Document Detail

Treatment strategies for patients with hyperdivergent Class II Division 1 malocclusion: is vertical dimension affected?
MedLine Citation:
PMID:  21889079     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The dilemma of extraction vs nonextraction treatment, along with the uncertain potential of orthodontic treatment to control vertical dimensions, still remains among the most controversial issues in orthodontics. The aim of this study was to evaluate 2 contradictory treatment protocols for hyperdivergent Class II Division 1 malocclusion regarding their effectiveness in controlling vertical dimensions.
METHODS: The subjects were retrospectively selected from 2 orthodontic offices that used contrasting treatment protocols. The patients had similar hyperdivergent skeletal patterns, malocclusion patterns, skeletal ages, and sexes. Group A (29 patients) was treated with 4 first premolar extractions and "intrusive" mechanics (eg, high-pull headgear), whereas group B (28 patients) was treated nonextraction with no regard to vertical control (eg, cervical headgear, Class II elastics). Twenty-seven landmarks were digitized on lateral cephalometric radiographs before and after treatment, and 14 measurements were assessed. Geometric morphometric methods were also implemented to evaluate size and shape differences.
RESULTS: As expected, the maxillary and mandibular molars translated mesially and the mandibular incisors uprighted in group A but remained approximately unchanged in group B. The vertical positions of the molars and the incisors were similar between groups before and after treatment, although they were altered by treatment or growth. No significant differences were observed in the posttreatment skeletal measurements between the 2 groups, including vertical variables, which remained unaltered. Permutation tests on Procrustes distances between skeletal shapes confirmed these results.
CONCLUSIONS: This study demonstrated the limitations of conventional orthodontics to significantly alter skeletal vertical dimensions. More important factors are probably responsible for the development and establishment of the vertical skeletal pattern, such as neuromuscular balance and function.
Nikolaos Gkantidis; Demetrios J Halazonetis; Evanggelos Alexandropoulos; Nikos B Haralabakis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics     Volume:  140     ISSN:  1097-6752     ISO Abbreviation:  Am J Orthod Dentofacial Orthop     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-05     Completed Date:  2011-10-24     Revised Date:  2012-05-07    
Medline Journal Info:
Nlm Unique ID:  8610224     Medline TA:  Am J Orthod Dentofacial Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  346-55     Citation Subset:  D; IM    
Copyright Information:
Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Department of Orthodontics, School of Dentistry, University of Athens, Athens, Greece.
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MeSH Terms
Bicuspid / surgery
Cephalometry / methods
Cohort Studies
Extraoral Traction Appliances
Malocclusion, Angle Class II / pathology,  therapy*
Maxillofacial Development
Orthodontics, Corrective / instrumentation*,  methods*
Retrospective Studies
Statistics, Nonparametric
Tooth Extraction
Vertical Dimension*
Comment In:
Am J Orthod Dentofacial Orthop. 2012 Apr;141(4):396; author reply 396-7   [PMID:  22464516 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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