The headgear effect of the herbst appliance: A cephalometric long-term study

Objective: To compare the dentoskeletal effects and treatment efficiency of the Twin Force Bite Corrector (TFBC) appliance in Class II correction of patients treated before or after the pubertal growth spurt. Materials and Methods: Forty-one normodivergent Class II patients treated with the TFBC appliance were divided into two groups based on their cervical vertebral maturation stage (CVMS). Group 1 (G1) consisted of 23 patients (mean age 12.44 6 1.59 years) where treatment was initiated before the pubertal growth spurt (CVMS I and II), while group 2 (G2) consisted of 18 patients (mean age 13.76 6 1.44 years) where treatment was started after the pubertal growth spurt (CVMS III to V). Dentoskeletal measurements were made on lateral cephalograms taken before (T1) and after orthodontic treatment (T2). Results: During treatment, G1 had significantly greater skeletal correction than G2, with more dentoalveolar effects being observed in G2 than G1. However, on comparing both groups at the end of treatment (T2) when growth is complete, no differences in the parameters measured were observed. Overall, treatment time was significantly longer for G1 (3.67 6 1.45 years) compared to G2 (2.75 6 1.07 years). Conclusions: There is no difference in overall dentoskeletal effects obtained at the end of treatment by the TFBC appliance in normodivergent prepubertal vs postpubertal patients. However, treatment efficiency based on treatment timing is significantly greater for the postpubertal group. (Angle Orthod. 2013;83:718-727.)

Section: Skeletal Effectsmentioning

confidence: 55%

Section: Dentoalveolar Effectsmentioning

confidence: 99%

Mechanism of Class II correction in prepubertal and postpubertal patients with Twin Force Bite Corrector

Chhibber

Upadhyay

Uribe

et al. 2012

“…Of these, 20 were graded as moderate value of evidence (grade B) and served as a basis for the conclusions, 3,4,71,[78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94] 18 were graded as low value of evidence (grade C) (Table 5), and none were graded as a high value of evidence (grade A).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies were graded B [85][86][87][88][89][90] (Table 7), and in these the follow-up period varied between 5 and 11 years. In one study 90 the treatment was performed with an Andresen activator, and in all other studies the Herbst appliance was used.…”

Section: Treatment Of Angle Class II Malocclusionmentioning

confidence: 99%

Long-term Stability of Orthodontic Treatment and Patient Satisfaction

Bondemark

Holm

Hansen

et al. 2007

160

107

Objective: To evaluate morphologic stability and patient satisfaction at least 5 years after orthodontic treatment. Materials and Methods: Published literature was searched through the PubMed and Cochrane Library electronic databases from 1966 to January 2005. The search was performed by an information specialist at the Swedish Council on Technology Assessment in Health Care. The inclusion criteria consisted of a follow-up period of at least 5 years postretention; randomized clinical trials, prospective or retrospective clinical controlled studies, and cohort studies; and orthodontic treatment including fixed or removable appliances, selective grinding, or extractions. Two reviewers extracted the data independently and also assessed the quality of the studies. Results:The search strategy resulted in 1004 abstracts or full-text articles, of which 38 met the inclusion criteria. Treatment of crowding resulted in successful dental alignment. However, the mandibular arch length and width gradually decreased, and crowding of the lower anterior teeth reoccurred postretention. This condition was unpredictable at the individual level (limited evidence). Treatment of Angle Class II division 1 malocclusion with Herbst appliance normalized the occlusion. Relapse occurred but could not be predicted at the individual level (limited evidence). The scientific evidence was insufficient for conclusions on treatment of cross-bite, Angle Class III, open bite, and various other malocclusions as well as on patient satisfaction in a long-term perspective. Conclusions: This review has exposed the difficulties in drawing meaningful evidence-based conclusions often because of the inherent problems of retrospective and uncontrolled study design.

“…Reported relapse rates following these treatments range from 20% to 52%. [2][3][4][5][6] Relapse, however, cannot be predicted at the individual level. 7 Moreover, relapse tendencies vary in extent and clinical significance.…”

Section: Introductionmentioning

confidence: 99%

Predictive factors of sagittal stability after treatment of Class II malocclusions

Maniewicz

Antonarakis

Kiliaridis

2015

Objective: To determine the existence of factors permitting the prediction of sagittal stability after orthodontic treatment in patients with Angle Class II malocclusion. Materials and Methods: PubMed, EMBASE, and the Cochrane Library were searched up to March 2015. Inclusion criteria were longitudinal studies with at least 10 subjects investigating associations between at least one factor and stability, with an average minimum follow-up period of 2 years; stability measured using posttreatment sagittal dental changes; and orthodontic treatment including removable and/or fixed appliances with or without extractions. Two reviewers independently selected and assessed the quality of the articles. Results: The search strategy resulted in 1372 articles, of which 17 met the inclusion criteria. Large changes during treatment in molar and canine relationships were the only two factors found to be positively associated with relapse, but with limited evidence. Fourteen factors were found not to be predictive of relapse, also with limited evidence. These factors included treatment characteristics, patient pretreatment characteristics, and final posttreatment characteristics. Conclusions: There is currently limited evidence to support the influence of factors predictive of sagittal stability following Class II malocclusion treatment. More high-quality prospective studies are needed, and functional factors possibly affecting relapse also need to be further assessed.