2013 aao annual Session Oral Research Presentations

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2013 AAO Annual Session Oral Research Presentations
The Oral Research presentation will be held on Sunday, May 5 in Pennsylvania Convention Center Room 107 from 8:00am-3:30pm with a break from Noon to 12:30pm. Oral Research presentations are 10 minutes long with 5 minutes for questions from the audience.
*- Denotes financial interest or visual enhancement

Analysis of Anterior Dentofacial Aesthetic Characteristics and Their Association to Post-Phase I Orthodontic Treatment Decisions

Carlos Flores Mir, M. Witt, G. Heo, P. Major
Edmonton, AB, Canada
The objective was to evaluate how anterior dentoalveolar aesthetic characteristics do affect the decision to undergo a phase II orthodontic treatment. Nine frontal dentofacial aesthetic factors were chosen based on previous research and were used in the analysis of photos (anterior teeth and lips) of 60 children (23 males, 37 females) having consecutively received Phase I orthodontic treatment with a class II corrector appliance. Half of this sample did undergo phase II later. A principal component analysis and a logistic regression were used. The angulation of the maxillary right central and lateral incisors increased the odds of proceeding with Phase II by 109%. Although the pattern lacked statistical significance, the results of this study demonstrate that males and patients with an increase in the width:width ratio of the maxillary central and lateral incisors, an increased vertical dimension of the lips, and smile arc consonance were less likely to continue to Phase II treatment.

The Influence of Smile Arch in Conjunction with Gingival Display on Smile Attractiveness

Burcak Kaya, R. Uyar
Ankara, Turkey
The aim is to evaluate the influence of smile arch and gingival display amount on the perception of smile attractiveness for orthodontist, dentists and laypersons. The frontal intraoral photograph of aligned teeth was modified using image processing software. 7 smile arches ranging from flat to vaulted were obtained and each smile arch were adjusted so that 4 different gingival display amounts were achieved. The attractiveness of 28 smile images was evaluated by raters from 3 groups (n=70 in each). Both smile arch (p<0,05) and gingival display amount (p<0,001) has a significant influence on smile attractiveness. Smile attractiveness scores with reference to gingival display amount shows significant (p<0,001) difference between rater groups. Significant (p<0,05) interaction between smile arch and gingival display amount was observed. Flat smile arches are preferred with insufficient gingival display, whereas vaulted smile arches are preferred with excessive gingival display.
Maxillary Expansion

The Effect of Cappari Spinosa Extract after Rapid Maxillary Expansion

Muharrem Serif Erdogan, H. Babacan
Sivas, Turkey
The aim of this study was to increase osteoblastic activity by Capparis Spinosa Extract (CSE) after Rapid Maxillary Expansion applied to rats (RME) given systemically during the retention period to examine osteoblastic activities stereologically. 32 Wistar rats were used. Subjects were divided into four working groups.Orthopedic expansion force applied for 5 days. Retantion period was 1 week for g-I and II: 2 week for g-III and IV. According to the findings made by the method of Cavalieri stereological analysis of new bone area and volume of new bone, connective tissue space and connective tissue volume was higher in g-II than g-I.It was statistically significantly different than the g-I. It was numerically higher mentioned criterias In g-IV than g-III. But no statistically significant difference was found. As a result, CSE nearly doubled osteoblastic activity in the early period, in late period group activities not completely nearly captured in the control group formation.


Does Rapid Palatal Expansion Decrease Sleep Bruxism in Children?

Audrey Bellerive, A. Montpetit, H. El-Khatib, C. Remise, N. Huynh

Montreal, QC, Canada
Objective Since sleep bruxism (SB) seems to be related to respiratory events and rapid palatal expansion (RPE) improves respiration, the objective of this study is to evaluate the possible reduction of SB after RPE therapy. Methods This prospective randomized controlled clinical pilot study includes 27 children currently in treatment for transverse maxillary deficiency (>5 mm) (8-14 y.o. 8 boys). Patients underwent an ambulatory polysomnography before (T0) and after RPE (T1). They were randomly assigned to 2 different types of hyrax: banded or bonded. Results The preliminary results show a significant interaction between groups (control/bruxers) and between T0/T1 (p=0.02), where the mean rhythmic masticatory muscle activity index of bruxers decreased after RPE (p=0.059). No difference between the two types of appliance was found (p=0,39) Conclusions These preliminary results seem to support the link between the reduction of SB following RPE therapy.


