Effects of mandibular protraction appliance associated to fixed appliance in adults

Furquim, Bruno D’Aurea; Henriques, José Fernando Castanha; Janson, Guilherme; Siqueira, Danilo Furquim; Furquim, Laurindo Zanco

doi:10.1590/s2176-94512013000500009

Cited by 9 publications

(15 citation statements)

References 27 publications

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“…Within the field of dentoskeletal relationships, it was important to note that there was no significant restriction of maxillary molar mesialization. This was also be observed in other studies that showed the improvement in Class II would occur to a larger extent by mesialization of the mandibular molar 9,13 and mild limitation of anterior displacement of the maxillary first molars 9,13 . According to the methodology used, there was significant restriction of maxillary anterior displacement, a restriction that was also highlighted in another study 25 . However, in a comparative study between MPA, Jasper Jumper and a Class II control group, there was no significant restriction of anterior maxillary growth in comparison with the control group 19 , and the same result was found in another study 24 .…”

Section: Discussionsupporting

confidence: 82%

“…The MPA improved the molar ratio and increased the interincisive angle, which could be explained by lingualization of the maxillary incisors 10,25 and vestibularization of the mandibular incisors 13,24 . According to the original proposal of the MPA, the main concern related to mandibular advancement was to maintain the inclination of the mandibular incisors 11,12 .…”

Section: Discussionmentioning

confidence: 87%

“…To evaluate the results, we did not consider a control group because the increments were substantiated by the author of the analysis 20 , and these (values) showed that the variables of this study incorporated the changes that would occur with the normal growth of the individual; that is, the results of this study did not occur without the action of the MPA in correction of the sagittal discrepancy. Moreover, it is possible to observe other studies that have evaluated the effects of mandibular protraction in the treatment of Class II, without including a control group in the study 4,13,16,24 .…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have studied the effects of Class II treatment by means of cephalometric evaluation 13,14 , including cephalometric changes in MPA treatment 3,13,15 but there is a scarcity of studies in the literature assessing the effects of mandibular protraction by the Ricketts Analysis. Those that used Ricketts, only evaluated alterations in the profile, mesialization of the first molars, and verified the upper airway space [16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

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Dentoskeletal and aesthetic effects of mandibular protraction appliance (MPA) using Ricketts analysis

Chacón

Henriques

Filho

et al. 2018

Rev. odontol. UNESP

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Objective This study was designed to evaluate the skeletal, dental and soft tissue effects of mandibular deficiency treatment with the mandibular protraction appliance (MPA) using 12 factors of the Ricketts analysis. Material and method This cross-sectional retrospective study sample consisted of a group (n = 27), with Class II malocclusion, convex facial profile, increased horizontal trespass and mandibular deficiency, with initial mean age of 12.27 and final of 15.18 years, treated with fixed appliance combined with the MPA, in an average time of 2.9 years. Initial and final radiographs were investigated using Ricketts analysis. The dependent t-test was used to compare the initial and final phases of the MPA group, with a significance level of 5%. Result Statistically significant differences were observed for dental changes such as retrusion (p=0.000) and palatal inclination of the maxillary incisors (p=0.000); protrusion (p=0.000) and buccal inclination of the mandibular incisors (p=0.000); increased interincisal angle (p=0.002) and improved molar ratio (p=0.003). There was also a restriction of the anterior displacement of the maxilla (p=0.000) and a decrease in the mandibular plane angle (p=0.024). The variable inferior labial protrusion with significance (p=0.000), reiterated the improvement in the profile. Conclusion The effects of MPA on correction of malocclusion Class II, verified by Ricketts analysis occurred predominantly by dentoalveolar changes, decrease in the Mandibular Plane Angle, and restriction of anterior displacement of the maxilla, which contributed to the improvement in the patient's profile.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dentoskeletal and aesthetic effects of mandibular protraction appliance (MPA) using Ricketts analysis

Chacón

Henriques

Filho

et al. 2018

Rev. odontol. UNESP

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“…Despite MPA's widespread use in South America, there are only a few reports on its effects (5,8,9) at different stages of dentofacial development. Furthermore, these reports do not identify changes caused by MPA according to dentofacial development, an important variable associated with craniofacial changes produced by orthopedic appliances (1).…”

