The nature of class II relapse after herbst appliance treatment: A cephalometric long-term investigation

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.

Section: Resultsmentioning

confidence: 99%

Section: Treatment Of Angle Class II Malocclusionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term Stability of Orthodontic Treatment and Patient Satisfaction

Bondemark

Holm

Hansen

et al. 2007

160

107

“…A well-intercuspated final occlusion may promote prolonged stability of orthodontic treatment 12 ; excellent occlusal results are reflected in PAR scores lower than 10. In the present study, the mean final PAR score following maxillary surgery in isolation was 9.6, which was marginally higher than that reported with bimaxillary procedures and mandibular surgery in isolation.…”

Section: Discussionmentioning

confidence: 99%

Influence of single-jaw surgery vs bimaxillary surgery on the outcome and duration of combined orthodontic-surgical treatment

Arad¹,

Jandu²,

Bassett³

et al. 2011

Objective: To analyze the effects of single-jaw surgery (mandible or maxilla only) vs bimaxillary surgery on final peer assessment rating (PAR) score outcome and overall treatment duration. Materials and Methods: Treatment records of 63 consecutively treated orthognathic patients were assessed; 41 underwent bimaxillary procedures, and the remainder single-jaw procedures. All treatment was undertaken at Kent and Canterbury Hospital in the United Kingdom. Demographic characteristics and clinical parameters, including treatment duration, number of visits required, initial and final PAR scores, and number of extractions undertaken, were recorded. Results: The mean treatment time was 30.6 months; treatment time was shortest in the maxillary procedure only group. The mean reduction in percentage PAR score was 77%, with an average final score of 9. Linear regression analysis confirmed that procedure type had no influence on final PAR score (P 5 .62) or on overall treatment duration after adjustment for extractions and initial PAR score as confounders (P 5 .47). Conclusions: No significant difference was noted in treatment duration or in occlusal outcome between single-and double-jaw surgeries. (Angle Orthod. 2011;81:983-987.)

“…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.