Effects of Bonded Maxillary Expander Followed by Inter-Maxillary Elastic Traction on Skeletal Class III Patients with Permanent Dentition

Xingzhong Zhang, G. Wolf, B. Amberman, Y. Wu, M. Hans

Jacksonville, FL, USA
Objectives: To evaluate the treatment effects of a clinical protocol using bonded maxillary expander and class III elastics to a full bonded lower arch on post-adolescent Class III patients with skeletal hyperdivergent pattern. Methods: The pre- and post-treatment (T1 and T2) lateral cephs of 43 consecutively treated patients and 43 untreated Class III/I subjects, matched on race, gender, and age, were traced and measured. Measurements were also made on overall and regional superimpositions of T1 and T2. A p value ≤ 0.05 was used to assign statistical significance. Results: Significant treatment effects included: A-point 0.63±1.48mm forward (95% CI: 0.17 to 1.08 mm); upper first molars 1.24±2.32 mm mesially, B point 1.27±2.98 mm backward, and lower incisors 1.42±2.65 mm lingually. No significant difference was found in the vertical dimension between two groups. Conclusions: This treatment protocol produced clinically and statistically significant improvements in Class III patients.

Pharyngeal Airway Analysis in Subjects with Different Skeletal Patterns

Eduardo Franzotti Sant' Anna, C. de Mattos, L. Claudino, A. Ruellas
Rio de Janeiro, Brazil
Objective: to assess the volume (V) and morphology (M) of the pharyngeal airway in subjects with different skeletal patterns. Method: 50 subjects submitted to CBCT scans were divided in 3 groups: Class I, II and III. The V of the Upper Pharyngeal Portion (UPP) and Nasopharynx (NP), and the V and M of the Lower Pharyngeal Portion (LPP), Velopharynx (VP), Oropharynx (OP) and Hypopharynx (HP) were assessed. The Kruskal-Wallis and the Mann-Whitney tests were used to identify intergroup differences. Correlation was tested (Spearman). Results: Class II subjects presented significantly lower VP and OP volumes than Class I and Class III and lower LPP volume than Class III. A negative correlation was observed between ANB and the LPP, VP and OP volumes. Significant difference was observed in the M among Class II and Class III in the VP and OP. Conclusions: Class II subjects presented smaller airway volumes than Class I and Class III and a different airway morphology compared to Class III.

Surgically-Assisted Rapid Maxillary Expansion: CBCT Evaluation of Different Surgical Techniques and Their Effect on Maxillary Dentoskeletal Complex

Antonios Sygouros, M. Motro, F. Ugurlu, A. Acar
Istanbul, Turkey
AIM:To evaluate the dentoskeletal effects associated with surgically assisted rapid maxillary expansion performed with(+)and without(-)pterygomaxillary disjunction(PD) using CBCT.SUBJECTS AND METHODS:20 patients who underwent SARME were divided into two equal groups.In group(-PD) LeFort I plus midline osteotomy was performed.In group(+PD)pterygoid disjunction was performed additionally.CBCT scans were obtained preoperatively and 3-6 months postretention.Transverse expansion at skeletal,dentoalveolar and dental level,dental inclinations,alveolar bending/width,and the pattern of expansion sagittally were evaluated.RESULTS:Transverse measurements at dental and dentoalveolar level significantly increased in both groups.No differences were found between groups.In(-PD)group significant buccal tipping of the premolars,increased buccal bending of alveolar crest and reduced width of buccal alveolar bone were observed.CONCLUSION:SARME is an effective treatment of maxillary transverse deficiency.

Three-Dimensional Computed Tomography Analysis of Airway Volume Changes after Rapid Maxillary Expansion

Ahmed Ghoneima, T. Smith, K. Kula

Indianapolis, IN, USA

Introduction: This study evaluated airway volume, soft-palate area, and soft-tissue thickness changes before and after rapid maxillary expansion (RME) in adolescents using 3 dimensional CT images. Methods: The sample comprised 20 patients who were treated with RME. Spiral tomographs were taken before and 3 months after treatment. Volumetric, soft-palate area, soft-tissue thickness, and cephalometric parameters were compared. Intraclass correlations were performed to assess reliability. Before and after RME measurements were compared by using Wilcoxon signed rank tests. Spearman correlation coefficients were used to evaluate the associations among the airway volume, soft-palate area, soft-tissue thickness, and cephalometric measurements. Significance was accepted at P ≤0.05. Results and conclusions: RME causes significant increases in nasal cavity volume, nasopharynx volume, anterior and posterior facial heights, and palatal and mandibular planes.

