The aim of this systematic review of the literature was to assess the scientific evidence on the efficiency of functional appliances in enhancing mandibular growth in Class II subjects. A literature survey was performed by applying the Medline database (Entrez PubMed). The survey covered the period from January 1966 to January 2005 and used the medical subject headings (MeSH). The following study types that reported data on treatment effects were included: randomized clinical trials (RCTs), and prospective and retrospective longitudinal controlled clinical trials (CCTs) with untreated Class II controls. The search strategy resulted in 704 articles. After selection according to the inclusion/exclusion criteria, 22 articles qualified for the final analysis. Four RCTs and 18 CCTs were retrieved. The quality standards of these investigations ranged from low (3 studies) to medium/high (6 studies). Two-thirds of the samples in the 22 studies reported a clinically significant supplementary elongation in total mandibular length (a change greater than 2.0 mm in the treated group compared with the untreated group) as a result of overall active treatment with functional appliances. The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation. None of the 4 RCTs reported a clinically significant change in mandibular length induced by functional appliances; 3 of the 4 RCTs treated subjects at a prepubertal stage of skeletal maturity. The Herbst appliance showed the highest coefficient of efficiency (0.28 mm per month) followed by the Twin-block (0.23 mm per month). © 2006 American Association of Orthodontists

BackgroundTo analyze the prevalence and associations between dental anomalies detectable on panoramic radiographs in a sample of non-orthodontic growing subjects.MethodsFor this cross-sectional study, digital panoramic radiographs of 5005 subjects were initially screened from a single radiographic center in Rome. Inclusion criteria were: subjects who were aged 8–12 years, Caucasian, and had good diagnostic quality radiographs. Syndromic subjects, those with craniofacial malformation, or orthodontic patients were excluded and this led to a sample of 4706 subjects [mean (SD) age = 9.6 (1.2) years, 2366 males and 2340 females]. Sample was subsequently divided into four subgroups (8, 9, 10, and 11–12 year-old groups). Two operators examined panoramic radiographs to observe the presence of common dental anomalies. The prevalence and associations between dental anomalies were also investigated.ResultsThe overall prevalence of dental anomalies was 20.9%. Approximately, 17.9% showed only one anomaly, 2.7% two anomalies, while only 0.3% had more than two anomalies. The most frequent anomalies were the displacement of maxillary canine (7.5%), hypodontia (7.1%), impacted teeth (3.9%), tooth ankylosis (2.8%), and tooth transposition (1.4%). The lower right second premolar was the most frequent missing teeth; 3.7% had only one tooth agenesis, and 0.08% had six or more missing tooth (Oligodontia). Mesiodens was the most common type of supernumerary tooth (0.66%). Two subjects had taurodontic tooth (0.04%). Tooth transpositions and displacement of maxillary canine were seen in 1.4 and 7.5%, retrospectively (approximately 69 and 58% were in the 8 and 9 year-old groups, retrospectively). Significant associations were detected between the different dental anomalies (P < .05).ConclusionsThe results of our study revealed significant associations among different dental anomalies and provide further evidences to support common etiological factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12903-017-0352-y) contains supplementary material, which is available to authorized users.

Objective: To determine by low-dose computed tomography (CT) protocol the dental and periodontal effects of rapid maxillary expansion (RME). Materials and Methods: The sample comprised 17 subjects (7 males and 10 females), with a mean age at first observation of 11.2 years. Each patient underwent expansion of 7 mm. Multislice CT scans were taken before rapid palatal expansion (T0), at the end of the active expansion phase (T1), and after a retention period of 6 months (T2). On scanned images, measurements were performed at the dental and periodontal levels. Mean differences between measurements at T0, T1, and T2 were examined through analysis of variance (ANOVA) for repeated measures with post-hoc tests. Results: All interdental transverse measurements were significantly increased at both T1 and T2 with respect to T0. In the evaluation of T0-T1 changes, periodontal measurements were significant on the buccal aspect of banded teeth with a reduction in alveolar bone thickness corresponding to the mesial (−0.5 mm; P &lt; .05) and distal (−0.4 mm; P &lt; .05) roots of the right first molar and to the mesial root of the left first molar (−0.3 mm; P &lt; .05). In the evaluation of overall T0-T2 changes, the lingual bone plate thickness of both first molars was found to be significantly increased (+0.6 mm; P &lt; .05). Conclusions: RME therapy induces a significant increase in the transverse dimension of the maxillary arch in growing subjects without causing permanent injury to the periodontal bony support of anchoring teeth discernible on CT imaging.

