Growth and treatment changes in patients treated with a headgear-activator appliance

Bendeus, Margareta; Hägg, Urban; Rabie, Bakr

doi:10.1067/mod.2002.122177

Cited by 53 publications

(27 citation statements)

References 37 publications

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“…[13][14][15][16][17][18][19] However, some investigators disagree with these findings, claiming that the changes might be only those expected with normal growth or conventional edgewise therapy. 20,21 Several researchers have proposed that the Class II correction observed with functional appliances was caused by a headgear effect restraining maxillary growth 20,22,23 along with a combination of dental changes, such as retroclination of the maxillary incisors and proclinaton of the mandibular incisors. 21,22 Anterior glenoid fossa remodeling and spontaneous anterior mandibular displacement that occurs after elimination of a functional retrusion also have been cited as contributors to Class II correction.…”

Section: Introductionmentioning

confidence: 99%

“…20,21 Several researchers have proposed that the Class II correction observed with functional appliances was caused by a headgear effect restraining maxillary growth 20,22,23 along with a combination of dental changes, such as retroclination of the maxillary incisors and proclinaton of the mandibular incisors. 21,22 Anterior glenoid fossa remodeling and spontaneous anterior mandibular displacement that occurs after elimination of a functional retrusion also have been cited as contributors to Class II correction. 24,25 The lack of success with functional appliance treatment has been attributed to a lack of patient compliance and the inability to control the amount and direction of mandibular growth.…”

Section: Introductionmentioning

confidence: 99%

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Treatment effects of the mandibular anterior repositioning appliance in patients with Class II skeletal malocclusions

Pangrazio

Pangrazio-Kulbersh

Berger³

et al. 2012

The Angle Orthodontist

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Objective: To examine the changes produced by the mandibular anterior repositioning appliance (MARA) appliance and compare the treatment effects to an untreated Class II control group. Materials and Methods: Thirty consecutively treated patients were matched with an untreated control group. Lateral cephalograms were taken at T1, 5 months pre-MARA (CVMS 2.7); T2, immediately after MARA removal and prior to placement of full fixed edgewise appliances (CVMS 4.2); and T3, at least 2 years after MARA removal and completion of edgewise treatment (CVMS 5.4). The mean age of the MARA patients was 11.9 years for boys and 10.8 years for girls. Repeated-measures analysis of variance (ANOVA) was used to assess if the samples were morphologically comparable at the outset and to test if there were significant differences between the groups for the various increments of change. Given a significant ANOVA, the source of the difference was explored via Tukey-Kramer tests. Results: Restriction of maxillary growth and no significant mandibular growth were observed with the MARA appliance. The Class II correction was obtained mainly by slight maxillary molar distalization and intrusion, in addition to mesial migration of the lower molars and flaring of the lower incisors. No vertical effect was observed with this appliance. Conclusion: The MARA appliance was effective in the treatment of Class II malocclusions. Restriction of maxillary growth and dentoalveolar changes in the maxillary and mandibular arches were responsible for the correction of the Class II malocclusion. Significant mandibular growth did not contribute to this correction. (Angle Orthod. 2012;82:971-977.)

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment effects of the mandibular anterior repositioning appliance in patients with Class II skeletal malocclusions

Pangrazio

Pangrazio-Kulbersh

Berger³

et al. 2012

The Angle Orthodontist

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“…However, previous studies analyzing the dentoskeletal effect of van Beek activator treatment demonstrated either a vertical control or an intrusion of the upper incisors. [14][15][16] The second possible explanation is a posterior rotation of the maxilla as described by Altenburger and Ingervall.…”

Section: Discussionmentioning

confidence: 99%

Dentoskeletal Effects and “Effective” Temporomandibular Joint, Maxilla and Chin Changes in Good and Bad Responders to van Beek Activator Treatment

Ruf

Bendeus

Pancherz

et al. 2007

The Angle Orthodontist

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Objective: To assess possible differences in dentoskeletal effects and ''effective'' temporomandibular joint, maxilla, and chin changes between good and bad responders to van Beek activator treatment. Materials and Methods:The subject material consisted of 20 consecutive normodivergent male Class II division 1 patients treated with a van Beek activator. Because of insufficient cooperation, four patients were excluded. Lateral head films were taken 6 months before treatment, at start of treatment, and after 12 months of treatment. The patients were placed into a good responder group (successful, n ϭ 8) and a bad responder group (unsuccessful, n ϭ 8). An overjet reduction Ն4 mm was considered successful. Results: During the van Beek treatment period, the good responders showed a significantly larger improvement in overjet and molar relationship than did the bad responders. The good responders exhibited a significant posterior development of condylion, less anterior mandibular autorotation, retrusion of upper incisors, protrusion of lower incisors, distalization of maxillary molars, and a mesial movement of mandibular molars. No significant dental movements were seen in the bad responders. Conclusions: Although van Beek activator treatment affected the direction of condylar growth, as well as the direction of maxilla and chin changes, it can be concluded that skeletal changes did not contribute to the Class II correction. Instead, overjet reduction during van Beek activator treatment was found to be due to a favorable dental reaction.

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“…In these types of patients, their prepubertal status can be made use of by functional appliances; however, the difficulty arises in selecting the right kind of appliance for the right patient. [12][13][14] In case of conventional activator being used, the retractor group of muscles will force the mandible backwards, whereas the construction bite taken will prevent the dentoalveolar segment to react to the muscular forces; hence, the lower incisors tend to procline which is a normal compensation for a class II skeletal pattern. 15 Many activator and activator headgear studies 6,[8][9][10][16][17][18] have reported a retroclination of upper incisors.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Cephalometric Evaluation of Dental Changes with Activator and Activator Headgear Combination in the Treatment of Skeletal Class II Malocclusion

Kumar¹,

Maheshwari²

2011

The Journal of Contemporary Dental Practice

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Aim:The aims of this study were to evaluate the dental changes brought about by activator and activator headgear combination (ACHG) and to determine whether we can achieve control over the lower incisor proclination which is a side effect of using functional appliances; or not, while treating cases of skeletal class II malocclusions.Methods: Lateral cephalograms of 45 skeletal class II division 1 patients were selected for the study. Fifteen of them were successfully treated with an Andresen activator and the other 15 with an activator headgear combination. Fifteen class II subjects who had declined treatment served as the control group. Cephalometric landmarks were marked by one author to avoid interobserver variability. Results:The results revealed that both the activator and the activator headgear combination significantly (p < 0.001) affected dental variables measured. The mandibular incisor proclination was effectively controlled in the activator headgear combination group. Conclusion:An activator headgear combination would offer itself as a better option compared with activator alone in the treatment of skeletal class II malocclusions especially in cases with proclined mandibular incisors.Clinical significance: When one of the treatment goals is to achieve a greater control over mandibular incisor proclination in the treatment of Skeletal Class II malocclusions, employing a combination of activator and headgear may substantially improve clinical outcomes.

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Growth and treatment changes in patients treated with a headgear-activator appliance

Cited by 53 publications

References 37 publications

Treatment effects of the mandibular anterior repositioning appliance in patients with Class II skeletal malocclusions

Treatment effects of the mandibular anterior repositioning appliance in patients with Class II skeletal malocclusions

Dentoskeletal Effects and “Effective” Temporomandibular Joint, Maxilla and Chin Changes in Good and Bad Responders to van Beek Activator Treatment

A Retrospective Cephalometric Evaluation of Dental Changes with Activator and Activator Headgear Combination in the Treatment of Skeletal Class II Malocclusion

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