Comparative Evaluation of Esthetic and Structural Aspects in Class II Functional Therapy. A Case–Control Retrospective Study

Abstract

To compare the skeletal, dental, and esthetic changes produced by three functional devices, Fränkel-2 appliance (FR-2), Twin Block (TB), and Occlus-o-Guide® (O-o-G®), for the treatment of Class II malocclusion. Methods: Sixty-five patients with Class II Division 1 malocclusion were divided into three groups and were analyzed through cephalometric analysis of skeletal, dental, and esthetic variables before and after treatment. The first group of 23 patients (F: 9; M: 14; mean age: 10.3 ± 1.08 years) was treated with FR-2, the second group of 18 patients (F: 8; M: 10; mean age 10.7 ± 1.05 years) was treated with TB, the third group (F: 11; M: 13; mean age: 9.05 ± 0.39 years) of 24 patients was treated with O-o-G®. The structural effects of the three devices were compared with a control group generated by the growth variations reported in the cephalometric atlas of Bhatia and Leighton. Esthetic analysis was performed comparing the results of the patients treated with a control group of 20 subjects with mandibular retrognathia and Class II Division 1 malocclusion, not subjected to therapy. Results: The three devices resulted in a significant increase in mandibular length, with higher results obtained for FR-2 and TB. A statistically significant increase in the IMPA angle was found for the O-o-G® group, and a notable reduction of both overjet and overbite was detected in all three groups of treated patients. The esthetic evaluation showed overall more significant results in the TB group, especially with regard to the reduction of facial convexity. The retrusion of the upper lip was on average more significant in the O-o-G® group, followed by that in the TB. Conclusion: All three devices have proven to be effective overall in resolving skeletal changes and improving facial esthetics.

Comparison of Twin Block appliance and Herbst appliance in the treatment of Class II malocclusion among children: a meta-analysis

“…In a prospective study assessing soft tissue aesthetic changes, there was a significant reduction in facial convexity and upper lip protrusion following treatment with a modified Twin Block appliance [ 34 ]. A retrospective case–control study revealed that the aesthetic assessment yielded notably better outcomes in the Twin Block group, particularly in terms of diminishing facial convexity [ 35 ].…”

The Efficacy of a New AMCOP® Elastodontic Protocol for Orthodontic Interceptive Treatment: A Case Series and Literature Overview

“…Different elastomeric appliances have been designed to treat many forms of malocclusions [ 38 ]. Generally, these devices feature two double-matched planes, upper and lower, and two flanges, one on the vestibular side and one on the lingual side.…”

“…Moreover, a good alignment of the incisors was observed in 98% of the treated children. This alignment was possible because the eruption guidance appliance was designed to solve crowding by expanding the dental arches [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ]. It was concluded that the Fränkel group, the EGA group and the EGA subgroup had significantly greater resorption than the control group.…”

Effect of condylar chondrocyte exosomes on condylar cartilage osteogenesis in rats under tensile stress

“…Surveys have shown that the prevalence of Class II malocclusion among children in China varies slightly at each dental stage, ranging from 25.8% at early mixed dentition to 19.4% at early permanent dentition ( Minkui Fu et al, 2002 ). For the orthodontic treatment of patients with Class II malocclusion at Growth and development period (around puberty), early functional orthopedic treatments, such as Activator ( Oh et al, 2020 ), Herbst ( Souki et al, 2017 ; Wei et al, 2020 ), Frankel II ( Galluccio et al, 2021 ), and Twin block ( Uy-Co et al, 2010 ), are usually used to induce displacement of the mandibular condyle in the downward and forward directions to promote forward mandibular growth, reduce the facial shape of the Class II skeleton, and reduce the need for later surgery. However, there is still a lack of research on the mechanism through which tensile stress promotes the growth and development of condylar cartilage.…”