Tratamento da classe II hiperdivergente com o aparelho extra bucal de Thurow modificado

Objectives: natural dentofacial changes and that induced by the Thurow modified extra oral appliance (TMEOA) were evaluated in this prospective study. Methodology: the data consisted of fifteen Class II division 1 children 7 to 10 years old, with anterior open bite and hiperdivergent facial pattern treated with the Thurow appliance and of fifteen Class II division 1 children followed longitudinally from 6 to 12 years of age without treatment (Burlington Growth Centre, Toronto University, Canada). The analyses were based in traditional measurements obtained in lateral cephalometric radiographs scanned with the aid of the software Radiocef Studio®. Radiographs were taken in the beginning and after 1 year of treatment for the treated group and at the 6, 9 and 12 years of age for the control group. Results: the data analysis showed that the TMEOA significantly reduced the SNA, ANB, AOBO, SNPOc SNPM, SGO/NMe, OJ e OB. On the other hand the appliance did not interfere with the SNB e SNPP. The natural growth promoted significant change in the ANB, AOBO, SNPOc, OJ e OB from 6 to 9 years and in the SNB, SNPOc e SGo/NMe from 9 to 12 years. The restriction of the maxillary growth (SNA), reduction of the skeletal discrepancy (ANB) and the reduction of the overjet (OJ) were significant with the treatment considering the natural growth as verified in the control group. Conclusion: the TMEOA corrected the skeletal Class II malocclusion by maxillary restriction, reducing the overjet, closing the anterior open bite and decreasing both the hyper divergent facial pattern and mandible plane inclination.

Aparelho Herbst x osteotomia sagital mandibular bilateral no tratamento do padrão II, classe II, divisão 1 em adultos: relato de casos

Two treatment options are available for adult patients with skeletal Class II malocclusion caused by mandibular deficiency: combined mandibular advancement surgery and orthodontic treatment or mandibular advancement appliance. This study aimed to analyze the effects of two therapeutic modalities of Class II malocclusion treatment with mandibular deficiency. Two distinct individuals with Class II malocclusion division 1 and mandibular deficiency were treated after growth spurt. The first individual used the Herbst appliance as a therapeutic option and the second individual was treated with bilateral sagittal osteotomy. The cephalometric, occlusion and face results were evaluated for both individuals. Correction of Class II malocclusion was observed on both Herbst and surgery patients resulting on a normal occlusal relationship with normal overjet and overbite. Therefore it was concluded that Herbst appliance can be used to treat borderline skeletal Class II in adult patients.

Avaliação anteroposterior da posição da mandíbula em crianças dolicofaciais com má oclusão Classe II, divisão 1 de Angle

In this study, it is proposed to evaluate the anteroposterior position of mandible in children with Angle Class II, division 1 malocclusions, to compare two different methods of evaluating the jaw position and verifying the correlation between these two methods. We selected 26 Brazilian children with vertical growth pattern and Angle Class II, division 1 malocclusions, aged between 7 years and 8 months to 9 years and 6 months. The evaluation of the anteroposterior position of the mandible was performed with the use of lateral cephalograms by cephalometric angular SNB and linear Pog-Nperp. Based on the results obtained, it was concluded that the SNB identified more children with mandibular retrusion than Pog-Nperp; the increased tip of the SN plane may have decreased values of SNB; Pog-Nperp minimizes the possibility of error in the anteroposterior position of the mandible, since it eliminates the variable tip of the anterior skull base (SN plane); none of the cephalometric measurements used are able to eliminate the influence of the nasion point in the anterior-posterior and vertical position; correlation between SNB and Pog-Nperp is very low.

Avaliação cefalométrica das alterações do perfil facial naturais e induzidas pelos aparelhos de Herbst e Bionator no tratamento da má oclusão de classe II, divisão 1ª

The aim of this study was to evaluate the facial profile changes due to natural growth and induced by Herbst appliance and Bionator in the treatment of Class II, division 1 malocclusion. In order to do that, we used a sample of 90 lateral radiographs of 45 individuals in pre-pubertal stage, divided up in two experimental groups and one control. The first group, composed of 15 brazilian individuals, with initial mean age of 9.4 years, was treated with the Herbst appliance for a period of seven months. The second experimental group consisting of 15 brazilian individuals, initial mean age of 9.9 years has gone through bionator therapy for an average period of 21 months. The control group of 15 individuals, who were not treated orthodontically, comes up from the Burlington Growth Centre, University of Toronto, Canada. The intragroup comparison was performed using the Student t test and intergroup comparisons by ANOVA complemented by the Bonferroni test. The results have shown that only the group treated with the Herbst appliance presented significant changes in facial profile with improvement of its convexity and lower lip protrusion.

