Objective: To assess skeletal, dentoalveolar, and soft-tissue effects of fixed functional appliances (FFAs), alone or in combination with multibracket appliances (comprehensive treatment), on Class II malocclusion in postpubertal patients. Data Sources: Literature survey was conducted using the Medline, SCOPUS, Latin American and Caribbean Health Sciences, and Scientific Electronic Library Online databases and the Cochrane Library, and through a manual search. No restrictions were set regarding the type of fixed appliance, treatment length, or to the cephalometric analysis used. Data extraction was mostly predefined at the protocol stage by 2 authors. Study Selection: Only double-blind randomized controlled trials (RCTs) of Class II skeletal cases treated by any FFA that had assessed specific skeletal, dental, or soft-tissue parameters were included. Data Synthesis: A total of 8 articles qualified for the final analysis. The studies were composed of late-adolescent or adult patients who were at the end of their postpubertal growth period. This meta-analysis included data from 271 subjects (142 Class II patients and 129 untreated individuals) and 8 RCTs, which assessed linear as well as angular cephalometric changes induced by Class II treatment with FFAs. Conclusions: Based on the data available on postpubertal patients, it was concluded that the fixed functional treatment is effective in Class II malocclusion and shows changes in skeletal, dental, as well as soft tissue.
Introduction: Skeletal maturity indicators are very important indicators when diagnosing and panning the treatment in growing population. Cervical Vertebrae Method (CVM) and Fishman’s Skeletal Maturity Indicators are two commonly used methods for the diagnosis and treatment planning. The aim of the study was to investigate the correlation between cervical vertebral maturation (CVM)and Fishman’s hand-wrist skeletal maturity indicator and chronological age by including subjects within the range of circumpubertal growth spurt in Central India.
Materials & Method: One Twenty Five contemporary hand-wrist and lateral cephalometric radiographs from population of Central India were randomly selected and analyzed. All subjects were within the circumpubertal period i.e. female subjects were between 10 and 15 years of age, and the male subjects were between 12 and 17 years of age. The hand-wrist bone analysis was evaluated using the method developed by Fishman whereas cervical vertebra bone analysis was evaluated using the method developed by Baccetti and co-workers. These two methods and chronological age were correlated using the Spearman rank correlation analysis.
Result: CVM was significantly correlated with hand-wrist maturation (r=0.8868). However low correlation was found between the CVM and chronological age( r =0.7139) and little correlation was found between the HWM and chronological age ( r =0.6892).
Conclusion: CVM is a valid indicator of skeletal growth during the circumpubertal growth period and has a high correlation with the HWM for the Central India population. However chronological age is not suitable to measure skeletal maturity as shown by the low correlations found between the chronological age and both CVM and HWM.
Skeletal class II malocclusion in adult patients with severe gummy smile is challenging for orthodontist and often requires surgical intervention. The difficulty increases when patients refuse orthognathic surgery, and orthodontists have limited treatment alternatives. This report describes the case of a patient with severe dento-skeletal class II malocclusion with excessive gingival display while smiling. The patient was treated with temporary anchorage devices, and an innovative method of lip repositioning was devised to correct the irregularity.
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