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Short-term dentoskeletal changes following Class II treatment using a fixed functional appliance: the Austro Repositioner

A pilot study

Dentoskelettale Veränderungen nach einjähriger Klasse-II-Behandlung mit einer festsitzenden funktionellen Apparatur: der Austro-Repositioner

Eine Pilotstudie

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objective

Purpose of this prospective study was to evaluate the skeletal and dentoalveolar effects of a fixed functional appliance, the Austro Repositioner, in dolicho- and brachyfacial skeletal Class II patients.

Material and methods

In all, 20 dolicho- and 25 brachyfacial consecutive patients treated with the Austro Repositioner were compared with untreated controls (20 dolicho- and 20 brachyfacial patients) with the same initial dentoskeletal features. Lateral cephalograms were acquired before and 1.0±0.2 year after therapy.

Results

Significant improvements in skeletal Class II relationships were observed in both groups. The ANB angle decreased (3.56° in dolicho- and 3.13° in brachyfacial patients, P < 0.001) due to changes localized exclusively in the mandible, the SNB angle increased to 3.20° in dolicho- and 3.02° in brachyfacial patients, and the total mandibular length (Co-Pg) increased to 6.47 mm in dolicho- and 5.78 mm in brachyfacial patients (P < 0.001). A favorable guidance of vertical pattern was also achieved in both groups, and no significant changes were observed in the upper and lower incisors in both groups.

Conclusions

The Austro Repositioner was effective for short-term treatment of skeletal Class II malocclusion resulting from the retrusion of the mandible in both dolicho- and brachyfacial patients.

Zusammenfassung

Ziel

In der vorliegenden prospektiven Studie sollten die skelettalen und dentoalveolären Effekte einer festsitzenden funktionellen Apparatur (Austro-Repositioner) bei Patienten mit skelettaler Angle Klasse-II und dolicho- bzw. brachyfazialem Wachstumsmuster evaluiert werden.

Material und Methoden

Insgesamt wurden 45 konsekutive Patienten (20 dolicho- und 25 brachyfazial) mit dem Austro-Repositioner behandelt und mit unbehandelten Kontrollpatienten (20 dolicho- und 20 brachyfazial) verglichen, die zu Behandlungsbeginn die gleichen initialen dentoskelettalen Befunde aufwiesen. Vor der Behandlung sowie 1,0±0,4Jahr nach Behandlungsbeginn wurden Fernröntgenseitenbilder angefertigt.

Ergebnisse

Hinsichtlich der skelettalen Klasse-II-Relation ließen sich in beiden Gruppen statistisch signifikante Verbesserungen beobachten, wobei die Veränderungen ausschließlich den Unterkiefer betrafen: Verringerung des ANB-Winkels (3,56° bei dolicho-, 3,13° bei brachyfazialen Patienten; p < 0,001), Vergrößerung des SNB-Winkels (3,20° bei dolicho- und 3,02° bei brachyfazialen Patienten) und Erhöhung der Unterkiefergesamtlänge (Co-Pg) auf 47 mm bei dolicho- und 5,78 mm bei brachyfazialen Patienten (p < 0,001). In beiden Gruppen wurde das vertikale Wachstumsmuster günstig beeinflusst. Bei der Stellung oberer wie unterer Inzisivi wurden keine statistisch signifikanten Änderungen beobachtet.

Schlussfolgerungen

Sowohl Klasse II-Patienten mit dolicho- als auch mit brachyfazialem Wachstumstyp profitierten von der einjährigen Behandlung mit dem Austro-Repositioner.

