Dentale und skelettale Veränderungen bei frühzeitiger Klasse-II-Behandlung mit dem offenen Aktivator nach Klammt

Abstract

In order to evaluate the initiation of treatment of Angle class II malocclusion at an early age, seventy-six patients, 34 girls aged on average 10.1 years and 42 boys, average age 11.3 years, were selected for the study. For the treatment we used the Klammt open activator. For evaluation purposes we used casts and cephalograms taken before and after treatment. The results showed distinctive differences between Angle class II/1 and II/2. The sagittal correction in class II/1 was a result of the reduction of the SNA angle, the mandibular protrusion, and the retrusion of the upper incisors. The face high index was normalized. No labial inclination of the lower incisors was registered. In the Angle class II/2 cases the SNA angle was unchanged. The sagittal correction was brought about exclusively through mandibular translation. The deep bite and the retrusion of the upper incisors weren't markedly improved. The lower incisors showed a labial tip. The incisor angle was unchanged. Our study showed that the ANB reduction on an annual basis is highest, when treatment is initiated at an age of 10 to 11 years for girls and 12 years for boys. On the growth curve this is a point in time below the accelerated growth phase of puberty.

Treating Class II Patients with Removable Plates and Functional Orthopedic Appliances

“…There are indications in the literature [6,7,9,14] that the horizontal craniofacial configuration becomes predominant in Class II, Division 1 and Class II, Division 2 patients over time. The present study agrees with the literature [5][6][7]9] in concluding that functional orthodontic treatment can attenuate increased horizontal or vertical growth tendencies. Whether and to what extent the treatment has a modulating effect can only be determined by comparison with untreated Class II patients [19].…”

“…As previously noted in the literature, the present study also showed that the proclination of the maxillary anteriors was improved in Class II, Division 1 patients [5,8,12], and the anteriors' retroclination was improved in Class II, Division 2 patients [6,8,12]. The treatment also reduced overjet and overbite in cases where they had been increased at baseline.…”

“…The present results indicate that functional orthodontic treatment may result in -sometimes significantly -different effects on dental and skeletal reactions in Class II, Division 1 and Class II, Division 2 patients [5,6,8]. Also, the craniofacial configuration at baseline is partly responsible for the treatment outcome [1,2,19].…”

“…Hirschfelder & Fleischer-Peters [8] mention a significant protrusion of the mandibular incisors in Class II, Division 1 patients and only an insignificant protrusion of the incisors in Class II, Division 2 patients. Eckardt et al [5], on the other hand, found exactly the opposite when comparing the two types of Class II malocclusion. Obijou & Pancherz [12] and Pancherz [14] observed a noticeable protrusion for both types of Class II patients, which was slightly more pronounced in Class II, Division 2 patients.…”

“…Die vorliegenden Ergebnisse weisen darauf hin, dass die funktionskieferorthopädischen Behandlungen zum Teil si gnifikant unterschiedliche Auswirkungen auf die dentalen und skelettalen Reaktionen von Klasse-II/1-und Klasse-II/2-Patienten haben [5,6,8]. Ebenso ist der Wachstumstyp bei Behandlungsbeginn mit verantwortlich für das erzielte Therapieresultat [1,2,19].…”