Elastic activator for treatment of open bite.
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This article presents a modified activator for treatment of open bite cases. The intermaxillary acrylic of the lateral occlusal zones is replaced by elastic rubber tubes. By stimulating orthopaedic gymnastics (chewing gum effect), the elastic activator intrudes upper and lower posterior teeth. A noticeable counterclockwise rotation of the mandible was accomplished by a decrease of the gonial angle. Besides the simple fabrication of the device and uncomplicated replacement of the elastic rubber tubes, treatment can be started even in mixed dentition when affixing plates may be difficult. (+info)
Class II combination therapy (distal jet and Jasper Jumpers): a case report.
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Class II combination therapy is a method that combines orthodontic and orthopedic mechanics in a single stage of treatment. Molar distalization is followed by fixed functional mechanics to reduce the dependence upon patient compliance while seeking more predictable completion of Class II correction. (+info)
Class II correction-reducing patient compliance: a review of the available techniques.
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The correction of Class II malocclusions has been hampered by the use of appliances which require the patient to co-operate with headgear, elastics, or the wearing of a removable appliance. 'Non-compliance therapy' involves the use of appliances which minimize the need for such co-operation and attempt to maximize the predictability of results. This article reviews and describes the types of appliances used, and their mode of action-based on the current available research. (+info)
The temporomandibular joint and the disc-condyle relationship after functional orthopaedic treatment: a magnetic resonance imaging study.
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Causative correction of Class II skeletal malocclusions may be achieved through bite jumping by various means. Numerous animal experiments have yielded evidence of remodelled temporomandibular structures after mandibular protrusion. However, the mode and extent of structural and/or topographic changes of the disc-condyle relationship after functional orthopaedic treatment is still unresolved. A problem exists in defining the physiological position of the condyles and disc-condyle relationship, which is tentatively determined by various methods particularly in magnetic resonance tomographic studies. Despite the high resolution provided, the results have to be interpreted with caution, as osseous resorption and apposition cannot be assessed by visual evidence. This investigation examined the impact on the temporomandibular joints (TMJ), i.e. the condylar shape and position, and the disc-condyle relationship, of the bionator plus extra-oral traction in combination with vertical elastics. The underlying reactions were studied by means of magnetic resonance images (MRI) obtained from n = 15 successfully treated patients (mean age 11.6 years). (+info)
A comparative study of two mandibular advancement appliances for the treatment of obstructive sleep apnoea.
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Mandibular advancement appliances (MAAs) are accepted as a treatment option for snoring and mild obstructive sleep disorders. In the present clinical study two differently designed devices were examined for their effectiveness in treating obstructive sleep apnoea (OSA). The study was based on an assessment of 26 patients with a polysomnographic diagnosis of mild OSA [22 men, four women; mean body mass index 27.3 kg/m2 (SD 3.1); mean age 56.8 years (SD 5.2); mean respiratory disturbance index (RDI): 16.0 events/hour (SD 4.4)]. After insertion of the first MAA and a 6-8-week habituation period, a cardio-respiratory home-sleep study was carried out. Following a 2-3-week period with no treatment, the second appliance was inserted. The sequence of the devices was randomized. Once the patients had become accustomed to the second appliance, another somnographic registration was carried out. Daytime sleepiness, snoring, and sleep quality were assessed subjectively on a visual analogue scale. The results showed that a statistically significant improvement in the respiratory parameters was achieved with both appliances (P < 0.01). However, the activator [RDI: 5.5 events/hour, SD 3.3; apnoea index (AI): 3.4 events/hour, SD 2.1] was significantly more effective (P < 0.01) than the Silencor (RDI, 7.3 events/hour, SD 5.3; AI: 5.8 events/hour, SD 3.2). No difference was recorded in the subjective assessment of the therapeutic effects. Both appliances reduced daytime sleepiness and snoring and improved sleep quality, and both influenced the treatment outcome. (+info)
Effective temporomandibular joint growth and chin position changes: Activator versus Herbst treatment. A cephalometric roentgenographic study.
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In 138 successfully treated Class II division 1 patients (40 Activator and 98 Herbst) effective temporomandibular joint (TMJ) growth changes (a summation of condylar remodelling, glenoid fossa remodelling, and condylar position changes within the fossa), and their influence on the position of the chin and the rotation of the mandible were analysed retrospectively. Lateral head films in habitual occlusion from before and after an average treatment period of 2.6 years for the Activator patients and 0.6 years for the Herbst patients were evaluated. Two different treatment changes were assessed: (1) overall growth changes and (2) treatment effects (overall growth changes minus age-related normal growth values: Bolton Standards). The comparison between the Activator and the Herbst group revealed larger effective TMJ and chin changes during Activator therapy due to the longer observation period (2.6 years versus 0.6 years). The treatment effects showed marked group differences for both the amount and direction of effective TMJ changes. The changes were vertical and slightly anterior in the Activator group, and predominantly posterior in the Herbst group. Concerning the chin changes, the treatment effects for the Herbst group exceeded those for the Activator group in both directions, caudally and anteriorly. The Activator group showed an anterior rotation and the Herbst group a slight posterior rotation of the mandible. The present investigation revealed that the effective TMJ and chin changes were increased by both Activator and Herbst treatment. However, the Herbst appliance renders more favourable sagittally orientated treatment effects in a much shorter period of time compared with the Activator. (+info)
The effects of activator treatment on the craniofacial structures of Class II division 1 patients.
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The aim of the present study was to clarify the skeletal treatment effects induced by activator treatment. Fifty actively growing patients with Class II division 1 malocclusions were treated with an activator appliance. A control group consisting of longitudinal growth data from 20 patients (untreated Class II division 1 malocclusions) was used to eliminate possible differences in growth pattern. Lateral cephalograms of each patient were taken at the start and end of treatment. Final cephalograms were taken after a mean of 16.4 (+/- 2.0) months activator treatment, compared with a mean of 14.2 (+/- 2.4) months for the control group. Each cephalogram was traced and digitized by the same individual. The mean and standard deviations for linear and angular cephalometric measurements were analysed statistically, and intra- and inter-group changes were evaluated by paired- and independent-sample t-tests. At the end of the study period, the overjet was decreased in all patients. Ramus height, corpus length, anterior and posterior face height all increased significantly (P < 0.05). In the treatment group, ANB angle decreased and the bite was opened. The activator appliance caused maxillary incisor lingual tipping and mandibular incisor labial tipping. The overjet was decreased as a result of the increased forward growth of the mandible and dentoalveolar changes. The results demonstrated that the activator appliance has a characteristic skeletal and dental effect on the developing craniofacial complex. (+info)
Contemporary treatment of a crowded Class II division 1 case.
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A 12-year-old Caucasian male presented with a severe Class II division 1 incisor relationship on a mild Skeletal II base with an average maxillary-mandibular planes angle and average lower facial height. Crowding was severe in the upper arch and moderate in the lower arch. Treatment was commenced using Twin Block appliances, and followed by extractions in all four quadrants and fixed appliances. This case illustrates the versatility of the Twin Block appliance in the treatment of those cases exhibiting crowding. (+info)