Dataset Information

Clear aligner mandibular advancement in growing patients with Class II malocclusion.

ABSTRACT: Treatment effects occurring during Class II malocclusion treatment with the clear aligner mandibular advancement protocol were evaluated in two growing patients: one male (12 years, 3 months) and one female (11 years, 9 months). Both patients presented with full cusp Class II molar and canine relationships. Intraoral scans and cone-beam computed tomography were acquired before treatment and after mandibular advancement. Three-dimensional skeletal and dental long-axis changes were quantiﬁed, in which the dental long axis was determined by registering the dental crowns obtained from intraoral scans to the root canals in cone-beam computed tomography scans obtained at the same time points. Class II correction was achieved by a combination of mandibular skeletal and dental changes. A similar direction of skeletal and dental changes was observed in both patients, with downward and forward displacement of the mandible resulting from the growth of the mandibular condyle and ramus. Dental changes in both patients included mesialization of the mandibular posterior teeth with ﬂaring of mandibular anterior teeth. In these two patients, clear aligner mandibular advancement was an effective treatment modality for Class II malocclusion correction with skeletal and dental effects and facial proﬁle improvement.

SUBMITTER: Gurgel ML

PROVIDER: S-EPMC10454533 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Clear aligner mandibular advancement in growing patients with Class II malocclusion.

Gurgel Marcela Lima ML de Oliveira Ruellas Antonio Carlos AC Bianchi Jonas J McNamara James A JA Tai Sandra S Franchi Lorenzo L Deleat-Besson Romain R Le Celia C Logan Candice C Turkestani Najla Al NA Massaro Camila C Del Castillo Aron Aliaga AA Arruda Karine Evangelista Martins KEM Benavides Erika E Yatabe Marilia M Cevidanes Lucia L

AJO-DO clinical companion 20230125 2

Treatment effects occurring during Class II malocclusion treatment with the clear aligner mandibular advancement protocol were evaluated in two growing patients: one male (12 years, 3 months) and one female (11 years, 9 months). Both patients presented with full cusp Class II molar and canine relationships. Intraoral scans and cone-beam computed tomography were acquired before treatment and after mandibular advancement. Three-dimensional skeletal and dental long-axis changes were quantiﬁed, in w ...[more]

PMID: 37636594

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Project description:ObjectivesThis study aimed to assess whether functional mandibular advancement (FMA) will cause temporomandibular joint disorders (TMD) or have side effects on temporomandibular joint (TMJ) in adolescent patients.MethodsAll searched databases, including PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trails and Scopus were searched. Gray literature and unpublished literature was also searched. Randomized controlled trails (RCT) and non-randomized studies of the effects of interventions (NRSI) directly observe the condition of adolescent patients' TMJ after finishing treatment will be considered to include in our study. According to Cochrane Handbook, Cochrane Collaboration risk of bias tool was used to assess the quality of included RCTs, and Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool was used to assess the quality of included NRSIs.ResultFinally 18 researches were evaluated as eligible to include in this study. 5 of the studies were RCTs, 8 were NRSIs and 5 were systematic reviews. The data of RCTs and NRSIs were statistically pooled in meta-analysis. The number of samples under investigated among primary studies was 579 individuals,there were 80 patients who developed temporomandibular symptoms during or after treatment. But all the subjective symptoms disappeared during follow-up time. The statistical outcomes proved that patients received FMA didn't show more tendency to develop temporomandibular symptoms [I2 = 27%, OR = 0.54, 95%CI (0.33,0.87), p = 0.01].Conclusion(1) TMJ symptoms may occur during the functional oral appliance wearing, but the symptoms will release or disappear after treatment or during the follow-up period. (2) Less convincing evidence indicates that slightly previous TMD and condyle-glenoid fossa relationship will be improved after treatment. (3) There is TMJ disc anterior displacement observed during treatment, but most of them will return to the normal position later. (4) Moderate evidence support that FMA will not have side effects on TMJ of adolescent patients.