Section: Introductionmentioning

confidence: 99%

Mandibular Protraction Appliance Effects in Class II Malocclusion in Children, Adolescents and Young Adults

et al. 2017

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The aim of this study was to evaluate the effects of the mandibular protraction appliance (MPA) for treating mild to moderate Class II malocclusion at different stages of dentofacial development. Lateral radiographs were evaluated before (T0) and at the end (T1) of orthodontic treatment with fixed appliance associated with MPA. Sixty-five consecutively treated patients were divided according to the stage of dentofacial development: 21 children in late mixed dentition, 22 adolescents and 22 young adults with full permanent dentition. The differences between and within groups were analyzed by MANOVA at p<0.05. The correction of anteroposterior discrepancy (Wits) was significantly reduced in all development stages (p<0.01), with no difference between groups. Class II was corrected predominantly by dental changes in the mandibular arch, with accentuated proclination of the mandibular incisors and mesial displacement of mandibular molars. The MPA had no skeletal effects in any of the groups, except for a mild reduction of SNA (p=0.018) and ANB angles (p<0.0001) among the mixed dentition children. With regard to soft-tissue profile, facial convexity decreased significantly in all groups (p<0.01). In conclusion, the MPA associated with fixed appliance corrected the Class II occlusion, basically by a mandibular arch protrusion. A mild skeletal maxillary change was significant only when this treatment protocol began during mixed dentition.

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Mandibular propulsion appliance for adults with Class II malocclusion: a systematic review and meta-analysis

Espinosa

Santos

Mendes

et al. 2019

European Journal of Orthodontics

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Summary Background The effects of mandibular propulsion appliances in adults have some controversial results. While some authors claim that its use in non-growing patients could produce some dentoskeletal effects, other studies indicate that Class II correction occurs only through significant dental effects. Objective To evaluate the effects in non-growing Class II patients with mandibular retrusion, promoted by the treatment with mandibular propulsion appliances and determine if they produce mandibular changes. Methods The research was carried out in nine electronic databases and additional manual searches up to July 2019. Selection criteria were no restriction was placed on date and publication language. Randomized or non-randomized clinical trials with/without control were included. They must evaluated non-growing patients with Class II malocclusion, treated with mandibular propulsion appliances; outcomes were assessed before and after treatment. Data collection and analysis Data were extracted by two independent examiners in duplicate. The ROBINS-I tool was used to assess the methodological quality of the included studies. Results Of the 2824 articles identified, 11 non-randomized clinical articles were selected for qualitative analysis and 8 for quantitative analysis. SNB (0.87°, CI 95% 0.08, 1.66), ANB (−0.82°, CI 95% −1.24 to 0.40) and Pg/OLp [2.3 to 1.2 mm (P < 0.001)] presented smallest but significant mandibular changes with some differences regarding the used appliance. The Herbst appliance showed the largest mandibular changes followed by the SUS appliance when evaluated through Ar-Pg. SNA showed non-significant changes. Overbite (−2.85. CI 95% −3.06, −2.64), Overjet (−5.00.CI 95% −5.45, −4.55) showed significant changes in all devices. Class II correction occurs through a significant labial movement of the mandibular incisors, some lingual inclination of the maxillary incisors and minor skeletal changes. Conclusions All mandibular propulsion appliances examined, showed efficiency in normalizing the Class II malocclusion in adult patients; however, changes were acquired mainly through dentoalveolar changes. Some minor mandibular forward changes was noted, mainly in patients treated with the Herbst appliance. Randomized clinical trials are needed to improve scientific evidence. Registration PROSPERO (code CRD42017067384).

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Effects of mandibular protraction appliance associated to fixed appliance in adults

Cited by 9 publications

References 27 publications

Dentoskeletal and aesthetic effects of mandibular protraction appliance (MPA) using Ricketts analysis

Dentoskeletal and aesthetic effects of mandibular protraction appliance (MPA) using Ricketts analysis

Mandibular Protraction Appliance Effects in Class II Malocclusion in Children, Adolescents and Young Adults

Mandibular propulsion appliance for adults with Class II malocclusion: a systematic review and meta-analysis

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