Dataset Information

Three-dimensional condylar changes from Herbst appliance and multibracket treatment: A comparison with matched Class II elastics.

ABSTRACT:

Introduction

The purpose of this study was to quantify and qualify the 3-dimensional (3D) condylar changes using mandibular 3D regional superimposition techniques in adolescent patients with Class II Division 1 malocclusions treated with either a 2-phase or single-phase approach.

Methods

Twenty patients with Herbst appliances who met the inclusion criteria and had cone-beam computed tomography (CBCT) images taken before, 8 weeks after Herbst removal, and after the completion of multibracket appliance treatment constituted the Herbst group. They were compared with 11 subjects with Class II malocclusion who were treated with elastics and multibracket appliances and who had CBCT images taken before and after treatment. Three-dimensional models generated from the CBCT images were registered on the mandible using 3D voxel-based superimposition techniques and analyzed using semitransparent overlays and point-to-point measurements.

Results

The magnitude of lateral condylar growth during the orthodontic phase (T2-T3) was greater than that during the orthopedic phase (T1-T2) for all condylar fiducials with the exception of the superior condyle (P <0.05). Conversely, posterior condylar growth was greater during the orthopedic phase than the subsequent orthodontic phase for all condylar fiducials (P <0.05). The magnitude of vertical condylar development was similar during both the orthopedic (T1-T2) and orthodontic phases (T2-T3) across all condylar fiducials (P <0.05). Posterior condylar growth during the orthodontic phase (T2-T3) of the 2-phase approach decreased for all condylar fiducials with the exception of the posterior condylar fiducial (P <0.05) when compared with the single-phase approach.

Conclusions

Two-phase treatment using a Herbst appliance accelerates condylar growth when compared with a single-phase regime with Class II elastics. Whereas the posterior condylar growth manifested primarily during the orthopedic phase, the vertical condylar gains occurred in equal magnitude throughout both phases of the 2-phase treatment regime.

SUBMITTER: Wei RY

PROVIDER: S-EPMC7773220 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Publications

Three-dimensional condylar changes from Herbst appliance and multibracket treatment: A comparison with matched Class II elastics.

Wei Robert Y RY Atresh Arjun A Ruellas Antonio A Cevidanes Lucia H S LHS Nguyen Tung T Larson Brent E BE Mangum Jonathan E JE Manton David J DJ Schneider Paul M PM

American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 20200820 4

<h4>Introduction</h4>The purpose of this study was to quantify and qualify the 3-dimensional (3D) condylar changes using mandibular 3D regional superimposition techniques in adolescent patients with Class II Division 1 malocclusions treated with either a 2-phase or single-phase approach.<h4>Methods</h4>Twenty patients with Herbst appliances who met the inclusion criteria and had cone-beam computed tomography (CBCT) images taken before, 8 weeks after Herbst removal, and after the completion of mu ...[more]

PMID: 32828608

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Project description:IntroductionThe aims of this study were to evaluate, using 3-dimensional superimposition techniques, the skeletal changes in Class II subjects with different vertical facial patterns treated with the Herbst appliance and to compare these skeletal changes to those of Class II controls treated with elastics.MethodsSixteen Herbst patients who met the inclusion criteria were divided into 2 equal groups based on vertical facial pattern as determined by the Frankfort mandibular plane angle (brachyfacial, ≤22°; mesofacial, 23°-29°) and had cone-beam computed tomographs taken before treatment, 8 weeks after Herbst appliance removal, and after subsequent fixed appliance treatment. Eleven Class II control patients treated with fixed appliances and elastics had cone-beam computed tomographs taken before and after treatment. Three-dimensional models were generated from the cone-beam computed tomography images, registered on the anterior cranial bases, and analyzed using color maps and point-to-point measurements.ResultsThere were minimal differences in treatment response between the 2 Herbst groups across all skeletal parameters measured. The Herbst subjects showed a greater inferior displacement of anterior nasal spine compared with the Class II controls (Herbst brachyfacial, -1.44 mm; Herbst mesofacial, -1.95 mm) with other maxillary changes being clinically insignificant. The Herbst subjects showed greater inferior displacement of B-point compared with the Class II controls (Herbst brachyfacial, -2.59 mm; Herbst mesofacial, -2.75 mm). There were no statistically significant differences in mean linear mandibular measurements. All groups showed a trend toward posterior displacement of the condyles and glenoid fossae from the start to the end of treatment, with no significant differences across the 3 groups. There were minimal differences in the changes in gonial angle and Frankfort mandibular plane angle across all groups.ConclusionApproximately 2 years after Herbst treatment, the Herbst subjects with different vertical facial patterns showed similar patterns of skeletal change compared with the Class II controls treated with elastics.