Timing of Force Application for Accelerating Tooth Movement toward Grafted Surgical Defect

Sujung Kim, H. Ahn, W. Moon, Y. Park, E. Ting
Seoul, South Korea
Objectives: We aimed to investigate optimal timing of force application toward grafted surgical defect based on the healing states. Methods: 18 beagles were randomly divided into 3 groups: bone defect only group (control), defect+bone graft group, defect+graft+laser group. Orthodontic force was applied on maxillary second premolar toward each surgical site at 3 different time points: 0, 2, and 12 weeks after surgery. The rate of TM was evaluated by model measurement and histomorphometry. Defect healing was analyzed quantitatively using micro-CT parameters, confirmed by histology. Results: Without graft, TM into the defect was the fastest in 2 wk-group, and impeded in 12 wk-group. With graft, TM was faster in 0 wk-group than in 2 wk-group, and progressed in 12 wk-group. With laser on graft, TM was retarded associated with faster graft healing. Conclusion: Timing of force application for faster movement toward surgical defect could be moved forward by graft but delayed by laser.

Effect of Low Level Semiconductor Diode Laser Therapy on the Rate of Orthodontic Tooth Movement

Sanjay Ganeshkar, D. Shetty

Dharwad, India

The hypothesis that mechanical forces combined with low-level laser therapy(LLLT) stimulate the rate of orthodontic tooth movement was evaluated.This study was designed to test the efficacy of GaAlAs laser irradiation on 8 patients who required retraction of maxillary canines into the first premolar extraction spaces using tension coil springs with fixed edgewise appliance. LLLT at 8J/cm2 energy density and at 100mW was applied on the mucosa at 8 points around the canine on the test side for 3 consecutive days for 3 months and this was validated by cast measurements and the estimation of the alkaline phosphatase levels in either groups. Repeated test of ANOVA and unpaired t-test showed a significant increase in the tooth movement on the LLLT side for the total time period (p-value-0.00).Thereby, LLLT using the above mentioned parameters enhances rate of tooth movement and maybe used as an adjunct to reduce treatment duration.

Alveolar Unilateral Corticotomy and Bilateral Molar Distalization with MBGM System: A Split Mouth Study

Maurilio Achille, B. Maino, C. Sgarbanti, S. Parma, A. Gracco
Pordenone, Italy

Purpose Evaluate on humans if corticotomy is able to change 1)tooth movement 2)biological behavior of osteocities 3)periodontal conditions. Methods 10 patients,class II.Unilateral buccal piezo- corticotomy and bilateral palatal biopsies with upper molar distalization (MGBM system) were performed.On experimental side E and on control side C,superimpositions on digital casts and on CBCT scans,histomorphometric analysis,periodontal parameters were detected at T0 and T1 (after 5 months).Comparisons were made: 1)T0-T1 on E, 2)T0-T1 on C, 3)T1 between E and C. Results At T1 movement was clinically greater on E,but not significant (Student’s t-test).On both side (T0-T1) and at T1 between E and C, qualitative histological changes can be observed.Only on E quantitative differences were found(P= 0.002;Friedman and Wilcoxon test).Periodontal parameters were unaffected. Conclusion At T1 corticotomy accelerates tooth movement and causes qualitative cellular changes without periodontal damage.


Effects of Piezocision in Orthodontic Canine Distalization Rate

Işıl Gün, B. Çakırer

Istanbul, Turkey

Introduction: The purpose of this study is to determine the effect of piezocision on the rate of orthodontic canine distalization . Material&Method: 10 patients whose treatment plans were upper first premolar extractions were included in the study. Before distalization ,3 mm deep cortical cuts were performed on mesiobuccal and distobuccal sides of right upper canine on alveolar bone with piezo-surgery blade while-no piezo cuts were performed on left side. The difference in distalization rates were measured on dental casts after 10 weeks. Results: The mean canine distalization rate was measured as 3.45 mm/month on piezocision assisted side and as 1.91 mm/month on control side, the difference between the groups was found to be statistically significant. Conclusion: Piezocision assisted canine distalization is found to be effective for accelerating tooth movement with minimal trauma on patients. This study is supported by Scientific Research Project Unit Of Marmara University.

