The aim of this study was to evaluate the dentofacial effects of a modified tandem traction bow appliance (modified TTBA) in skeletal Class III subjects, and the effect of age on treatment response. The material consisted of the pre-treatment/pre-observation and post-treatment/post-observation lateral cephalograms and hand-wrist films of 45 children with skeletal and dental Class III malocclusions. Thirty patients were treated with a modified TTBA. Two treatment groups of 15 patients each were formed: an early (nine girls, six boys; mean skeletal age: 8.18 ± 0.50 years) and a late treatment (5 girls, 10 boys; mean skeletal age: 11.75 ± 1.00 years) group. The remaining 15 children (5 girls, 10 boys; mean skeletal age: 7.90 ± 0.62 years) were observed without treatment for 8 months and served as a control for the early treatment group. Wilcoxon and Mann-Whitney U-tests were used for statistical analysis. Significant forward maxillary movement was determined in both treatment groups (P < 0.01) while the decrease in SNB was significantly greater in the early treatment group compared with the control (P < 0.01). Upper molar tipping and sagittal displacement of point A (point A-T, N(⊥)FH-A) was found to be significantly greater in the late treatment group compared with the early treatment group (P < 0.05). In both treatment groups, dental and skeletal correction of the Class III malocclusion was achieved.
Both appliances were found to be effective in the treatment of Class III malocclusion. Their skeletal and dental effects showed differences due to their design.
A multidisciplinary approach to develop the future implant site in the aesthetic zone was illustrated. A patient with perio-endo combined lesion at her upper central incisors was treated. Before extraction, forced eruption was performed and 12 months later, satisfactory amount of bone apposition was detected. At 2 weeks after atraumatic extraction, implants were placed and loaded with implant-supported restorations following osseous healing. Variables related to crown dimensions, periodontal/peri-implanter soft-tissue health and patient's aesthetic satisfaction were recorded at baseline, before extraction and after prosthetic treatment. At 12-month control, crown dimensions in the implant site were identical to the baseline and in addition to the healthy peri-implant tissues, successful aesthetics were obtained. Forced eruption is a successful non-invasive method to develop the aesthetics of the peri-implant tissues and implant-supported restorations.
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