Abstract
Objectives
The purpose of this work was to employ both cephalometric and tensor analysis in characterizing the skeletal changes experienced by patients with Angle Class II/1 malocclusion during functional orthodontic treatment with the functional regulator type II.
Methods
A total of 23 patients with Class II/1 malocclusion based on lateral cephalograms obtained before and after treatment with the functional regulator type II were analyzed. Another 23 patients with Angle Class II/1 malocclusion who had not undergone treatment were included as controls.
Results
Our cephalometric data attest to significant therapeutic effects of the functional regulator type II on the skeletal mandibular system, including significant advancement of the mandible, increases in effective mandibular length with enhancement of the chin profile, and reduction of growth-related bite deepening. No treatment-related effects were observed at the cranial-base and midface levels. In addition, tensor analysis revealed significant stimulation of mandibular growth in sagittal directions, without indications of growth effects on the maxilla. Its growth-pattern findings differed from those of cephalometric analysis by indicating that the appliance did promote horizontal development, which supports the functional orthodontic treatment effect in Angle Class II/1 cases.
Conclusions
Tensor analysis yielded additional insights into sagittal and vertical growth changes not identifiable by strictly cephalometric means. The functional regulator type II was an effective treatment modality for Angle Class II/1 malocclusion and influenced the skeletal development of these patients in favorable ways.
Zusammenfassung
Zielsetzung
Ziel der vorliegenden Arbeit war es, skelettale Veränderungen während der Therapie mit dem Funktionsregler Typ II (FR2) bei Angle-Klasse-II/1-Patienten mittels Kephalometrie und Tensoranalyse zu charakterisieren.
Methoden
Die Untersuchungsgruppe bestand aus 23 Patienten mit Angle-Klasse-II/1-Anomalie, deren Fernröntgenseitenbilder vor und nach FR2-Therapie analysiert wurden. Als Kontrollgruppen dienten 23 unbehandelte Probanden mit Angle-Klasse-II/1-Gebissanomalie. Die Auswertung erfolgte mittels Kephalometrie und Tensoranalyse.
Ergebnisse
Unter Anwendung der Kephalometrie zeigte sich, dass die Therapie mit dem Funktionsregler Typ II zu signifikanten Therapieeffekten in Bezug auf das skelettale mandibuläre System führt. Hierzu zählen eine signifikante Vorverlagerung des Unterkiefers, eine Zunahme der effektiven Unterkieferlänge mit einer Verbesserung des Kinnprofils sowie eine Reduzierung der wachstumsbedingten Bissvertiefung. Hingegen fanden sich keine Hinweise auf eine therapeutische Beeinflussung von Schädelbasis und Mittelgesichtsbereich. Die kephalometrischen Daten ergänzend zeigte die Tensoranalyse eine signifikante mandibuläre Wachstumsstimulation in sagittaler Richtung ohne Anhalt für eine Beeinflussung des maxillären Wachstums. Im Gegensatz zur Kephalometrie ergab die Tensoranalyse hinsichtlich des Wachstumsmusters eine Förderung der Horizontalentwicklung, die eine funktionskieferorthopädische Behandlung der Angle Klasse II/1 erleichtert.
Schlussfolgerungen
Die Tensoranalyse ermöglicht zusätzliche Erkenntnisse über Wachstumsveränderungen in sagittaler und vertikaler Richtung, die mit der Kephalometrie allein nicht zu identifizieren sind. Die Behandlung mit dem Funktionsregler Typ II war effektiv und führte zu positiver skelettaler Nachentwicklung.
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S. Schulz, B. Koos, K. Duske, and F. Stahl declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Bernd Koos: PD, Dr. med. dent.
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Schulz, S., Koos, B., Duske, K. et al. Skeletal effects in Angle Class II/1 patients treated with the functional regulator type II. J Orofac Orthop 77, 420–431 (2016). https://doi.org/10.1007/s00056-016-0050-4
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DOI: https://doi.org/10.1007/s00056-016-0050-4