Efeitos do aparelho de Herbst no tratamento proecoce da má oclusão classe II de Angle

Due to its high prevalence in general population, Angle Class II malocclusion has been widely studied by several authors, as well as the methods for its treatment. Among the possible treatment methods stands out the Herbst appliance. Reintroduced more than three decades ago in the orthodontics community, it became the most utilized appliance because it does not require patient compliance, and provides continued action through bilateral telescopic tubes. The objective of the present article was to demonstrate the early treatment of Class II Division 1 malocclusion with mandibular retrusion using Herbst appliance.

Eficiência do aparelho Herbst bandado na correção da Classe II divisão 1 -relato de caso

The current reports the case of a young patient with malocclusion Class II division 1 on permanent dentition treated in two stages, rthopedics and orthodontics, respectively. At first, the banded Herbst appliance was used duringa 7 months period, followed by a T4K appliance, Trainer for Kids used as retention, and on the second stage the corrective Orthodontics was performed. The results showed the acquirement of a Class I dental relationship, which was kept stable, with excellent intercuspation, even after 5 years of the removal of the Herbst appliance, as well as the correction of the overjet and the reduction of the facial profile convexity. It can be concluded that the Herbst appliance was very efficient in correcting the Class II malocclusion, long term, also providing a very favorable effect on the facial profile.

Estudo em telerradiografia em norma de 45º no tratamento da classe II com aparelho de Herbst

The aim of this retrospective study was to evaluate mandibular and maxillary changes induced by the use of Herbst applianceand by natural growth through oblique cephalometric radiographs in children with Class II division 1 malocclusion with mandibular retrusion. A sample of 49 individuals with age ranging from 8 to 10 years old (before growth peak) with Class II division 1, were into two groups: Herbst treated group (n=24) and control group (n=25). Both groups were paired for gender and chronological age. Statistical analysis was performed through Student’s t test. The Herbst appliance promoted the Class II correction in a 7 months period by mesialization of lower permanent first molars and distalization of upper permanent first molars. The Herbst appliance had no influence over the mandibular structure or the mandibular length. It was concluded that early treatment with Herbst appliance corrected the Class II malocclusion by means of dentoalveolar changes.

Tratamento da classe II divisão 2 com aparelho de Herbst após o pico de crescimento puberal

Patients with Class II division 2 malocclusion and mandibular retrusion have limited treatment options after the growth peak, such as surgical-orthodontic treatment or mandibular advancement devices. Among bite-jumping devices, the Herbst appliance allows greater increase of mandibular growth since it does not require patient compliance and allows continuous use. This case report presents the treatment of a Class II division 2 malocclusion in a patient after growth peak, performed in two stages. The first stage included the upper incisors proclination and overjet increase with multibracket appliance to benefit next stage. The second stage involved mandibular advancement using Herbst appliance aiming to correct the Class II molar relationship. The treatment resulted in a stable occlusion with periodontal health, normal functions and facial aesthetics improvement. Dental and skeletal changes arising from treatment could be assessed by cephalometric analysis and superimposition of pretreatment and post-treatment cephalometric tracings. Antero-posterior discrepancy was corrected by means of dental movement as well as by mandibular growth increment stimulated by the Herbst appliance.

Aparelho de Thurow modificado e aparelho ortodôntico fixo no tratamento da classe II com mordida aberta anterior

This work had aim to present two clinical cases with open bite Class II malocclusion that treated in the phase of the mixed dentition with the modified Thurow appliance and in the permanent dentition with fixed appliance. The dentoskeletal effects of these appliances were carefully analyzed with the aid of metallic implants inserted in both maxilla and mandible. The correction of the malocclusion and the improvement of the skeletal, dental and facial relationship were observed in both cases. The modified Thurow appliance followed by fixed-appliance as a two-phase treatment protocol revealed to be an effective treatment approach for the two young people that initially presented a Class II division 1 malocclusion associated to anterior open bite presented.

