975 resultados para CMH de classe II


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Pós-graduação em Ciências Odontológicas - FOAR

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This study compared the effect of the treatment protocol for correcting Class Il malocclusion using the Herbst appliance followed by full fixed Straigh-wire mechanics, in two populations, one Brazilian and one of North American origin As a untreated control sample the data from the University of Michigan Elementary and Secondary School Growth Study (UMGS) was used. Our sample was composed of 12 males and 12 females, with initial mean age of 12 years 7 months and final mean ages of 15 years and 3 months. The Michigan patients comprised 21 females and 7 males, with an initial mean age of 11 years and 9 months and final mean age of 14 years and 4 months. The control sample was paired in number, sex and age to the treated Michigan sample. ln both treated groups, lateral cephalometric radiographs were obtained before the Herbst appliance was cemented and at the end of the fixed appliance phase, The first comparison involved the Brazil group and the untreated controls, which demonstrated that the association of the Herbst appliance followed by fixed Straight-wire appliances provoked positive effects on the dentofacial complex, improving pre-existing maxillo-mandibular relationships, besides increasing dentoalveolar compensations which contributed to correct the malocclusion. The second comparison, involved the Brazl1ian and North-American patients treated with the same protocol. Although the pre-treatment comparison showed that the two groups were not similar in all aspects, they presented almost identical therapeutic modifications, which indicate that the effect of' treatment was very similar. These results point out that, in Class ll treatment, the combination of Herbst/Straight-wire mechanics produce consistent and systematic effects, correcting or minimizing possible skeletal imbalances

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Malocclusion class II-1, is represented by a high prevalence in Brazil, being something common in orthodontic practice. One of the main characteristics of this malocclusion is jaw retrusion, by what many devices of jaw advance are presented in the literature. Being one of them Herbst's device, which is a functional and fixed device created by Emil Herbst (1905) and updated by Hans Pancherz in the decade of 80s.This device is characterized by keeping the jaw advance in a continuous way, while presenting a less active treatment, leading to an immediate aesthetic impact, and the patient cooperation is not required. To improve the anchoring and prevent the collapse of the apparatus was set up last amended version of it by Dr Raveli quoted as Herbst splint. Recent research indicates the use of this device after the peak pubertal growth, creating an appropriate response condylar. The aim of this work is to show the orthodontist a choice of how to use the splint Herbst in Class malocclusions II-1.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.