The Effect of Dose on the Efficancy of Low-Level Laser Therapy (LLLT) on New Bone Formation

Burcu Ayse Altan, A. Biçakçi, M. Avunduk, H. Esen
Kocaeli, Turkey

The aim of this study was to investigate the influence of LLLT at different doses on new bone formation. Twenty-eight rats were divided into four groups-only expansion, LD (exp.+5 J/cm2), MD (exp.+20 J/cm2) and HD (exp.+6300 J/cm2) groups.The pre-maxillary suture was expanded for five days. Afterwards, the appliance was removed and re-attached passively for the eight-day retention period. Irradiations were started at this time with the parameters presented in Table 1. At the end of retention period, the pre-maxillae of the animals were dissected. All sections were transferred to PC environment and analyzed by using Image Analysis program. Osteoblasts, osteoclasts, fibroblasts, vessels, TGF-B expression and new bone formation were evaluated. The number of osteoclasts in lased groups were significantly lower than it was in OE group. New bone formation in LD and HD groups were found to be significantly increased. 5 J/cm2 and 6300 J/cm2 doses of laser therapy hastened new bone formation.


Does Movement of Maxillary Canines into the Grafted Alveolar Cleft Cause Bone Dehiscence?

Marília Sayako Yatabe, D. Garib-Carreira, G. Janson

Bauru, Brazil

The purpose of this study was to assess the periodontal tissue morphology surrounding maxillary canines mesially moved into the grafted alveolar cleft in tomographic exams of 30 patients with unilateral cleft lip and/or palate at least 6 months after orthodontic treatment. The maxillary canine and lateral incisor in the opposite side of the dental arch were controls. The alveolar bone thickness (ABT) of the cleft side canine (CC), the non-cleft side canine (CnC) and lateral incisor (LInC) were measured in axial sections. The alveolar bone crest level (BCL) was measured in cross sections. Wilcoxon or t tests were used. The CC presented a thinner labial ABT than the lingual side and the CnC and LInC. The BCL was similar between the experimental teeth and the controls, but the lingual BCL of the CC was dislocated more apically than the CnC and LInC. Moving CC into grafted area in patients with cleft lip and palate presents adequate periodontal results in the long term.

Archwire-Borne Distractor to Reduce Unilateral Alveolar Clefts: Is it Effective? A 3D-CBCT Analysis

Fady Fahim, S. Shahin, M. El-Kassaby, D. El-Boghdady, W. Abdel-Kader

Cairo, Egypt

A new Archwire-Borne (not tooth-borne nor bone-borne) distraction device was used to close wide alveolar clefts in 10 patients (7 females and 3 males) with unilateral cleft lip/palate patients with age range 12-22 years with mean age of 16.9 y. Osteotomies were performed to include the maxillary canine and the first premolar in the transport segment. Three-dimensional control was achieved by sliding the transport segment on 0.019x x0.025 stainless steel arch wire. A new reference system was designed for 3D analysis after automatic superimposition of the pre- and post-distraction CBCTs. Teeth in the transport segment were assessed in the antero-posterior and mediolateral dimension. Also, the volume of the alveolar cleft pre- and post-distraction was automatically calculated in cubic mms and compared to each other by paired t-test. The alveolar cleft volumes were significantly decreased post-distraction at P = 0.006, thus the distractor was efficient in closing alveolar clefts.

Orthodontic Tooth Movement within the DFDBA

Massoud Seifi, F. Atri, S. Ghoraishian, A. Arayesh

Tehran, Iran

Aim: To determine the effect of socket preservation with DFDBA following orthodontic tooth movement (OTM). Methods: Demineralized Freeze-dried bone allograft (DFDBA) (CenoBone®) was used as the graft material. Sample consisted of twelve sites in three dogs in a split-mouth technique experiment. The defects were made by the extraction of 3 rd premolar. On one side of each jaw, the defects were preserved by DFDBA and defects of the other side left opened as the control group. Simultaneously the teeth adjacent to the defects were pulled together by a NiTi coil spring. After eight weeks, the amount of (OTM) was measured. Analysis of variance was used for purpose of comparison. Results: There was a slight increase in OTM at grafted sites as they were compared to the control sites (P<0.05). Conclusion: Socket preservation by DFDBA has some advantages like enhanced rate of OTM and reducing the chance of alveolar height loss. After socket preservation, tooth movement can be immediately started

