ABSTRACT Functional appliances have been used over a century in clinical orthodontic treatments for skeletal Class II malocclusion patients. Its popularity is attributed to its high patient adaptability and ability to produce rapid treatment changes. The twin block and lip bumper can be combined depending on the patient’s cases. The purpose of therapy with twin block is effective in mandibular growth deficiencies to induce supplementary lengthening of mandibular by stimulating increased growth at the condylar cartilage. The patient was a ten-year-old male patient with skeletal Class II malocclusion. He had a convex facial profile, SNA (sella, nasion, A point) angle of 77.5°, SNB (sella, nasion, B point) angle of 73.0°, ANB (A point, nasion, B point) angle of 4.5°, overjet of 6.5 mm, overbite of 11/41 = 5.0 mm, 21/31 = 4.5 mm, abnormal upper labial frenulum, crossbite in the second left premolar of maxilla, crowded anterior teeth of mandibular, deficiency of mandibular growth, lower lip sucking habit, anterior teeth of maxilla with diastema and proclination. Orthodontic treatment for patient is a combination of twin block and lip bumper appliances. After seven months, frenectomy is used to eliminate and correct the spacing in the frenulum. After 10 months, the patient’s skeletal and profile had improved to skeletal Class I malocclusion, SNA angle of 78.0°, SNB angle of 75.0°, ANB angle of 3.0°, overbite and overjet of 4.0 mm, and the lower lip sucking habit had stopped. Twin block and lip bumper appliances are particularly good alternative treatment in managing selected cases of skeletal Class II malocclusion.
Malocclusion, Angle Class II

Increased overbite has always been a challenging orthodontic problem in treating most periodontal-associated problems. This case report described the management of a class II division 2 malocclusion with cover bite without extraction. A 19-year-old female patient came with a chief complaint of irregularities on the anterior teeth. A fixed appliance was placed without extraction. The patient was instructed to use intermaxillary elastic band class II to correct the canine and molar relation. Treatment time was 16 months. A class I canine and molar relation with good interdigitation was achieved. The treatment of class II division 2 malocclusion without extraction in the adult patient showed promising results.
Angle Class II Malocclusion ; Class II Malocclusion ; Malocclusion Class II Division 2 ; Orthodontic Treatment

OBJECTIVEThis study aimed to analyze the condylar position changes produced by functional appliances in class Ⅱ malocclusion by systematic review.

METHODSElectronic search was conducted using Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Medline, Embase, Pubmed, and Cochrane Central Register of Controlled Trials. Studies on condylar position changes produced by functional appliances in class Ⅱ malocclusion were included. Risk of bias assessment and data extraction of included studies were conducted by two reviewers independently. The meta-analysis was carried out using Revman 5.1.

RESULTSSix studies were included (five high quality and one low quality). The condylar position showed no changes after Herbst treatment. The condylar posterior space after Twin-block treatment averagely increased by 0.31 mm (P<0.000 01), whereas the condylar anterior space averagely reduced by 0.32 mm (P<0.000 01).

CONCLUSIONSTwin-block appliance enables forward movement of the condylar position. This result contributes to the correction of class Ⅱ malocclusion.

Databases, Factual ; Humans ; Malocclusion, Angle Class II

OBJECTIVETo study the association of vertical facial skeletal types and sagittal facial skeletal types with anterior alveolar bone thickness.

METHODSAmong 168 cases with malocclusion in early permanent dentition stage, 93 patients were male and 75 patients were female. All patients (aged 10-14 years) were divided into 9 groups by different facial skeletal types, mandibular anterior alveolar bone thickness in patients' lateral cephalometric films were measured. ANOVA were performed to measurement results with the SPSS 13.0 statistical software.

RESULTSThough sagittal facial skeletal types were the same, there were significant differences between different vertical facial types groups. The order was low-angle group, average-angle group and high-angle group according to the size. A high-angle individual often had a thin anterior alveolar bone while a low-angle individual often had the opposite morphology character. There was no statistical significance between skeletal type I, II and III. But group of skeletal type III also had a thin alveolar bone thickness which had no significant difference with high-angle group. Low-angle group III had no significant difference with average-angle group I and II in alveolar bone thickness.

CONCLUSIONSagittal facial skeletal types have little influence on anterior alveolar morphology, but the vertical facial skeletal types have strong connection with anterior alveolar bone thickness.

