Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.05717
Revista de Odontologia da UNESP
Original Article

Dentoskeletal and aesthetic effects of mandibular protraction appliance (MPA) using Ricketts analysis

Efeitos dentoesqueléticos e tegumentares do aparelho de protração mandibular (APM) usando a análise cefalométrica de Ricketts

Marcelo CHACON; José Fernando Castanha HENRIQUES; Mario VEDOVELLO FILHO; Carolina Carmo de MENEZES; Silvia Amélia Scudeler VEDOVELLO; Giovana Cherubini VENEZIAN; Adriana Simoni LUCATO

http://dx.doi.org/10.1590/1807-2577.05717 Rev. odontol. UNESP, vol.47, n1, p.7-11, 2018
PDF
Downloads: 1
Views: 1190

Abstract

Objective: This study was designed to evaluate the skeletal, dental and soft tissue effects of mandibular deficiency treatment with the mandibular protraction appliance (MPA) using 12 factors of the Ricketts analysis.

Material and method: This cross-sectional retrospective study sample consisted of a group (n = 27), with Class II malocclusion, convex facial profile, increased horizontal trespass and mandibular deficiency, with initial mean age of 12.27 and final of 15.18 years, treated with fixed appliance combined with the MPA, in an average time of 2.9 years. Initial and final radiographs were investigated using Ricketts analysis. The dependent t-test was used to compare the initial and final phases of the MPA group, with a significance level of 5%.

Result: Statistically significant differences were observed for dental changes such as retrusion (p=0.000) and palatal inclination of the maxillary incisors (p=0.000); protrusion (p=0.000) and buccal inclination of the mandibular incisors (p=0.000); increased interincisal angle (p=0.002) and improved molar ratio (p=0.003). There was also a restriction of the anterior displacement of the maxilla (p=0.000) and a decrease in the mandibular plane angle (p=0.024). The variable inferior labial protrusion with significance (p=0.000), reiterated the improvement in the profile.

Conclusion: The effects of MPA on correction of malocclusion Class II, verified by Ricketts analysis occurred predominantly by dentoalveolar changes, decrease in the Mandibular Plane Angle, and restriction of anterior displacement of the maxilla, which contributed to the improvement in the patient's profile.

Keywords

Angle class II malocclusion, functional orthopedic appliance, mandibular advancement

Resumo

Objetivo: Este estudo analisou as alterações dentárias, esqueléticas e tegumentares promovidas pelo Aparelho de Protração Mandibular (APM) por meio da análise de Ricketts.

Material e método: A amostra contou com 27 pacientes (14 meninas e 13 meninos) com má oclusão de Classe II, perfil facial convexo, trespasse horizontal aumentado e deficiência mandibular, com idade média inicial de 12,27 e final de 15,18 anos, tratados com aparelho fixo combinado com o APM. A comparação das telerradiografias iniciais (T1) e finais (T2) foi realizada pelo teste t dependente, com nível de significância de 5%.

Resultado: Observou-se diferença estatisticamente significante para a retrusão (p=0.000) e lingualização dos incisivos superiores (p=0.000), protrusão (p=0.000) e vestibularização dos incisivos inferiores (p=0.000), aumento do ângulo interincisivos (p=0.002), melhora da relação molar (p=0.003), restrição do deslocamento anterior da maxila (p=0.000), diminuição do ângulo do plano mandibular (p=0.024) e melhora do perfil facial (p=0.000).

Conclusão: O APM promoveu alterações dentoalveolares, observadas principalmente pela diminuição do ângulo do plano mandibular e restrição do deslocamento para anterior da maxila que contribuíram para a melhora do perfil do paciente.
 

Palavras-chave

Má oclusão de Classe II de Angle, aparelho ortodôntico funcional, avanço mandibular

References

Angle EH. Classification of malocclusion. Dent Cosmos. 1899;41(3):248-64, 350-7.

Cassidy SE, Jackson SR, Turpin DL, Ramsay DS, Spiekerman C, Huang GJ. Classification and treatment of Class II subdivision malocclusions. Am J Orthod Dentofacial Orthop. 2014 Apr;145(4):443-51. PMid:24703282. http://dx.doi.org/10.1016/j.ajodo.2013.12.017.

Jena AK, Singh SP, Utreja AK. Effectiveness of twin-block and mandibular protraction appliance-IV in the improvement of pharyngeal airway passage dimensions in Class II malocclusion subjects with a retrognathic mandible. Angle Orthod. 2013 Jul;83(4):728-34. PMid:23241007. http://dx.doi.org/10.2319/083112-702.1.

Burhan AS, Nawaya FR. Dentoskeletal effects of the bite-jumping appliance and the twin-block appliance in the treatment of skeletal Class II malocclusion: a randomized controlled trial. Eur J Orthod. 2015 Jun;37(3):330-7. PMid:25296729. http://dx.doi.org/10.1093/ejo/cju052.

Herbst E. New ideas and apparatus in orthodontics. Am J Orthod. 1932 July;18(9):962-9. http://dx.doi.org/10.1016/S0099-6963(32)90027-1.

Neves LS, Janson G, Cançado RH, de Lima KJ, Fernandes TM, Henriques JF. Treatment effects of the jasper jumper and the bionator associated with fixed appliances. Prog Orthod. 2014;15(1):54. PMid:25182030. http://dx.doi.org/10.1186/s40510-014-0054-9.