Esthetic Improvement following White-Spot Lesion Infiltration (ICON) In Vivo: 1-Year Follow-Up*

Michael Knösel, A. Eckstein, H. Helms

Göttingen, Germany

Purpose: To assess the esthetic improvement of white-spot lesions (WSL) achieved by resin infiltration (Icon, DMG) in comparison to untreated WSL over 1 year. Methods: 20 subjects with WSL after multibracket treatment were recruited for lesion infiltration using a controlled, randomised split-mouth design. Color and lightness (CIE-L*a*b* data) of WSL were assessed in comparison to surrounding sound enamel using a spectrophotometer prior to infiltration (Baseline, T0), and after 1 day (T1), 1 week (T2), 4 weeks (T3), 3 months (T4), 6 months (T5) and 1 year (T6). Multi-factorial ANOVA with repeated measures and pairwise comparisons were used to analyse effects of infiltration and time elapse on color differences (delta-E values) at an a-level of 5%. Results: There was an assimilation of WSL colour to surrounding enamel following infiltration that was found to be color stable without significant delta-E changes over 1 year. Untreated control WSL did not change significantly.

Quality Influence of the Orthodontic Finished in the Treatment Stability of Class II Malocclusion

Renata Cristina Faria Ribeiro de Castro, M. de Freitas, C. Guimarães, Jr., J. Pereira Lauris, K. Salvatore de Freitas

Bauru, Brazil

The objective of this retrospective study was to seek oclusal variables related to correction of Class II malocclusion stability prognosis, treated without and with extractions. As such, 78 documentation records were selected, belonging to the Orthodontic Department from the Bauru Dental School, with an initial complete bilateral malocclusion of Class II, division 1, treated with Edgewise mechanics and followed up for an average period of 10 years post-treatment. Occlusal evaluations were done on the patients cast models. When separating the sample in groups well finalized (50 patients with PAR T2 ≤ 5) and with bad finalization (28 patients with PAR T2 > 5) in relation to the alterations occurred in the post-treatment period (PAR T3 - T2 and Little T3 - T2), it was verified by using an independent “t” test that both groups were statistically similar in relation to relapse, however, good orthodontic finalization provided better occlusal and functional results in phases T2 and T3.

Stability of Quad-Helix/Crib Therapy in Dentoskeletal Openbite: A Long-Term Controlled Study

Letizia Perillo, C. Chimenti, P. Cozza, L. Franchi

Naples, Italy

Objective: To evaluate the long-term stability of Quad-Helix/Crib (Q-H/C) treatment in subjects with dentoskeletal openbite. Methods: 28 subjects (mean age 8.2±1.3 years) were treated consecutively with Q-H/C appliance. The patients were reevaluated at the end of active treatment with Q-H/C (mean age 9.7±1.6 years), and at least 5 years after the completion of treatment (mean age 14.6±1.9 years). A control group of 20 untreated subjects with the same dentoskeletal disharmony was used for the statistical comparison (Mann-Whitney U test). Results: In the long term, compared to controls, the Q-H/C group showed significant reduction in the ANB angle, downward rotation of the palatal plane, greater increase in overbite and a decrement in overjet. Conclusions: In the long term, Q-H/C appliance led to successful outcomes in about 93% of the patients. Correction of dentoskeletal openbite was associated with a clinically significant downward rotation of the palatal plane.

Accuracy, Reproducibility, and Time-Efficiency of Dental Measurements Using Different Technologies

Thorsten Gruenheid, N. De Felippe, B. Larson, N. Patel, A. Wey

Minneapolis, MN, USA

Objectives: To assess the accuracy, reproducibility, and time-efficiency of measurements taken on 3 types of digital models and compare them to the present gold standard plaster casts. Methods: Three operators measured tooth widths on 30 sets of dental models. The measurements were recorded and timed for plaster casts, emodels (Geodigm, Minneapolis, MN), SureSmile models (OraMetrix, Richardson, TX), and AnatoModels (Anatomage, San Jose, CA). To assess accuracy and reproducibility, the Altman-Bland agreement was calculated for individual teeth. Differences in time-efficiency among the model types were tested for statistical significance using one-way ANOVA. Results: When compared to plaster casts, the measurements taken on SureSmile models were most accurate followed by those taken on emodels and AnatoModels. The measurements taken on SureSmile models were also the most reproducible. The measurements were completed most quickly on emodels followed by SureSmile models, plaster casts.
Class II Treatment

