Comparison of treatment effects between the modified C-palatal plate and cervical pull headgear for total arch distalization in adults

Chong Ook Park, Noor Laith Sa'aed, Mohamed Bayome, Jae Hyun Park, Yoon-Ah Kook, Young-Seok Park, Seong Ho Han, Chong Ook Park, Noor Laith Sa'aed, Mohamed Bayome, Jae Hyun Park, Yoon-Ah Kook, Young-Seok Park, Seong Ho Han

Abstract

Objective: The purpose of this study was to evaluate the dental and skeletal effects of the modified C-palatal plate (MCPP) for total arch distalization in adult patients with Class II malocclusion and compare the findings with those of cervical pull headgear.

Methods: The study sample consisted of the lateral cephalograms of 44 adult patients with Class II Division 1 malocclusion, including 22 who received treatment with MCPP (age, 24.7 ± 7.7 years) and 22 who received treatment with cervical pull headgear (age, 23.0 ± 7.7 years). Pre- (T1) and post-treatment (T2) cephalograms were analyzed for 24 linear and angular measurements. Multivariate analysis of variance was performed to evaluate the changes after treatment in each group and differences in treatment effects between the two groups.

Results: The mean amount of distalization at the crown and root levels of the maxillary first molar and the amount of distal tipping was 4.2 mm, 3.5 mm, and 3.9° in the MCPP group, and 2.3 mm, 0.6 mm, and 8.6° in the headgear group, respectively. In addition, intrusion by 2.5 mm was observed in the MCPP group. In both groups, the distal movement of the upper lip and the increase in the nasolabial angle were statistically significant (p < 0.001). However, none of the skeletal and soft tissue variables exhibited significant differences between the two groups.

Conclusions: The results of this study suggest that MCPP is an effective treatment modality for total arch distalization in adults.

Keywords: Class II; Headgear; Orthodontic implant; Palatal plate.

Conflict of interest statement

The authors report no commercial, proprietary, or financial interest in the products or companies described in this article.

Figures

Figure 1. Linear cephalometric variables used for…
Figure 1. Linear cephalometric variables used for analysis of the effects of cervical pull headgear or the modified C-palatal plate.
Po, Porion; Pt, pterygoid; Or, orbitale; Sn, subnasale; UL, upper lip; LL, lower lip; FH, Frankfort horizontal plane; HRL, horizontal reference line; VRL, vertical reference line; TVL, true vertical line; 1, central incisor apex to HRL; 2, central incisor apex to VRL; 3, central incisor crown to HRL; 4, central incisor crown to VRL; 5, first molar apex to HRL; 6, first molar apex to VRL; 7, first molar crown to HRL; 8, first molar crown to VRL; 9, overjet; 10, overbite; 11, UL to TVL; 12, LL to TVL.
Figure 2. Angualr cephalometric variables used for…
Figure 2. Angualr cephalometric variables used for analysis of the effects of cervical pull headgear or the modified C-palatal plate.
S, Sella; N, nasion; Po, porion; Or, orbitale; FH, Frankfort Horizontal plane; PNS, posterior nasal spine; ANS, anterior nasal spine; Col, columella; A, A point; U, upper; Occ, occlusal plane point; L, lower; Go, gonion; B, B point; Me, menton; 1, SNA; 2, ANB; 3, occlusal plane angle; 4, palatal plane angle; 5, incisor mandibular plane angle (IMPA); 6, central incisor inclination; 7, first molar angulation; 8, nasolabial angle.
Figure 3. Force vectors associated with the…
Figure 3. Force vectors associated with the modified C-palatal plate. The solid line shows the force vector when the most apical hook is engaged. It results in more intrusion and more root movement of the maxillary first molars compared with the other force vectors. The dashed line shows the force vector when the most occlusal hook is engaged. It may result in slight extrusion and more distal tipping compared with the other vectors. The dotted line shows the force vector when the middle hook is engaged.