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References

  1. Baccetti T, Franchi L, McNamara JA Jr. (2005) The cervical vertebral maturation (CVM) method for the assessment of optimal treatment timing in dentofacial orthopedics. Semin Orthod 11:119–129

    Article  Google Scholar 

  2. Baccetti T, Franchi L, Toth LR, McNamara JA Jr. (2000) Treatment timing for twin-block therapy. Am J Orthod Dentofacial Orthop 118:159–170. https://doi.org/10.1067/mod.2000.105571

    Article  PubMed  Google Scholar 

  3. Ballester A, Langlade M (2001) Unlocking the malocclusion with a semifixed bite plate. J Clin Orthod 35:544–548

    PubMed  Google Scholar 

  4. Baysal A, Uysal T (2014) Dentoskeletal effects of twin block and Herbst appliances in patients with class II division 1 mandibular retrognathy. Eur J Orthod 36:164–172. https://doi.org/10.1093/ejo/cjt013

    Article  PubMed  Google Scholar 

  5. Burhan AS, Nawaya FR (2015) Dentoskeletal effects of the bite-jumping appliance and the twin-block appliance in the treatment of skeletal class II malocclusion: a randomized controlled trial. Eur J Orthod 37:330–337. https://doi.org/10.1093/ejo/cju052

    Article  PubMed  Google Scholar 

  6. Cozza P, Baccetti T, Franchi L, De Toffol L, McNamara JA Jr. (2006) Mandibular changes produced by functional appliances in Class II malocclusion: a systematic review. Am J Orthod Dentofacial Orthop 129:599.e1–599.e12. https://doi.org/10.1016/j.ajodo.2005.11.010 (discussion e591–596)

    Google Scholar 

  7. De Almeida MR, Henriques JF, Ursi W (2002) Comparative study of the Frankel (FR-2) and bionator appliances in the treatment of class II malocclusion. Am J Orthod Dentofacial Orthop 121:458–466

    Article  PubMed  Google Scholar 

  8. Franchi L, Alvetro L, Giuntini V, Masucci C, Defraia E, Baccetti T (2011) Effectiveness of comprehensive fixed appliance treatment used with the forsus fatigue resistant device in class II patients. Angle Orthod 81:678–683. https://doi.org/10.2319/102710-629.1

    Article  PubMed  Google Scholar 

  9. Franchi L, Baccetti T, McNamara JA Jr. (1999) Treatment and posttreatment effects of acrylic splint Herbst appliance therapy. Am J Orthod Dentofacial Orthop 115:429–438

    Article  PubMed  Google Scholar 

  10. Ghislanzoni LT, Toll DE, Defraia E, Baccetti T, Franchi L (2011) Treatment and posttreatment outcomes induced by the mandibular advancement repositioning appliance; a controlled clinical study. Angle Orthod 81:684–691. https://doi.org/10.2319/111010-656.1

    Article  PubMed  Google Scholar 

  11. Giuntini V, Vangelisti A, Masucci C, Defraia E, McNamara JA Jr., Franchi L (2015) Treatment effects produced by the twin-block appliance vs the forsus fatigue resistant device in growing class II patients. Angle Orthod 85:784–789. https://doi.org/10.2319/090514-624.1

    Article  PubMed  Google Scholar 

  12. Jakobsone G, Latkauskiene D, McNamara JA Jr. (2013) Mechanisms of class II correction induced by the crown Herbst appliance as a single-phase class II therapy: 1 year follow-up. Prog Orthod 14:27. https://doi.org/10.1186/2196-1042-14-27

    Article  PubMed  PubMed Central  Google Scholar 

  13. Jena AK, Duggal R, Parkash H (2006) Skeletal and dentoalveolar effects of twin-block and bionator appliances in the treatment of class II malocclusion: a comparative study. Am J Orthod Dentofacial Orthop 130:594–602. https://doi.org/10.1016/j.ajodo.2005.02.025

    Article  PubMed  Google Scholar 

  14. Lund DI, Sandler PJ (1998) The effects of twin blocks: a prospective controlled study. Am J Orthod Dentofacial Orthop 113:104–110. https://doi.org/10.1016/S0889-5406(98)70282-3

    Article  PubMed  Google Scholar 

  15. Martina R, Cioffi I, Galeotti A, Tagliaferri R, Cimino R, Michelotti A, Valletta R, Farella M, Paduano S (2013) Efficacy of the Sander bite-jumping appliance in growing patients with mandibular retrusion: a randomized controlled trial. Orthod Craniofac Res 16:116–126. https://doi.org/10.1111/ocr.12013