The Association between Vertical Facial Pattern and Sagittal Relationship in Patients with Class II Malocclusion

Humam Saltaji, M. Youssef, C. Flores-Mir, P. Major
Edmonton, AB, Canada
Objective: To examine the association between vertical facial morphology and sagittal relationship determined by overjet, Wits appraisal, and ANB in patients with Class II malocclusion. Methods: Lateral cephalograms and dental casts were obtained from 140 untreated patients (68 males and 72 females, between the ages of 8 and 11) with skeletal and dental Class II malocclusion. Stepwise regression analysis was used to determine the statistical significance of the relationships. Results: Linear regression identified associations between vertical facial characteristics and overjet (female R2 value, 0.55; male R2 value, 0.47). Associations between vertical facial characteristics and sagittal skeletal parameters were weaker: ANB (female R2 value, 0.32; male R2 value, 0.20) and Wits (female R2, 0.17; male R2, 0.15). Conclusions: Sagittal relationship is associated with vertical facial morphologic characteristics and is a moderate predictor of vertical facial morphologic pattern.

Effects of Twin Block on Pharyngeal Airway Space in Class II Division 1 Cases: A 3D CT Study

Parul Temani, P. Jain

Jaipur, India

The present study was conducted with a sample consisting of 25 patients with Class II div 1 malocclusion of age group 9-15 years to evaluate the changes in pharyngeal airway dimensions with and without myofunctional appliance therapy (Twin block). The sample was divided into two groups: Group A (15 subjects):Treated with Twin block appliance for correction of Class II div 1 malocclusion. Group B (10 subjects):Patients with Class II div1 malocclusion in which no treatment was given. Patients in each group underwent CT scan of head and neck region at pretreatment stage and six months after the initial scan. Volume, area, transverse and anterio-posterior dimensions of upper (oropharynx) and lower (Hypopharynx) pharyngeal airways were measured on scanogram The results showed that there was a statistically significant increase in the volume of both Hypopharynx and oropharynx in patients treated with twin block

Is it Possible to Distinguish between Extraction and Non-Extraction Treatments Using Facial Photographs of Adolescents with Skeletal Class II?

Fernando Lima Martinelli, C. Kochenborger

Porto Alegre, Brazil

The objective of this study was to evaluate the possibility of distinguishing between treatments with and without extraction of the first four premolars in facial photographs of adolescents with skeletal Class II malocclusion. The sample comprised 181 individuals presenting ANB angles ≥5 during growth. Scores of a facial harmony index were determined by superimposition of their facial photographs with ideal proportion templates, from the initial and final treatment records. The error was calculated by paired t-test and intraclass correlation coefficient. The improvement index was determined for isolated factors, and intragroup comparisons were performed with the Wilcoxon nonparametric test, in which binomial variables were analyzed with the chi-squared test with McNemar correction. An effective improvement in facial harmony was observed in adolescents with skeletal Class II without differences between extraction and non-extraction treatments.

Long Term Profile Changes in Class II Division 1 Malocclusion Patients Treated with and without Extractions

Lucas Marzullo Mendes, G. Janson, C. Junqueira, M. Freitas, N. Castello Branco

Bauru, Brazil

This research aimed to cephalometrically evaluate long term changes in soft tissue profile, soft tissue thickness and growth pattern. Sixty nine full cusp Class II division 1 malocclusion patients were divided into three groups: non-extraction (21), 2 maxillary premolar extractions (27) and 4 premolar extractions (21). Lateral cephalograms were taken at the end and 15 years after treatment on average. All patients were matched at the end of treatment regarding gender, age, posttreatment time, Objective Grading System index, 7 esthetic lip lines, ANB and overjet. Twenty seven variables were measured. All long-term posttreatment variable changes were compared by analysis of variance and presented no statistically significant differences between the 3 groups. It was concluded that in the long-term there were similar changes in soft tissue profile, soft tissue thickness and in the growth pattern in Class II division 1 malocclusion patients treated with and without extractions.