References

    1. Greenspan RA. Reference charts for controlled extraoral force application to maxillary molars. Am J Orthod. 1970;58:486–491.
    1. Haas AJ. Headgear therapy: the most efficient way to distalize molars. Semin Orthod. 2000;6:79–90.
    1. Jambi S, Thiruvenkatachari B, O'Brien KD, Walsh T. Orthodontic treatment for distalising upper first molars in children and adolescents. Cochrane Database Syst Rev. 2013;(10):CD008375.
    1. Fontana M, Cozzani M, Caprioglio A. Non-compliance maxillary molar distalizing appliances: an overview of the last decade. Prog Orthod. 2012;13:173–184.
    1. Kinzinger GS, Eren M, Diedrich PR. Treatment effects of intraoral appliances with conventional anchorage designs for non-compliance maxillary molar distalization: a literature review. Eur J Orthod. 2008;30:558–571.
    1. Caprioglio A, Cafagna A, Fontana M, Cozzani M. Comparative evaluation of molar distalization therapy using pendulum and distal screw appliances. Korean J Orthod. 2015;45:171–179.
    1. Han S, Bayome M, Lee J, Lee YJ, Song HH, Kook YA. Evaluation of palatal bone density in adults and adolescents for application of skeletal anchorage devices. Angle Orthod. 2012;82:625–631.
    1. Ryu JH, Park JH, Vu Thi, Bayome M, Kim Y, Kook YA. Palatal bone thickness compared with cone-beam computed tomography in adolescents and adults for mini-implant placement. Am J Orthod Dentofacial Orthop. 2012;142:207–212.
    1. Vu T, Bayome M, Kook YA, Han SH. Evaluation of the palatal soft tissue thickness by conebeam computed tomography. Korean J Orthod. 2012;42:291–296.
    1. Lee SM, Park JH, Bayome M, Kim HS, Mo SS, Kook YA. Palatal soft tissue thickness at different ages using an ultrasonic device. J Clin Pediatr Dent. 2012;36:405–409.
    1. Kook YA, Park JH, Kim Y, Ahn CS, Bayome M. Sagittal correction of adolescent patients with modified palatal anchorage plate appliances. Am J Orthod Dentofacial Orthop. 2015;148:674–684.
    1. Kook YA, Park JH, Kim Y, Ahn CS, Bayome M. Orthodontic treatment of skeletal class II adolescent with anterior open bite using mini-screws and modified palatal anchorage plate. J Clin Pediatr Dent. 2015;39:187–192.
    1. Sa'aed NL, Park CO, Bayome M, Park JH, Kim Y, Kook YA. Skeletal and dental effects of molar distalization using a modified palatal anchorage plate in adolescents. Angle Orthod. 2015;85:657–664.
    1. Kook YA, Bayome M, Trang VT, Kim HJ, Park JH, Kim KB, et al. Treatment effects of a modified palatal anchorage plate for distalization evaluated with cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2014;146:47–54.
    1. Park HS, Yoon DY, Park CS, Jeoung SH. Treatment effects and anchorage potential of sliding mechanics with titanium screws compared with the Tweed-Merrifield technique. Am J Orthod Dentofacial Orthop. 2008;133:593–600.
    1. Lai EH, Yao CC, Chang JZ, Chen I, Chen YJ. Three-dimensional dental model analysis of treatment outcomes for protrusive maxillary dentition: comparison of headgear, miniscrew, and miniplate skeletal anchorage. Am J Orthod Dentofacial Orthop. 2008;134:636–645.
    1. Yao CC, Lai EH, Chang JZ, Chen I, Chen YJ. Comparison of treatment outcomes between skeletal anchorage and extraoral anchorage in adults with maxillary dentoalveolar protrusion. Am J Orthod Dentofacial Orthop. 2008;134:615–624.
    1. Lee J, Miyazawa K, Tabuchi M, Kawaguchi M, Shibata M, Goto S. Midpalatal miniscrews and high-pull headgear for anteroposterior and vertical anchorage control: cephalometric comparisons of treatment changes. Am J Orthod Dentofacial Orthop. 2013;144:238–250.
    1. Chen M, Li ZM, Liu X, Cai B, Wang DW, Feng ZC. Differences of treatment outcomes between self-ligating brackets with microimplant and headgear anchorages in adults with bimaxillary protrusion. Am J Orthod Dentofacial Orthop. 2015;147:465–471.
    1. Grave K, Townsend G. Cervical vertebral maturation as a predictor of the adolescent growth spurt. Aust Orthod J. 2003;19:25–32.
    1. Kook YA, Kim SH, Chung KR. A modified palatal anchorage plate for simple and efficient distalization. J Clin Orthod. 2010;44:719–730. quiz 743.
    1. Kook YA, Lee DH, Kim SH, Chung KR. Design improvements in the modified C-palatal plate for molar distalization. J Clin Orthod. 2013;47:241–248. quiz 267-8.
    1. Kirjavainen M, Hurmerinta K, Kirjavainen T. Facial profile changes in early Class II correction with cervical headgear. Angle Orthod. 2007;77:960–967.
    1. Egolf RJ, BeGole EA, Upshaw HS. Factors associated with orthodontic patient compliance with intraoral elastic and headgear wear. Am J Orthod Dentofacial Orthop. 1990;97:336–348.
    1. Brandão M, Pinho HS, Urias D. Clinical and quantitative assessment of headgear compliance: a pilot study. Am J Orthod Dentofacial Orthop. 2006;129:239–244.
    1. Yu IJ, Kook YA, Sung SJ, Lee KJ, Chun YS, Mo SS. Comparison of tooth displacement between buccal mini-implants and palatal plate anchorage for molar distalization: a finite element study. Eur J Orthod. 2014;36:394–402.
    1. Kang JM, Park JH, Bayome M, Oh M, Park CO, Kook YA, et al. A three-dimensional finite element analysis of molar distalization with a palatal plate, pendulum, and headgear according to molar eruption stage. Korean J Orthod. 2016;46:290–300.

Source: PubMed

3
Abonnere