    Article  PubMed  Google Scholar 

  16. McNamara JA Jr. (1981) Components of class II malocclusion in children 8–10 years of age. Angle Orthod 51:177–202. https://doi.org/10.1043/0003-3219(1981)051<0177:COCIMI>2.0.CO;2

    PubMed  Google Scholar 

  17. McNamara JA Jr. (1984) A method of cephalometric evaluation. Am J Orthod 86:449–469

    Article  PubMed  Google Scholar 

  18. McNamara JA Jr., Howe RP, Dischinger TG (1990) A comparison of the Herbst and Frankel appliances in the treatment of class II malocclusion. Am J Orthod Dentofacial Orthop 98:134–144. https://doi.org/10.1016/0889-5406(90)70007-Y

    Article  PubMed  Google Scholar 

  19. Nance HN (1947) The limitations of orthodontic treatment; mixed dentition diagnosis and treatment. Am J Orthod 33:177–223

    PubMed  Google Scholar 

  20. O’Brien K, Wright J, Conboy F, Sanjie Y, Mandall N, Chadwick S, Connolly I, Cook P, Birnie D, Hammond M, Harradine N, Lewis D, McDade C, Mitchell L, Murray A, O’Neill J, Read M, Robinson S, Roberts-Harry D, Sandler J, Shaw I (2003) Effectiveness of early orthodontic treatment with the twin-block appliance: a multicenter, randomized, controlled trial. Part 1: dental and skeletal effects. Am J Orthod Dentofacial Orthop 124:234–243. https://doi.org/10.1016/S0889540603003524 (quiz 339)

    Article  PubMed  Google Scholar 

  21. O’Brien K, Wright J, Conboy F, Sanjie Y, Mandall N, Chadwick S, Connolly I, Cook P, Birnie D, Hammond M, Harradine N, Lewis D, McDade C, Mitchell L, Murray A, O’Neill J, Read M, Robinson S, Roberts-Harry D, Sandler J, Shaw I (2003) Effectiveness of treatment for class II malocclusion with the Herbst or twin-block appliances: a randomized, controlled trial. Am J Orthod Dentofacial Orthop 124:128–137. https://doi.org/10.1016/S0889540603003457

    Article  PubMed  Google Scholar 

  22. Pancherz H (1982) The mechanism of class II correction in Herbst appliance treatment. A cephalometric investigation. Am J Orthod 82:104–113

    Article  PubMed  Google Scholar 

  23. Pancherz H, Zieber K, Hoyer B (1997) Cephalometric characteristics of class II division 1 and class II division 2 malocclusions: a comparative study in children. Angle Orthod 67:111–120. https://doi.org/10.1043/0003-3219(1997)067〈0111:CCOCID〉2.3.CO;2

    PubMed  Google Scholar 

  24. Pangrazio MN, Pangrazio-Kulbersh V, Berger JL, Bayirli B, Movahhedian A (2012) Treatment effects of the mandibular anterior repositioning appliance in patients with class II skeletal malocclusions. Angle Orthod 82:971–977. https://doi.org/10.2319/120511-748.1

    Article  PubMed  Google Scholar 

  25. Perinetti G, Cordella C, Pellegrini F, Esposito P (2008) The prevalence of malocclusal traits and their correlations in mixed dentition children: results from the Italian OHSAR Survey. Oral Health Prev Dent 6:119–129

    PubMed  Google Scholar 

  26. Phelan A, Tarraf NE, Taylor P, Honscheid R, Drescher D, Baccetti T, Darendeliler MA (2012) Skeletal and dental outcomes of a new magnetic functional appliance, the Sydney Magnoglide, in class II correction. Am J Orthod Dentofacial Orthop 141:759–772. https://doi.org/10.1016/j.ajodo.2012.01.014

    Article  PubMed  Google Scholar 

  27. Proffit WR, Fields HM, Sarver DM (2013) Contemporary orthodontics, 5th edn. Elsevier, St. Louis

    Google Scholar 

  28. Proffit WR, Fields HM, Sarver DM (2007) Contemporary orthodontics, 4th edn. CV Mosby, St. Luis

    Google Scholar 

  29. Ricketts RM (1981) Perspectives in the clinical application of cephalometrics. The first fifty years. Angle Orthod 51:115–150. https://doi.org/10.1043/0003-3219(1981)051<0115:PITCAO>2.0.CO;2

    PubMed  Google Scholar 

  30. Riolo ML, Moyers RE, McNamara JA Jr, Hunter WS (1974) An atlas of craniofacial growth: cephalometric standards from The University School Growth Study, The University of Michigan. Monograph 2, Craniofacial Growth Series, Center for Human Growth and Development. Ann Arbor, Mich: The University of Michigan.

