Abstract
Purpose
The aim of this respectively cohort study was to evaluate the lower second and third molars and canine angulations, retromolar space and occlusal relationships after functional orthodontic treatments with the monoblock or Herbst appliance using panoramic radiographs.
Methods
Pre- and posttreatment cephalometric and panoramic radiographs of 133 patients (mean age 13.89 ± 1.14 years) treated non-extraction with monoblock (n: 44), Herbst (n: 45) and fixed orthodontic appliances (control group; n: 44) were included to the study. Dental and skeletal measurements were performed on cephalometric radiographs. The angle between the third and second molars, and canines with the lower border of the mandible and the occlusal plane, gonial angle, the angle between the third and second molars and the retromolar space width were assessed on pre- and posttreatment panoramic radiographs. Paired and independent t tests were used for the statistical analysis of the data for intragroup and intergroup comparisons.
Results
Functional treatment with both the monoblock and the Herbst appliances resulted in improvement of skeletal class II relationships. Retromolar space significantly increased in the functional appliance groups compared to the control group (p ≤ 0.001), but improvement of the angulations of posterior teeth was significant only in the monoblock group (p ≤ 0.001).
Conclusion
While both the Herbst and monoblock appliances led to an increase in retromolar space, monoblock treatment resulted in more favorable angulation of the third molars compared to the Herbst treatment.
Zusammenfassung
Zielsetzung
Ziel dieser Kohortenstudie war es, die Angulation der unteren zweiten und dritten Molaren und Eckzähne, den retromolaren Raum und die okklusalen Beziehungen nach funktionskieferorthopädischen Behandlungen mit der Monoblock- bzw. der Herbst-Apparatur anhand von Panoramaröntgenaufnahmen zu untersuchen.
Methoden
In die Studie wurden vor und nach der Behandlung erstellte kephalometrische und Panoramaröntgenaufnahmen von 133 Patienten (Durchschnittsalter 13,89 ± 11,14 Jahre) aufgenommen, die ohne Extraktion mit Monoblock- (n: 44), Herbst- (n: 45) und festsitzenden kieferorthopädischen Apparaturen (Kontrollgruppe; n: 44) behandelt wurden. Dentale und skelettale Messungen wurden auf kephalometrischen Röntgenbildern durchgeführt. Der Winkel zwischen den dritten und zweiten Molaren und den Eckzähnen mit dem unteren Rand des Unterkiefers und der Okklusionsebene, der Gaumenwinkel, der Winkel zwischen den dritten und zweiten Molaren und die Breite des retromolaren Raums wurden auf den Panoramaröntgenbildern vor und nach der Behandlung gemessen. Für die statistische Analyse der Daten wurden gepaarte und unabhängige t‑Tests für gruppeninterne und gruppenübergreifende Vergleiche verwendet.
Ergebnisse
Die funktionelle Behandlung sowohl mit der Monoblock- als auch mit der Herbst-Apparatur führte zu einer Verbesserung der skelettalen Klasse-II-Beziehungen. Der retromolare Raum vergrößerte sich signifikant in den Gruppen mit funktionellen Apparaturen im Vergleich zur Kontrollgruppe (p ≤ 0,001), aber die Verbesserung der Winkel der Seitenzähne war nur in der Monoblockgruppe signifikant (p ≤ 0,001).
Schlussfolgerung
Während sowohl die Herbst- als auch die Monoblock-Apparatur zu einer Vergrößerung des retromolaren Raums führten, führte die Monoblock-Behandlung im Vergleich zur Herbst-Behandlung zu einer günstigeren Angulation der dritten Molaren.
