Treatment outcome in angle class II, division 1 patients in pre-puberty and puberty after jumping-the-bite appliance.

AIM: The aim of this study was to investigate whether, and if so, to what extent, skeletal and dento-alveolar developments of the stomatognathic system take a different course due to influence of Tränkmann's jumping-the-bite appliance (JTB) in pre-pubertal and pubertal patients in comparison to untreated control groups presenting the same conditions at baseline. We aim to discover whether the results are better when the device is used on prepubertal children, or those in puberty. PATIENTS AND METHODS: Two lateral cephalograms were scanned in treated children presenting Angle Class II, Division 1 malocclusion; they were scanned in untreated children with the same distoclusion at intervals between at least 11 months and at most 25 months. The same procedure was taken in children in pre-puberty (female, min. = 8.6 yrs, max. = 11 yrs; male, min. = 9 yrs, max. = 12.6 yrs) and in puberty (female, min. = 11 yrs, max. = 14 yrs; male, min. = 12.6 yrs, max. = 15 yrs). The cephalometric analysis was made with the orthodontics-PC-program Onyx Ceph (Image Instruments, Chemnitz, Germany) using a modified Bergen/Hasund analysis [7, 8]. RESULTS: The Angle Class II, Division 1 malocclusion of all treated patients evolved into an Angle Class I occlusion via Tränkmann's JTB design. The location of this transformation was mainly dento-alveolar in both pre-puberty and puberty. The differences between the control and JTB groups concerning the development of cephalometric values in pre-pubertal age were unremarkable if one considers the range of reading error. The exception to this was with angleUP1-NA, which increased more in the control group than in the treated group. angleSNB, arB (mm), angleANB and angleML-NSL showed greater change in the targeted direction in the control group than in the JTB group in pubertal patients. The increase in the arA length (mm) was clearly, but not statistically significantly, inhibited by the JTB in puberty. Comparing both treated groups, one can conclude that cephalometric values developed more favorably in the pre-pubertal than in the pubertal patients, with the exception of angleSNA.

Changes of vertical skeletal morphology in patients with complete unilateral and bilateral cleft lip and palate.

OBJECTIVE: The aim of this retrospective investigation was to qualify and quantify changes of the vertical skeletal morphology during puberty in cleft patients compared with an age-matched noncleft control. METHODS: Patients with unilateral cleft lip and palate (UCLP; n = 12) and bilateral cleft lip and palate (BCLP; n = 11) who fulfilled strict inclusion criteria according to the Hanover treatment protocol were evaluated by means of cephalometric analysis. Lateral cephalograms were analyzed for each cleft patient at age 10 and 15 and compared with corresponding data of a noncleft control (n = 20). RESULTS AND CONCLUSIONS: It was concluded that a vertical growth impairment of the maxilla is found in patients with cleft lip and palate. The maxilla of cleft patients shows a significant clockwise rotation, whereas the inclination of the mandible shows little difference. Consequently, there is a skeletal superposition of the jaws. The posterior height of the maxilla is significantly shorter in patients both with UCLP and BCLP at T(0) and T(1). An increase of the anterior height of the mandible is found in the cleft groups.

Vertical changes in patients with complete unilateral and bilateral cleft lip, alveolus and palate.

AIMS AND METHODS: Twelve UCLP and eleven BCLP patients who had been treated according to the Hanover treatment protocol were evaluated by means of cephalometric analysis and cast measurements. The aim of this investigation was to demonstrate changes in the vertical plane and in incisor position in the course of craniofacial growth compared to age-matched non-cleft controls. Lateral cephalograms and casts were analyzed for each cleft patient at age 10 and 15 and compared with corresponding data of a non-cleft control group (n = 20). RESULTS: A vertical growth impairment of the maxilla was registered in patients with cleft lip, alveolus and palate. The maxilla of the cleft patients showed a significant clockwise rotation while the inclination of the mandible remained virtually unchanged. Both upper and lower incisors, which were significantly retruded at the beginning of the late mixed dentition, could be protruded in the course of craniofacial growth, development of the dentition and treatment, but remained retruded in comparison with the non-cleft controls. The posterior midfacial height was highly significantly shorter in both UCLP and BCLP patients at both evaluation timepoints, whereas the anterior lower jaw height was greater than in the control group

Treatment begin and treatment effect in functional orthodontics with jumping-the-bite appliances.

AIM: The aim of the present study was to investigate the effects of treatment begin in the early and in the late mixed dentition on treatment with jumping-the-bite appliances. PATIENTS AND METHODS: Casts and lateral cephalograms of 69 patients with Angle Class II, Division 1 malocclusions treated with jumping-the-bite appliances were evaluated. RESULTS: A treatment begin in the early or late mixed dentition resulted in a highly significant reduction in overjet and overbite (p < 0.001), in [symbol: see text] SNA and in [symbol: see text] ANB (p < 0.001). An increase of [symbol: see text] SNB depended upon early (p < 0.001) and late (p < 0.01) treatment begin. In the vertical dimension, an early treatment start induced a slightly significant increase in [symbol: see text] NL/NSL and highly significant changes in the upper and lower incisors. With a late treatment start, these changes applied only to the lower incisors. The changes differed significantly only with respect to incisor inclination (upper arch p < 0.01, lower arch p < 0.05). The later the treatment start, the less significant were the dentoalveolar effects. CONCLUSION: At the end of the study period, a slightly significant intergroup difference was recorded for lower incisor inclination only.

Effects of angle Class II, division 1 treatment with jumping-the-bite appliances. A longitudinal study.

AIM: The present study investigated treatment effects in patients with Angle Class II, Division 1 malocclusions treated with jumping-the-bite appliances on the basis of cast evaluation and lateral cephalometrics. RESULTS: A significant reduction in overjet (p < 0.001) and overbite (p < 0.01) occurred during the course of treatment. A significant reduction in the SNA-angle (p < 0.001) and increase in the SNB-angle (p < 0.001) led to a reduced ANB-angle (p < 0.001). The treatment effect on the maxilla was greater than on the mandible. A slight posterior rotation of the maxilla (p < 0.05) occurred whereas the other vertical relations did not change significantly. The upper incisors were significantly retruded (p < 0.001) while the lower incisors were increasingly protruded (p < 0.001). The interincisal angle was not markedly altered.