Project description:BackgroundOur meta-analysis aimed to evaluate the efficacy of applying Herbst and Twin Block appliances in the treatment of Class II malocclusion among children.MethodsDatabases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China VIP Database (VIP), and Wanfang were thoroughly searched from inception to August 9, 2023. The outcomes included skeletal, dental, and soft tissue changes. The weighted mean difference (WMD) was used as the effect indicator, and the effect size was expressed with a 95% confidence interval (CI). The heterogeneity of each outcome effect size was tested, and the heterogeneity statistic I2 ≥ 50% was analyzed by the random-effect model, otherwise, the fixed-effect model was conducted. Sensitivity analysis was performed.ResultsA total of 12 studies involving 574 patients were included in this meta-analysis. Herbst appliance had a statistically significant increase in mandibular body length (WMD: 1.44, 95% CI: 0.93 to 1.96, P < 0.001) compared with the Twin Block appliance. More increases in angle and distance of L1 to mandibular plane (MP) were found in the Herbst appliance compared with the Twin Block appliance. Significant and greater improvements in molar relationship (WMD: 0.79, 95% CI: 0.28 to 1.29, P = 0.002), posterior facial height (WMD: -1.23, 95% CI: -2.08 to -0.38, P = 0.005), convexity angle (WMD: -1.89, 95% CI: -3.12 to -0.66, P = 0.003), and Sella-Nasion plane angle (U1 to SN) (WMD: 3.34, 95% CI: 2.25 to 4.43, P < 0.001) were achieved in the Twin Block appliance. Herbst and Twin Block appliances produced similar effects in the skeletal and dentoalveolar changes including Sella-Nasion-point A (SNA), Sella-Nasion-point B, point A-Nasion-point B (ANB), overjet, and overbite.ConclusionAs the findings revealed both Herbst and Twin Block appliances contributed successfully to the correction of Class II malocclusion. Compared with the Twin Block appliance, the Herbst appliance may have more advantages in mandibular bone movement. Twin Block therapy resulted in more improvement in the aesthetics of the face.

Project description:ObjectiveThis study aimed to evaluate the condylar positional changes following mandibular reconstruction with preservation of the condylar head using Cone-Beam Computed Tomography (CBCT). Also, to assess joint space changes and the overall volumetric space compared to the preoperative status.MethodologyThis prospective study included 30 patients (60 joints) subjected to unilateral mandibular resection and reconstruction with preservation of the condylar head. The Helkimo index and preoperative (T1), two weeks postoperative (T2), and follow-up CBCTs (T3) after at least six months were gathered and processed to evaluate the condylar position and TMJ joint space using Anatomage Invivo 6. A student's t-test and repeated-measures ANOVA statistics were used. A P value of less than 0.05 was considered statistically significant.ResultsThirty patients (14 males, 16 females) with a mean age of 40.01 ± 12.7 years (a range of 18.1-62.9 years) were included. On the tumor side, there were significant variances in the vertical and mediolateral condylar positions between the three-time points (T1, T2, T3). Immediately after the operation, the condyles were significantly displaced in a downward direction at T2, which became larger after the last follow-up period (T3) (p = 0.007). The condylar positions at the anteroposterior direction were relatively stable without significant differences between the three times points (p = 0.915). On the non-tumor side, the condylar positions were relatively stable in the mediolateral and anteroposterior positions. In the tumor side, all of the TMJ spaces were significantly increased in size following the mandibular reconstructions (T2 and T3). However, on the non-tumor side, the anterior, posterior, and medial joint spaces were significantly changed postoperatively.ConclusionAfter mandibular reconstruction with condylar preservation, the condylar position and volumetric measurement immediately changed noticeably and continued to be a permanent change over time compared to relatively stable condyles on the non-tumor side. According to Helkimo index, patients become adapted to the postoperative changes without significant differences between the two sides.

Project description:Objective This study aimed to compare dentoskeletal changes in skeletal class-II malocclusion with removable twin block appliance and fixed AdvanSync2 appliance.Materials and methods A prospective randomized clinical trial was conducted over a span of 1 year at AFID at Rawalpindi. Thirty patients with skeletal class-II malocclusion, 16 males (53.3%) and 14 females (46.6%), were randomly selected and divided in two equal groups (15 each) to be treated with either fixed functional appliances (FFAs) or with removable functional appliances (RFAs). Out of 30 patients, 15 between cervical vertebral maturation (CVM) stages of 2 and 3 were treated with RFA (twin block appliances) and remaining 15 between CVM stages of 4 and 5 were treated with FFA (AdvanSync2 appliances). Pretreatment (T1) and posttreatment (T2), angular variable, and linear variable were measured to compare the dentoskeletal effects between the two groups.Statitical analysis Paired sample t-test was used to assess significant difference between variables at T1 (Pre-treatment) and T2 (Post-treatment) stage for both RFA and FFA group. Comparison among the RFA and FFA group was made using non-parametric Mann-Whitney U Test. IBM SPSS version 25.0 was used for evaluation.Results No significant difference was found in angular variables between the RFA and FFA groups (p > 0.05) with the exception of linear variables. Sella-posterior nasal spine (S-PNS) length significantly increased and Jarabak's ratio significantly decreased for FFA group (p = 0.010 and 0.045, respectively), when compared with RFA group.Conclusion Both the appliances, twin block (RFA) and AdvanSync2 (FFA), are effective for correction of skeletal class-II malocclusion. Both the appliances produced similar effects in the sagittal plane but for better vertical control twin block should be the appliance of choice. AdvanSync2 appliance could be preferred over twin block appliance when dentoalveolar and slight retrusive effect on the maxilla is desired especially for individuals in postpubertal growth spurt.

Dataset Information

Three-dimensional condylar changes from Herbst appliance and multibracket treatment: A comparison with matched Class II elastics.

Introduction

Methods

Results

Conclusions

Publications

Three-dimensional condylar changes from Herbst appliance and multibracket treatment: A comparison with matched Class II elastics.

Similar Datasets

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