed of a palatal crib associated with chin cup therapy for 12 months. A control group of 30 individuals (7 males and 23 females) closely matched for age, initial mean age 8.6 years, gender, and ethnicity with a mean AOB of 4.6 mm was followed without treatment. The measurements (means and standard deviations) were statistically analysed using a paired t-test. The results showed no significant differences in the level of molar eruption or in lower anterior face height, suggesting that the vertical control expected from the chin cup therapy did not occur. Dentoalveolar changes at the anterior region were evident, with statistically significant extrusion, retrusion, and lingual tipping of the maxillary and mandibular incisors (P < or = 0.05). However, these hard tissue changes did not imply soft tissue changes and the variables related to the soft profile were not statistically significantly different between the groups. The dentoalveolar changes at the anterior region of the dental arches were mainly responsible for closure of the AOB in patients treated in the mixed dentition.

Treatment effects produced by the Bionator appliance. Comparison with an untreated Class II sample.

The purpose of this retrospective investigation was to evaluate the dentoalveolar and skeletal cephalometric changes of the Bionator appliance on individuals with a Class II division 1 malocclusion. Lateral cephalograms of 44 patients were divided into two equal groups. The control group comprised 22 untreated Class II children (11 males, 11 females), with an initial mean age of 8 years 7 months who were followed without treatment for a period of 13 months. The Bionator group (11 males, 11 females) had an initial mean age of 10 years 8 months, and were treated for a mean period of 16 months. Lateral cephalometric headfilms were obtained of each patient and control at the beginning and end of treatment. The results showed that there were no changes in forward growth of the maxilla in the experimental group compared with the control group. However, the Bionator treatment produced a statistically significant increase in mandibular protrusion, and in total mandibular and body lengths. There were no statistically significant differences in craniofacial growth direction between the Bionator group and the control group, although the treated patients demonstrated a greater increase in posterior face height. The Bionator appliance produced labial tipping of the lower incisors and lingual inclination of the upper incisors, as well as a significant increase (P < 0.01) in mandibular posterior dentoalveolar height. The major effects of the Bionator appliance were dentoalveolar, with a smaller significant skeletal effect. The results indicate that the correction of a Class II division 1 malocclusion with the Bionator appliance is achieved not only by a combination of mandibular skeletal effects, but also by significant dentoalveolar changes.