Adult ; Cephalometry ; Face ; Female ; Humans ; Male ; Malocclusion ; Malocclusion, Angle Class II ; Malocclusion, Angle Class III ; Mandible

OBJECTIVE: This study aimed to investigate the therapeutic effects and advantages of skeletal class Ⅲ malocclusion treatment by transmission straight wire technique. METHODS: Ninety-seven patients who received treatment for skeletal class Ⅲ malocclusion at the Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2012 to January 2017 were selected for this retrospective study. All these patients refused surgery. They were divided into two groups in accordance with the type of skeletal malocclusion: mild-to-moderate skeletal malocclusion group (-4°≤ANB <0°) and severe skeletal malocclusion group (-8°≤ANB<-4°). Each of the two groups was divided further into two small groups in accordance with the technique used: T group (transmission straight wire technique) and M group (MBT technique). RESULTS: The crossbite of all 59 patients in the mild-to-moderate skeletal malocclusion group was successfully treated. The molars were classified as classⅠrelationship, and the facial profile improved. Significant differences were found in the values of U1/SN angle, L1/MP angle, and Lip-Diff between the T and M groups before and after the treatment (P<0.05). The extent of incisor root resorption was lighter in the T group than in the M group (P<0.05). In the severe skeletal malocclusion group, the crossbite of all 38 patients was cured or partially cured. Fourteen patients showed severe lower anterior teeth inclination (five in the T group and nine in the M group), and the profiles did not significantly improve. Significant differences were observed in the values of U1-NA value, U1/SN angle, L1-NB value, L1/MP angle, LLP, and Lip-Diff between the T and M groups before and after the treatment (P<0.05). The extent of incisor root resorption was lighter in the T group than in the M group (P<0.05). CONCLUSIONS Relative to the MBT technique, the transmission straight wire technique has great advantages in improving facial profile, reducing the compensatory inclination of the upper and lower anterior teeth, and reducing the risk of root resorption in the treatment of skeletal class Ⅲ malocclusion.
Cephalometry ; Humans ; Malocclusion ; Malocclusion, Angle Class II ; Malocclusion, Angle Class III ; Maxilla ; Retrospective Studies

OBJECTIVE: Intraoral noncompliance upper molar distalization techniques have gained in popularity and have subsequently found to be successful in Class II correction. The aim of the present study was to introduce a screw supported intraoral distalization appliance and investigate its efficiency. METHODS: Twenty-one subjects (11 females, 10 males; average age of 14.9 years) with Angle Class II malocclusion participated in this study. Two screws were inserted behind the incisive foramen and immediately loaded to distalize the upper first molars. An intraoral screw supported distalization appliance was used to distalize the upper molars in order to achieve a Class I molar relationship. Skeletal and dental changes were evaluated using cephalometric and three-dimensional (3D) model analysis. RESULTS: Upper molars were distalized 3.95 mm on average and a Class I molar relationship was achieved without any anchorage loss. The upper molars were tipped only 1.49degrees and the upper right and left molars were rotated only 0.54degrees and 0.74degrees respectively which were statistically non-significant (p > 0.05). CONCLUSIONS: The newly designed screw supported noncompliance distalization appliance was found to be an effective device for achieving bodily molar distalization without any anchorage loss.
Female ; Humans ; Malocclusion ; Malocclusion, Angle Class II ; Molar

OBJECTIVETo figure out the differences of the morphological characteristics of mandibular symphysis between Class II and Class III adult skeletal malocclusions with different abnormal vertical skeletal patterns.

METHODS109 Chinese female adults of skeletal Class II and Class III were chosen and divided into four groups according to vertical and sagittal skeletal pattern: Class II--vertical-growth-pattern group (n=30), Class III--vertical-growth-pattern group (n=25), Class II--horizontal-growth-pattern group (n=29), Class III--horizontal-growth-pattern (n=25). Lateral cephalograms were taken. The symphyseal widths and heights, along with lower incisor positions were evaluated. Observation and statistics analysis were done to clarify the morphological characteristics of the symphyseal region of different skeletal patterns.

RESULTSThere were morphological differences of symphyseal region between Class II and Class III skeletal malocclusions, but not significant in width and total height. With a vertical-growth-pattern, Class II malocclusions had higher alveolus than Class III, but smaller chin prominence and lower basal bone (P < 0.01). With a horizontal-growth-pattern, Class II malocclusions had higher alveolus (P < 0.05) and larger alveolar top width (P < 0.001). With a same sagittal skeletal pattern, vertical-growth-pattern group had thinner but higher symphyseal region and bigger chin prominence (P < 0.001 in Class II while P < 0.05 in Class III). Besides, a vertical-growth-pattern malocclusion was prone to have a cucurbit-morph chin, of which Id width was larger than basal width (P < 0.01).

CONCLUSIONThere are morphological differences in symphyseal region between Class II and Class III skeletal malocclusions with different abnormal vertical skeletal patterns. The influence of abnormal vertical skeletal pattern to symphyseal morphological characteristics is greater than that of abnormal sagittal skeletal pattern. There is a risk of orthodontic movement of low incisors in vertical-growth-pattern skeletal malocclusion.