Project description:BackgroundCervical headgear (cHG) has been shown to be effective in Class II correction both with dental and orthopaedic effects but has traditionally been associated with vertical adverse effects in terms of posterior mandibular rotation.ObjectiveTo assess the treatment effects of cHG treatment in the vertical dimension.Search methodsUnrestricted literature search of five databases up to May 2023.Selection criteriaRandomized/non-randomized clinical studies comparing cHG to untreated controls, high-pull headgear (hp-HG), cHG adjuncts, or other Class II treatment alternatives (functional appliances or distalisers).Data collection and analysisAfter duplicate study selection, data extraction, and risk-of-bias assessment according to Cochrane, random-effects meta-analyses of mean differences (MD)/standardized mean diffences (SMD) and their 95% confidence intervals (CIs) were performed, followed by meta-regressions, sensitivity analyses, and assessment of certainty on existed evidence.ResultsTwo randomized/16 non-randomized studies (12 retrospective/4 prospective) involving 1094 patients (mean age 10.9 years and 46% male) were included. Compared to natural growth, cHG treatment was not associated on average with increases in mandibular (eight studies; SMD 0.22; 95% CI -0.06, 0.49; P = 0.11) or maxillary plane angle (seven studies; SMD 0.81; 95% CI -0.34, 1.95; P=0.14). Observed changes translate to MDs of 0.48° (95% CI -0.13, 1.07°) and 1.22° (95% CI -0.51, 2.94°) in the SN-ML and SN-NL angles, respectively. No significant differences were seen in y-axis, facial axis angle, or posterior face height (P > 0.05). Similarly, no significant differences were found between cHG treatment and (i) addition of a lower utility arch, (ii) hp-HG treatment, and (iii) removable functional appliance treatment (P > 0.05 for all). Meta-regressions of patient age, sex, or duration and sensitivity analyses showed relative robustness, while our confidence in these estimates was low to very low due to the risk of bias, inconsistency, and imprecision.ConclusionscHG on average is not consistently associated with posterior rotation of the jaws or a consistent increase in vertical facial dimensions among Class II patients.RegistrationPROSPERO registration (CRD42022374603).

Project description:The aim of this pilot randomized controlled trial (RCT) was to evaluate the sagittal mandibular response induced by rapid maxillary expansion (RME) therapy in mixed dentition patients with class II malocclusion, comparing the effects of bonded RME and banded RME with a matched untreated class II control group.This RCT was designed in parallel with an allocation ratio of 1:1:1. The sample consisted of 30 children with a mean age of 8.1 ± 0.6 years who were randomly assigned to three groups: group 1 treated with bonded RME, group 2 treated with banded RME, and group 3 the untreated control group. All patients met the following inclusion criteria: early mixed dentition, class II molar relationship, transverse discrepancy ??4 mm, overjet ??5 mm, and prepubertal skeletal maturity stage (CS1-CS2). The expansion screw was activated one quarter of a turn per day (0.25 mm) until overcorrection was reached. For each subject, lateral cephalograms and plaster casts were obtained before treatment (T1) and after 1 year (T2). A randomization list was created for the group assignment, with an allocation ratio of 1:1:1. The observer who performed all the measurements was blinded to group assignment. The study was single-blinded in regard to statistical analysis.RME was effective in the correction of maxillary deficiency. Class II patients treated with both types of RME showed no significant improvement of the anteroposterior relationship of the maxilla and the mandible at both skeletal and occlusal levels. The acrylic splint RME had significant effects on reducing the skeletal vertical dimension and the gonial angle.The orthopedic expansion did not affect the sagittal relationship of class II patients treated in the early mixed dentition when compared with the untreated control group. Additional studies with a larger sample are warranted to elucidate individual variations in dento-skeletal mandibular response to the maxillary expansion protocol in class-II-growing patients.ClinicalTrials.gov NCT03159962 .

Dataset Information

Clear aligner mandibular advancement in growing patients with Class II malocclusion.

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Clear aligner mandibular advancement in growing patients with Class II malocclusion.

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