Giuntini V, Vangelisti A, Masucci C, Defraia E, McNamara JA Jr, Franchi L. Treatment effects produced by the twin-block appliance vs the forsus fatigue resistant device in growing Class II patients. Angle Orthod. 2015 Sep;85(5):784-9. PMid:25786056. http://dx.doi.org/10.2319/090514-624.1.

Yamazaki MS, Rosário HD, El-Haje O, Alvim-Pereira F, Paranhos LR. The use of Twin Force functional fixed orthopedic appliance in the treatment of Class II division 1 malocclusion. Int J Orthod Milwaukee. 2014;25(1):57-60. PMid:24812744.

Chiqueto K, Henriques JFC, Barros SEC, Janson G. Angle Class II correction with MARA appliance. Dental Press J Orthod. 2013 Feb;18(1):35-44. PMid:23876947. http://dx.doi.org/10.1590/S2176-94512013000100011.

Coelho CM Fo. Mandibular protration appliance for Class II treatment. J Clin Orthod. 1995 May;29(5):319-36. PMid:8617856.

Coelho CM Fo. The mandibular protraction appliance No. 3. J Clin Orthod. 1998 Jun;32(6):379-84. PMid:9852834.

Coelho CM Fo. Mandibular protraction appliance IV. J Clin Orthod. 2001 Jan;35(1):18-24. PMid:11314525.

Furquim BD, Henriques JFC, Janson G, Siqueira DF, Furquim LZ. Effects of mandibular protraction appliance associated to fixed appliance in adults. Dental Press J Orthod. 2013 Oct;18(5):46-52. PMid:24352387. http://dx.doi.org/10.1590/S2176-94512013000500009.

Pachori Y, Navlani M, Gaur T, Bhatnagar S. Treatment of skeletal class II division 1 malocclusion with mandibular deficiency using myofunctional appliances in growing individuals. J Indian Soc Pedod Prev Dent. 2012 Jan-Mar;30(1):56-65. PMid:22565519. http://dx.doi.org/10.4103/0970-4388.95584.

Jena AK, Duggal R. Treatment effects of twin-block and mandibular protraction appliance-IV in the correction of class II malocclusion. Angle Orthod. 2010 May;80(3):485-91. PMid:20050741. http://dx.doi.org/10.2319/062709-359.1.

Nedeljkovic N, Cubrilo D, Hadzi-Mihailovic M. Changes in soft tissue profile following the treatment using a Herbst appliance--a photographic analysis. Vojnosanit Pregl. 2014 Jan;71(1):9-15. PMid:24516984. http://dx.doi.org/10.2298/VSP120629033N.

Lima BP, Pinzan-Vercelino CR, Dias LS, Bramante FS, Tavarez RR. Correlation between the rotation of the first molars and the severity of class II division 1 malocclusion. Scientific World Journal. 2015;2015: 261485.

Silva NN, Lacerda RHW, Silva AWC, Ramos TB. Assessment of upper measurements in patients with mandibular skeletal Class II malocclusion. Dental Press J Orthod. 2015 Sep-Oct;20(5):86-93. PMid:26560826. http://dx.doi.org/10.1590/2177-6709.20.5.086-093.oar.

Henriques RP, Janson G, Henriques JFC, Freitas MR, Freitas KMS. Efeitos do aparelho Jasper Jumper no tratamento da má oclusão de Classe II. Rev Dent Press Ortodon Ortop Facial. 2009 Dec;14(6):82-96. http://dx.doi.org/10.1590/S1415-54192009000600011.

Ricketts RM. Cephalometric synthesis: an exercise in stating objectives and planning treatment with tracings of the head roentgenogram. Am J Orthod. 1960 Sep;46(9):647-73. http://dx.doi.org/10.1016/0002-9416(60)90172-X.

Ricketts RM, Roth RH, Chaconnas SJ, Schulhof RJ, Engle GA. Orthodontic diagnosis and planning. Denver: Rock Mountain Data System; 1982.

Dahlberg G. Statistical methods for medical and biological students. New York: Interscience; 1940.

Baumrind S, Frantz RC. The reliability of head fil measurements. 1. Landmark identification. Am J Orthod. 1971 Aug;60(2):111-27. PMid:5283996. http://dx.doi.org/10.1016/0002-9416(71)90028-5.

Siqueira DF, Almeida RR, Janson G, Brandão AG, Coelho CM Fo. Dentoskeletal and soft-tissue changes with cervical headgear and mandibular protraction appliance therapy in the treatment of Class II malocclusions. Am J Orthod Dentofacial Orthop. 2007 Apr;131(4):447.e21-30. PMid:17418708. http://dx.doi.org/10.1016/j.ajodo.2006.04.029.

Pontes LF, Maia FA, Almeida MR, Flores-Mir C, Normando D. Mandibular protraction appliance effects in Class II malocclusion in children, adolescents and young adults. Braz Dent J. 2017 Mar-Apr;28(2):225-33. PMid:28492754. http://dx.doi.org/10.1590/0103-6440201701032.
 

5a96e1690e88256f361db5bf rou Articles
Links & Downloads
1807-2577 (Electronic)
Rev. odontol. UNESP ©2024 All rights reserved.

Rev. odontol. UNESP

Share this page
Page Sections