Adult ; Female ; Humans ; Malocclusion, Angle Class II ; pathology ; Malocclusion, Angle Class III ; pathology ; Mandible ; pathology

OBJECTIVETo study the characteristics of the arch form of skeletal Class III malocclusion and provide references for diagnosis and treatment plan.

METHODS7 indexes in dental casts of 47 patients with skeletal Class III malocclusion and 50 individuals with normal occlusion were measured respectively. And differences between corresponding upper and lower measurements were calculated. Independent samples t-test was employed for comparing between the two groups by SPSS 17.0.

RESULTSCompared with normal occlusion sample, Class III malocclusion group had smaller anterior segment lengths and larger canine angles (P<0.05). Differences between upper and lower first premolar widths were larger in males with skeletal Class III malocclusion. And differences between upper and lower anterior segment lengths were smaller in males with skeletal Class III malocclusion (P<0.05).

CONCLUSIONArch widths of patients with skeletal Class III malocclusion are basically normal. The lengths of anterior segment are smaller and the anterior arch forms are straighter.

Bicuspid ; Dental Arch ; Dental Occlusion ; Female ; Humans ; Male ; Malocclusion, Angle Class II ; Malocclusion, Angle Class III

PURPOSE: This retrospective study was performed to investigate the prevalence of the idiopathic osteosclerosis (IO) in Korean malocclusion patients according to age, sex, and the Angle's classification of malocclusion. MATERIALS AND METHODS: This study consisted of 2,001 randomly selected patients from the Department of Orthodontics at the Gangneung-Wonju National University Dental Hospital, Korea. The prevalence of IO in Korean malocclusion patients was recorded using their panoramic radiographs, and the following parameters were surveyed; age, sex, and the Angle's classification of malocclusion. The chi-square test was analyzed to determine the statistical significance of differences in the prevalence of IO between age, sex, and the Angle's classification of malocclusion. RESULTS: The prevalence of IO in the jaws was 6.7% in a total of 2,001 examined orthodontic patients. The majority of IO was found in the mandible (96.58%). The 30-39 age group showed the highest prevalence of IO (9.60%). There was a higher prevalence in females (6.89%) than in males (6.45%). The prevalence of IO in Angle Class I group (7.07%) was the most frequent, followed by Angle Class II group (6.72%), and Angle Class III group (6.40%). However, there was no statistical significance in sex and Angle's classification of malocclusion. CONCLUSION: The prevalence of IO in malocclusion patients showed the differences between various age groups and most of them were found in the mandibular posterior area. However, sex and the type of malocclusion are not to be considered as a contributing factor of IO.
Female ; Humans ; Jaw ; Korea ; Male ; Malocclusion ; Malocclusion, Angle Class I ; Malocclusion, Angle Class II ; Malocclusion, Angle Class III ; Mandible ; Orthodontics ; Osteosclerosis ; Prevalence ; Radiography, Panoramic ; Retrospective Studies

OBJECTIVE: To evaluate the relationship of gingival thickness (GT) and the width of keratinized gingiva (WKG) with different malocclusion groups and the level of crowding. METHODS: A total of 187 periodontally healthy subjects (121 females and 66 males) who presented at the Faculty of Dentistry in Yüzüncü Yıl University for orthodontic treatment were enrolled in the study. The individuals involved in the study were divided into three groups; Angle Class I malocclusion, Angle Class II malocclusion, and Angle Class III malocclusion. Each group was classified as mild, moderate, or severe according to the level of crowding. WKG was determined as the distance between the mucogingival junction and the free gingival margin. GT was determined by the transgingival probing technique. Factorial variance analysis and the Duncan multiple comparison test were employed to identify the extent to which a difference was apparent between the groups according to these parameters. RESULTS: It was determined that teeth in the mandibular anterior region display the thin gingival biotype. WKG and GT were observed as being higher at the mandibular incisor teeth in the severe crowding group and at the mandibular canine teeth in the mild crowding group. The GT of the mandibular right central and lateral incisors was found to be thinner in the Angle Class III group. CONCLUSIONS: Within the limits of this study, the results demonstrate that, there is no significant relationship of WKG and the mean GT in the mandibular anterior region according to the Angle classification.
Crowding* ; Cuspid ; Dentistry ; Female ; Gingiva* ; Healthy Volunteers ; Humans ; Incisor ; Malocclusion* ; Malocclusion, Angle Class I ; Malocclusion, Angle Class II ; Malocclusion, Angle Class III ; Tooth