Article

A systematic review of cephalometric facial soft tissue changes with the Activator and Bionator appliances in Class II division 1 subjects

Orthodontic Graduate Program and Cranio-facial and Oral-health Evidence-based Group, Faculty of Medicine and Dentistry, University of Alberta, Canada.
The European Journal of Orthodontics (Impact Factor: 1.39). 01/2007; 28(6):586-93. DOI: 10.1093/ejo/cjl034
Source: PubMed

ABSTRACT The objective of the present systematic review was to evaluate, through lateral cephalograms, facial soft tissue changes after the use of the Activator and Bionator appliances in Class II division 1 malocclusion subjects. Several electronic databases (PubMed, Medline, Medline In-Process and Other Non-Indexed Citations, Cochrane Database, Embase, Web of Sciences, and Lilacs) were searched with the assistance of a senior health sciences librarian. Abstracts, which appeared to fulfil the initial criteria, were selected by consensus. The original articles were then retrieved. Their references were also hand searched for possible missing articles. Clinical trials, which assessed facial soft tissue changes with the use of either an Activator or a Bionator appliance without any surgical intervention or syndromic characteristics, were considered. A comparable untreated control group was required to factor out normal growth changes. Five articles using the Activator and six using the Bionator fulfilled the selection criteria and quantified facial soft tissue changes. An individual analysis of these articles was undertaken and some methodological flaws were identified. Based on the available evidence, a significant amount of controversy regarding the soft tissue changes produced by the Activator and the Bionator exists. Soft tissue changes that were reported as being statistically significant were of questionable clinical significance. Long-term, double-blinded, prospective randomized clinical trials are needed to confirm the findings. Three-dimensional quantification is also required to overcome current limitations in our understanding of the soft tissue changes obtained with the use of removable functional appliances.

1 Follower
 · 
149 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Summary Objective: To assess the treatment effects of fixed functional appliances (FFAs) in treated versus untreated Class II patients by means of lateral cephalometric radiographs. Search methods: Unrestricted electronic search of 18 databases and additional manual searches up to October 2014. Selection criteria: Prospective randomized and non-randomized controlled trials reporting on cephalometric angular measurements of Class II patients treated with FFAs and their matched untreated controls. Data collection and analysis: Skeletal, dental, and soft tissue cephalometric data were annualized and stratified according to the time of evaluation in effects. Following risk of bias evaluation, the mean differences (MDs) and 95 % confidence intervals (CIs) were calculated with random-effects models. Patient- and appliance-related subgroup analyses and sensitivity analyses were performed with mixed-effects models. Results: Nine studies were included (244 patients; mean age: 13.5 years and 174 untreated controls; mean age: 12.8 years) reporting on cephalometric effects directly after the removal of FFAs. FFAs were found to induce a small reduction of SNA angle (MD = −0.83 degree/year, 95 % CI: −1.17 to −0.48), a small increase of SNB angle (MD = 0.87 degree/year, 95 % CI: 0.30–1.43), and moderate decrease of ANB angle (MD = −1.74 degree/year, 95 % CI: −2.50 to −0.98) compared to untreated Class II patients. FFA treatment resulted in significant dentoalveolar and soft tissue changes. Several patient- or appliance-related factors seem to affect the treatment outcome. Long-term effectiveness of FFAs could not be assessed due to limited evidence. Conclusions: According to existing evidence, FFAs seem to be effective in improving Class II malocclusion in the short term, although their effects seem to be mainly dentoalveolar rather than skeletal.
    The European Journal of Orthodontics 05/2015; DOI:10.1093/ejo/cjv034 · 1.39 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background The purpose of this study was to evaluate the long-term behavior of the interlabial gap in patients with Class I and Class II malocclusion after orthodontic treatment and to investigate whether interlabial gap behavior is related to treatment with or without extraction. Methods Lateral head-films at the pre- and post-treatment and long-term follow-up stages were obtained from 61 patients who initially had Class I or Class II malocclusion and with pre- and post-treatment lip incompetence, who were treated with or without extraction. Dependent and independent Student's t tests were used for the intra- and intergroup comparisons. Results There were significant interlabial gap reductions of 1.64 and 1.72 mm in Class I and II, respectively, but there was no significant intergroup difference. Nonextraction patients had significantly greater interlabial gap reduction (2.7 mm) than did extraction patients (1.3 mm) in the long-term. Conclusions It was concluded that the interlabial gap decreases significantly and similarly in treated Class I and Class II malocclusion patients and that nonextraction treatment has greater interlabial gap reduction than does extraction treatment in the long-term post-treatment period.
    12/2013; DOI:10.1016/j.ejwf.2013.11.001
  • [Show abstract] [Hide abstract]
    ABSTRACT: Clinicians have hypothesized that lip competence is related to dental inclination, overjet, and overbite. Though some studies have been made to clarify this interrelation, a distinctive conclusion has not been reached. Studies have further shown that some subjects with normal occlusion show lip incompetence. Considering this, it could be hypothesized that dento-facial morphology plays a role in the causes of lip incompetence. To establish this it is necessary to distinguish dento-facial morphology factors from occlusal conditions such as overjet or overbite.A number of methods evaluate lip sealing: visual examination, cephalometric radiographs, and others; however these methods make determinations for short periods, and none evaluate the lip competence directly.The purpose of this study is to elucidate a correlation between lip competence and dento-facial morphology using subjects with normal occlusion, excluding overbite and overjet factors, with a sufficiently reproducible and reliable method to evaluate lip sealing.The study shows that individuals with normal occlusion (n=30) can be divided into 3 groups based on lip sealing ability: a competent, a partially competent, and an incompetent group. Statistical evaluations showed morphologically significant differences between these groups on SNA, ANB, NA-Pog, NPog-A, ANS-Me, N-ANS/ANS-Me, ANS-Me/N-Me, Wits appraisal, L1-MP, NPog-U1, NPog-L1, and FMIA measurements.According to the results, more skeletal class II relationships, longer anterior lower facial height, and a backward positioned Pogonion were observed, in the group with lip incompetence.
    Orthodontic Waves 03/2009; 68(1):12-19. DOI:10.1016/j.odw.2008.11.002

Preview

Download
2 Downloads