Predictors for Class II treatment duration.

BACKGROUND: The purpose of this study was to identify clinical factors that predict treatment length for patients with Class II malocclusions. METHODS: A sample of 237 active retention patients representing 3 observational groups (Angle Class I nonextraction, and Class II Division 1 extraction and nonextraction), based on specific selection criteria, was obtained from 3 private offices. From the patient records, data were collected in these categories: (1) patient information, (2) model information, (3) pretreatment cephalogram information, and (4) treatment information. Two regression analyses were completed, with total treatment time as the dependent variable for both models. RESULTS: The first regression analysis (Class I and Class II patients) indicated significant predictors for the patient, model, and cephalometric variables. These predictors included age, pretreatment overjet, and pretreatment ANB angle. The second regression analysis (Class II treatment variables) identified the following factors as significantly associated with treatment length: (1) type of Class II appliance, (2) number of months of Class II appliance wear, (3) number of months of interarch elastic wear, (4) maxillary expansion, (5) number of debonds, and (6) average time (weeks) between appointments. CONCLUSIONS: Six variables explained 56.7% of the variation in Class II treatment length. Further research is required to help explain more of the variance associated with treatment duration.

Effect of Herbst treatment on temporomandibular joint morphology: a systematic literature review.

The purpose of this systematic review was to evaluate the effect of Herbst appliance therapy on temporomandibular joint (TMJ) morphology, with special reference to glenoid fossa remodeling, condylar remodeling, condylar position, and articular disc position. Publications of controlled trials of Herbst treatment of Class II patients using magnetic resonance imaging (MRI), computerized tomography scans, or tomography to assess TMJ morphology were identified with Medline (1966-2001), Best Evidence (1991-2001), Cochrane Database of Systematic Reviews (second quarter, 2001), and Embase (1998-2001). Case reports were excluded. Based on our search, only 5 studies met the selection criteria. All studies used internal controls with pretreatment and posttreatment imaging. Four studies used MRI, and 1 used tomograms. The 4 MRI studies used overlapping patient samples and were not considered as independent evidence. The MRI studies did not provide conclusive evidence of osseous remodeling or condyle position change. The tomography study demonstrated minor condyle position change. Methodological deficiencies prevented major conclusions regarding disc position. The reviewed studies highlight the importance of further research. Prospective controlled studies using serial MRI and tomography are required to establish the effect of Herbst treatment on TMJ morphology.