    Google Scholar 

  31. Rosenblum RE (1995) Class II malocclusion: mandibular retrusion or maxillary protrusion? Angle Orthod 65:49–62. https://doi.org/10.1043/0003-3219(1995)065<0049:CIMMRO>2.0.CO;2

    PubMed  Google Scholar 

  32. Spalding O (2001) Treatment of class II malocclusion. In: Bishara S (ed) Text book of orthodontics. International edition. W.B. Saunders Company, Philadelphia, pp 324–374

    Google Scholar 

  33. Steiner CC (1953) Cephalometrics for you and me. Am J Orthod 39:729–755

    Article  Google Scholar 

  34. Toth LR, McNamara JA Jr. (1999) Treatment effects produced by the twin-block appliance and the FR-2 appliance of Frankel compared with an untreated class II sample. Am J Orthod Dentofacial Orthop 116:597–609

    Article  PubMed  Google Scholar 

  35. Tulloch JF, Proffit WR, Phillips C (2004) Outcomes in a 2-phase randomized clinical trial of early class II treatment. Am J Orthod Dentofacial Orthop 125:657–667. https://doi.org/10.1016/S088954060400160X

    Article  PubMed  Google Scholar 

  36. Tumer N, Gultan AS (1999) Comparison of the effects of monoblock and twin-block appliances on the skeletal and dentoalveolar structures. Am J Orthod Dentofacial Orthop 116:460–468

    Article  PubMed  Google Scholar 

  37. Viera AJ, Garrett JM (2005) Understanding interobserver agreement: the kappa statistic. Fam Med 37:360–363

    PubMed  Google Scholar 

  38. Wahl N (2006) Orthodontics in 3 millennia. Chapter 9: functional appliances to midcentury. Am J Orthod Dentofacial Orthop 129:829–833. https://doi.org/10.1016/j.ajodo.2006.03.019

    Article  PubMed  Google Scholar 

  39. Windmiller EC (1993) The acrylic-splint Herbst appliance: a cephalometric evaluation. Am J Orthod Dentofacial Orthop 104:73–84. https://doi.org/10.1016/0889-5406(93)70030-R

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors are deeply grateful to Dr. Enrique Bejarano, for his helpful contribution in the conception and design of the new appliance presented in this work.

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Authors and Affiliations

  1. Department of Stomatology, Section of Pediatric Dentistry, Faculty of Odontology, Hospital General Universitario Morales Meseguer, University of Murcia, Avda. Marqués de los Vélez, s/n, 30008, Murcia, Spain

    M. Dolores Austro

  2. Department of Stomatology, Section of Pediatric Dentistry, Faculty of Odontology, University of Granada, Granada, Spain

    Encarnación González & M. Angustias Peñalver

  3. Department of Stomatology, Section of Statistics, Faculty of Odontology, University of Murcia, Murcia, Spain

    Domingo Pérez

  4. Department of Stomatology, Section of Orthodontics, Faculty of Odontology, University of Granada, Granada, Spain

    José Antonio Alarcón

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  1. M. Dolores Austro
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  4. Domingo Pérez
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Correspondence to M. Dolores Austro.

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Conflict of interest

M.D. Austro, E. González, M.A. Peñalver, D. Pérez and J.A. Alarcón declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Austro, M.D., González, E., Peñalver, M.A. et al. Short-term dentoskeletal changes following Class II treatment using a fixed functional appliance: the Austro Repositioner. J Orofac Orthop 79, 147–156 (2018). https://doi.org/10.1007/s00056-018-0135-3

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