Avaliação das alterações dentárias e esqueléticas induzidas pelo uso do aparelho de Herbst no tratamento da classe II na dentadura mista: Revisão sistemática

Objective: evaluate the immediate dental and skeletal changes induced by the Herbst appliance on early treatment of Angle´s Class II malocclusion. Material and Method: several electronic databases such as Scopus, Pub Med, Medline, Cochrane Library, Lilacs and Scielo were searched. The abstracts that fullfilled the selection criteria were selected and those that did not provide enough information about these criteria were selected but the final decision of including them or not on the research, was taken after the complete reading of the article. The selection criteria were: clinical studies with Class II individuals, both male and female, with initial age of 7 to 10 years, treated with the Herbst appliance that analysed the dental and/or skeletal changes evaluated on lateral cephalometric radiographs; researches where the treatment performed did not involve extractions or surgical interventions; studies that included patients without syndromes or health concerns and articles published in English or Portuguese. Results and Conclusions: five articles were selected. The articles showed that significant changes happened in the mandibular sagittal lenght, on facial convexity angle, on maxillo-mandibular relationship, on retroclination of the upper incisors and on distal movement of the upper molars, on proclination of the lower incisors and on extrusion of the lower molars. The appliance exerted a limited effect on the anterior relocation of the maxillary complex and on facial heights. However, more studies about the performance of the Herbst appliance on early treatment of Class II are needed.

Estabilidade oclusal a longo prazo de Classe II, divisão 1, após tratamento com extração de pré-molares

Patients are looking for esthetic and functional changes when seeking orthodontic treatment and expect the remaining of a stable occlusion. Occlusion stability is one of the goals of the orthodontist; however, dental relationships changes in long-term can occur leading to a relapse of the treatment. Teeth and shape of arches tend to return to the original form, been the retention phase important after the appliance removal, even after several years of post-treatment. This article approaches a submission of a clinical case of Class II division 1 treated with extraction of premolars analyzing its long-term stability.

Tratamento da má-oclusão de classe II divisão 1 de Angle, com aparelho de Herbst splint metálico seguido de aparelho fixo, na dentição permanente

The Herbst appliance is currently one of the most used appliances for the correction of Class II division 1 with mandibular retrusion. When used in peak, or just after the peak of growth it can result in some skeletal gain, which is favorable to the correction of anteroposterior discrepancy with effective and stable results. This article aims to report a case of a patient with malocclusion Class II division 1 with mandibular retrusion, associated with maxillary protusion, treated in two stages: with Herbst splint metallic appliance followed by fixed appliance orthodontic treatment.

Tratamento da má oclusão de classe II com aparelho Jasper Jumper

The Jasper Jumper appliance was developed as a fixed orthopedic device that is connected to the upper and lower leveling arches to promote the Class II correction by restricting the maxillary growth (headgear effect), mandibular growth inducement (activator effect) and dentoalveolar changes.

Tratamento da má oclusão de classe II, divisão 1, na dentadura mista com apareljo extrabucal removivel

Extraoral appliances represent an alternative for correction of Class II malocclusions. The application of external force leads to tooth movement and influence the growth of the maxillomandibular complex. This article aims to present the removable headgear as an adjuvant in the treatment of Class II division 1 in the mixed dentition.

Aplicação da análise de jarabak, no estudo da relação entre a altura total facial anterior e posterior, em pacientes portadores de má-oclusão de classe I e classe II divisão 1 de angle, por meio de radiografias cefalométricas

ln order to predict the facial growth using Jarahak's analysis, cephalometric radiographies of 120 subjects during the mixed dentition and between 6 and 10 years of age were studied. From the total, 60 subjects (30 males and 30 females) were classified as Angle's Class I and 60 subjects (30 males and 30 females) were classified as Angle's Class II, Division 1. AIl subjects did not receive any orthodontic treatment. The proportion between anterior and posterior facial heigth (SGo-NMe) was studied, which is determined by the formula PFH x 100/ AFH = %, neither being straight (> 62% < 65), clockwise ( > 58% < 62%) and anti-clockwise ( > 65% - 80%). Mean average, standard deviation and facial height proportion (SGo - NMe) were determined for males and females according to Angle's classification of malocc!usion. Sexual dimorphism was examined with regard to different types of Angle's malocclusion and the direction of the facial growth, and the correlation of four cephalometrics measurements were analvsed