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References
Richardson ME (1977) The etiology and prediction of mandibular third molar impaction. Angle Orthod 47(3):165–172
Svendsen H, Björk A (1988) Third molar impaction: a consequence of late M3 mineralization and early physical maturity. Eur J Orthod 10(1):1–12
Artun J, Thalib L, Little RM (2005) Third molar angulation during and after treatment of adolescent orthodontic patients. Eur J Orthod 27(6):590–596
Türköz Ç, Ulusoy Ç (2013) Effect of premolar extraction on mandibular third molar impaction in young adults. Angle Orthod 83(4):572–577
Hattab FN, Alhaija ES (1999) Radiographic evaluation of mandibular third molar eruption space. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88(3):285–291
Sandhu S, Kaur T (2005) Radiographic evaluation of the status of third molars in the Asian-Indian students. J Oral Maxillofac Surg 63(5):640–645
Ghougassian SS, Ghafari JG (2014) Association between mandibular third molar formation and retromolar space. Angle Orthod 84(6):946–950
Björk A, Jensen E, Palling M (1956) Mandibular growth and third molar impaction. Acta Odontol Scand 14(3):231–272
Ricketts RM (1979) Studies leading to the practice of abortion of lower third molars. Dent Clin N Am 23(3):393–411
McNamara JA Jr (1981) Components of class II malocclusion in children 8–10 years of age. Angle Orthod 51(3):177–202
Palomo JM, Hunt DW Jr, Hans MG, Broadbent BH Jr (2005) A longitudinal 3–dimensional size and shape comparison of untreated class I and class II subjects. Am J Orthod Dentofac Orthop 127(5):584–591
Stahl F, Baccetti T, Franchi L, McNamara JA Jr (2008) Longitudinal growth changes in untreated subjects with class II division 1 malocclusion. Am J Orthod Dentofac Orthop 134(1):125–137
Baccetti T, Stahl F, McNamara JA Jr (2009) Dentofacial growth changes in subjects with untreated Class II malocclusion from late puberty through young adulthood. Am J Orthod Dentofac Orthop 135(2):148–154
Janson G, de Lima KJRS, Woodside DG, Metaxas A, de Freitas MR, Henriques JFC (2007) Class II subdivision malocclusion types and evaluation of their asymmetries. Am J Orthod Dentofac Orthop 131(1):57–66
Baysal A, Uysal T (2014) Dentoskeletal effects of Twin Block and Herbst appliances in patients with Class II division 1 mandibular retrognathy. Eur J Orthod 36(2):164–172
Aslan BI, Akarslan ZZ, Karadağ Ö (2021) Effects of Angle class II correction with the Forsus fatigue resistant device on mandibular third molars. J Orofac Orthop 82(6):403–412
Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–191
Jain S, Valiathan A (2009) Influence of first premolar extraction on mandibular third molar angulation. Angle Orthod 79(6):1143–1148
Kamalakannan D, Anathanarayanan V, Padmanaban S (2019) Effect of extraction or non-extraction orthodontic treatment modality on favorability of eruption of impacted third molars. Indian J Dent Res 30(3):428–436
Capelli J Jr (1991) Mandibular growth and third molar impaction in extraction cases. Angle Orthod 61(3):223–229
Sampaio LP, Raveli DB, Santos-Pinto AD, Landázuri DRG, Maia SDA (2012) Influence of the banded Herbst appliance on dental changes in mixed dentition. Dental Press J Orthod 17(1):44–46
Pancherz H, Hensen K (1986) Occlusal changes during and after Herbst treatment: a cephalometric investigation. Eur J Orthod 8(4):215–228
Björk A (1963) Variations in the growth pattern of the human mandible: longitudinal radiographic study by the implant method. J Dent Res 42(1):400–411
Behbehani F, Årtun J, Thalib L (2006) Prediction of mandibular third-molar impaction in adolescent orthodontic patients. Am J Orthod Dentofac Orthop 130(1):47–55
Lai M, McNamara JA Jr (1998) An evaluation of two-phase treatment with the Herbst appliance and preadjusted edgewise therapy. Semin Orthod 4(1):46–58
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E.B. Gümüş, E. Esenlik, G.E. Kayafoğlu and M. Yıldırım declare that they have no competing interests.
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Approval for this retrospective cohort study was obtained from the Ethical Committee of Akdeniz University Faculty of Medicine (approval date 18 August 2021; no. 579, Antalya, Turkey).
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Gümüş, E.B., Esenlik, E., Kayafoğlu, G.E. et al. Third molar angulation and retromolar space after functional orthodontic treatment. J Orofac Orthop (2024). https://doi.org/10.1007/s00056-024-00516-3
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DOI: https://doi.org/10.1007/s00056-024-00516-3