The aim of this study was to evaluate and compare the effects of activator and Twin Block (TB) appliances on the soft tissue profile. The study included 50 skeletal Class II patients (25 girls and 25 boys, mean age: 11.9 +/- 0.16 years) who were randomly allocated to one of two functional appliance treatment groups. The control group included 25 untreated skeletal Class II patients (13 boys and 12 girls, mean age: 10.11 +/- 0.91 years). Data were obtained from standardized lateral cephalograms taken at the beginning (T0) and end (T1) of appliance wear. The mean treatment time was 9 months for the activator group and 8 months for the TB group. The observation period of the control group was 8 months. Soft tissue profile changes were evaluated by means of 12 linear and five angular measurements. The groups were compared at T0 and T1 using analysis of variance, and treatment/observation differences (T1-T0) were evaluated with the Kruskal-Wallis test. Treatment changes in both appliance groups differed significantly (P < or = 0.001) from those in the control group, except for Ss-y, Ls-y, Li-E, and A-y measurements in the TB group and Ls-y, Li-E, nasolabial angle, and A-y measurements in the activator group. When the effects of the two appliances were compared, significant differences were observed only for SS-y (P < or = 0.05), Ss-E (P < or = 0.05), Si-E (P < or = 0.05), and nasolabial angle (P < or = 0.01). The effects of the activator and TB appliances on the soft tissue profile were similar; both significantly changed the soft tissue profile.

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Objective: To test the hypothesis that lower facial height has no influence on frontal facial attractiveness and treatment need perception of lay people. Materials and Methods: Frontal facial silhouettes of a man and a woman with normal lower facial height values (male: 81.5 mm; female: 70.5 mm) were modified by increasing and decreasing their lower facial heights in steps of 1 mm to obtain frontal images with different lower facial height alterations ranging from +6 mm to 26 mm for each sex. A panel of 100 lay people scored each silhouette's attractiveness on a 100-mm visual analogue scale (VAS) and also indicated whether they would seek treatment if the image represented their own. The Wilcoxon signed rank test was used to compare the VAS scores. Results: Unaltered 61-mm and 62-mm silhouettes got the highest VAS scores. Scores were significantly lower (P # .001) as the divergence from the normal value exceeded 2 mm. Beyond +3 mm and 24 mm in females and +4 mm and 23 mm in males the difference between the scores became statistically insignificant. At 64 mm, more than 75% of the raters elected to have treatment.

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In this study, the effects of cervical headgear (CHG) use on the transverse dimension of the maxillary dental arch were evaluated in patients in the permanent dentition. Thirteen girls and 12 boys (mean age: 13.41 +/- 0.52 years) with a bilateral full cusp Class II molar relationship comprised the study group. Fifteen girls and 10 boys with a Class I normal occlusion comprised the controls. In the treatment group, CHG with an expanded inner bow was used for a mean period of 11.2 +/- 5.6 months. The headgear was used for molar distalization and the force magnitude was 196.1 cN. After CHG treatment, the patients underwent non-extraction fixed orthodontic treatment for 14.1 +/- 2.5 months. During this period, the control group received regular dental check-ups. Dental casts obtained at the beginning (T1) and end (T2) of headgear use and at the end of orthodontic treatment (T3) and posteroanterior cephalograms taken at T1 and T2 were evaluated. A Student's t-test was used for intergroup comparison at T1, T2, and T3 and a Mann-Whitney U-test with a Bonferroni correction for comparison of treatment/observation changes. At T2, intercanine (0.96 +/- 0.56 mm), interpremolar (1.6 +/- 0.55 mm for the first premolar, 1.74 +/- 0.65 mm for the second premolar), and intermolar (2.31 +/- 0.75 mm) widths increased, while the distance between the intersection of the zygomatic process and the maxillary alveolar process on the right (JR) and left (JL) did not change. Fixed orthodontic treatment did not have any effect on any of the measurements. With the intentional expansion of the inner bow of CHG, the amount of maxillary dental arch expansion achieved in the permanent dentition was statistically significant (P < 0.017).

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The aim of this study was to investigate the effects of reverse headgear (RH) on pharyngeal airway morphology in two groups of Class III patients with different vertical craniofacial features in comparison with an untreated Class III group. Seventeen subjects (9 males, 8 females; mean age 11.3 ± 0.98 years) with optimum vertical growth and 17 subjects (10 males, 7 females, mean age 11.5 ± 1.1 years) with a vertical growth pattern treated with a removable intra-oral appliance and a Delaire type facemask were included. An untreated Class III control group of 11 subjects (8 males, 3 females, mean age 9.1 ± 1.1 years) was included to compare the treated groups. The paired t-test for intragroup and one-way ANOVA for intergroup comparisons were performed. The relationships between changes in the craniofacial morphology and airway were assessed by Spearman correlation analysis. The airway dimensions at the adenoid side and soft palate were increased in the treatment groups compared to the control group (p < 0.05). The nasopharyngeal area demonstrated a significant difference in normodivergent and control subjects (p < 0.05). No significant difference was found in the airway morphology due to different vertical features. The effect of RH treatment on the sagittal airway dimensions revealed no significant difference between different vertical craniofacial features in the short term.

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