Introduction: The aim of this prospective controlled study was to evaluate the long-term effects of rapid maxillary expansion and facemask therapy in Class III subjects. Methods: Twenty-two subjects (9 boys, 13 girls; mean age, 9.2 years 6 1.6) with Class III disharmony were treated consecutively with rapid maxillary expansion and facemask therapy followed by fixed appliances. The patients were reevaluated at the end of the 2-phase treatment (mean age, 14.5 years 6 1.9) and then recalled about 8.5 years after the end of rapid maxillary expansion and facemask treatment (mean age, 18.7 years 6 2.1). Two groups of controls with untreated Class III malocclusion were used for statistical comparisons of the short-term and long-term intervals. Statistical comparisons were performed with the Mann-Whitney U test. Results: In the long term, no significant differences in maxillary changes were recorded, whereas the treatment group showed significantly smaller increases in mandibular protrusion. The sagittal maxillomandibular skeletal variables maintained significant improvements in the treatment group vs the control groups. Conclusions: In the long term, rapid maxillary expansion and facemask therapy led to successful outcomes in about 73% of the Class III patients. Favorable skeletal changes were mainly due to significant improvements in the sagittal position of the mandible. (Am J Orthod Dentofacial Orthop 2011;140:493-500)

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Objective: To assess the scientific evidence on the effectiveness of early orthopedic treatment in Class III subjects. Materials and Methods: A literature survey was performed by applying the Medline database (Entrez PubMed). The survey covered the period from January 1966 to December 2005 and used the Medical Subject Headings (MeSH). The following study types that reported data on the effects of Class III treatment with orthopedic appliances (facial mask, chincup, FR-3) on intermaxillary sagittal and vertical relationships were included: randomized clinical trials (RCTs), and prospective and retrospective longitudinal controlled clinical trials (CCTs) with untreated Class III controls. Results:The search strategy resulted in 536 articles. After selection according to criteria for inclusion and exclusion, 19 articles qualified for the final review analysis. One RCT and 18 CCTs were retrieved. Conclusion:The quality standard of the retrieved investigations ranged from low (four studies) to medium/high (five studies). Data derived from medium/high quality research described over 75% of success of orthopedic treatment of Class III malocclusion (RME and facial mask therapy) at a follow-up observation 5 years after the end of orthopedic treatment.

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Introduction:The aim of this study was to apply low-dose computed tomography (CT) to evaluate treatment and posttreatment effects produced by rapid maxillary expansion (RME) at the levels of the midpalatal suture and the pterygoid processes. Methods: A sample of 17 subjects (7 boys, 10 girls; mean age, 11.2 years) was analyzed. Multi-slice CT scans were taken before RME, at the end of the active expansion phase, and after a retention period of 6 months. Statistical analysis was performed with ANOVA for repeated measures with post-hoc tests. Results: The amounts of opening of the midpalatal suture during the active phase of expansion were 3.01, 2.17, and 1.15 mm for the anterior, middle, and posterior suture widths, respectively. Pterygoid width also showed a statistically significant increase (1.49 mm). In the postretention period, all transverse measurements had significant decreases except for pterygoid width. Conclusions: At the end of the retention phase after RME therapy, the transverse width of the midpalatal suture was similar to the pretreatment width, whereas the width between the pterygoid processes was significantly increased. (Am J Orthod Dentofacial Orthop 2008;134:389-92)