Comparison of Fixed Functional Appliances Versus Overall Treatment Changes in Class II Correction

Aditya Chhibber, M. Upadhyay, F. Uribe, R. Nanda

Farmington, CT, USA

Objective:To analyze effects of a fixed functional appliance (FFA)& compare the stability of the effects to overall treatment changes in ClassII correction.Method:27 ClassII patients (mean age 12.01±1.24yrs) were treated with Twin Force Bite Corrector. Lat cephs were taken at pretreatment(T1), pre-appliance(T2), post appliance(T3), & postreatment(T4).Linear & angular measurements were made to determine overall effects. Statistical analyses were done using ANOVA. Result:On comparison of appliance effects(T3-T2)& overall treatment(T4-T1) significant (P˂0.05) differences were observed for SNB 0.48˚&1.3˚, ANB= -1.48˚&-2.72˚ &occlusal plane rotation=3.07˚&-1.7˚, upper incisor A-P= -2.26&0.87mm, upper molar A-P= -1.26&3.02mm, upper molar vertical= -1.2&2.85mm. Mandibular dental parameters were not significantly different. Conclusion:The findings suggest that effects of the FFA on the mandible& mandibular dentition were stable while on maxillary dentition were unstable during overall treatment.

Prospective Study Of Dentoskeletal Changes In Class Ii Division 1 Malocclusion Treatment With Twin Force Bite Corrector

Carlos Henrique Guimaraes, J. Castanha Henriques, R. Faria Ribeiro De Castro, G. Janson, R. Nanda

Sao Paulo, Brazil

This study evaluated the dentoskeletal changes of Class II malocclusion treatment with the Twin Force.The sample comprised 86 lateral cephalograms from 43 subjects of both genders with Class II division 1 malocclusion, divided in two groups.The experimental group comprised 23 patients with a initial age 11.81 years, treated with the Twin Force combined with fixed appliances, for a period of 2.49 years. The control group included 40 lateral cephalograms from 20 Class II non-treated patients, with initial age 12.54 years and a mean observation period of 2.19 years.T tests were used to compare the initial and the final cephalometric characteristics of the groups, as well as the amount of changes. Results:The experimental group presented greater maxillary growth restriction and mandibular retrusion than the control group.Conclusion:The Twin Force promotes improvement of maxilomandibular relationship without changes in facial growth and significant buccal tipping of mandibular incisors

Influence of Premolar Extractions on Soft-Tissue Profile in the Long Term

Cintia Helena Zingaretti Junqueira, G. Janson, L. Mendes, N. Castello Branco, D. Garib

Bauru, Brazil

This study aimed to compare the long-term soft tissue profile of extraction and non-extraction treated patients, after a mean period of 16.17 years. Frontal and lateral photographs of 65 treated patients that initially presented complete Class II division 1 malocclusion, were divided into 3 groups as following: G1 (non-extraction, n=21), G2 (2-maxillary premolar extractions, n=25) and G3 (4-premolar extractions, n=18). All groups were matched by gender, age, posttreatment time, Objective Grading System Index and profile outcomes. Cephalometric soft tissue measures were obtained from the lateral photographs. Analysis of variance showed no statistically significant differences between the three groups, except for the vertical length of upper lip and the lower anterior facial height, which were slightly larger in G3. Therefore, it was concluded that treatment of complete Class II division 1 malocclusion with and without extractions had similar long-term tegumental profile.


Soft-Tissue Profile Changes Resulting from Class II Treatment Using Skeletal Anchorage Miniplates: A Randomized Controlled Trial

Abdulsalam Aldomaini, H. Saltaji, E. Halboub

Damascus, Syria

Objective: To evaluate the soft-tissue profile changes resulting from mandibular advancement using elastic forces based on skeletal anchorage miniplates (SAM) compared with conventional Class II elastic forces. Method: 53 subjects with skeletal Class II (mean age, 11.5±0.5y) were allocated randomly to one of two groups. The 1st group (26subjects) was treated by elastic forces based on SAM. The 2nd group (27subjects) received conventional Class II elastic forces. Lateral cephalographs were obtained at the beginning and end of treatment (9-11months). Paired/unpaired t-tests, as appropriate, were performed to evaluate the differences. Results: Both techniques were effective in inducing changes in soft-tissue profile. However, those induced by the SAM were significantly better. These changes included significant improve in Facial convexity angle and in interlabial gap. Conclusion: Treatment of Class II with SAM results in significant soft-tissue profile changes and even in short period.

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