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Biomedical subjects

J M Battagel

Publications and source records attributed to J M Battagel.

11 recordsLinked to original sources
PubMed1991

Class III malocclusion: a comparison of extraction and non-extraction techniques.

A retrospective cephalometric study was made of the hard tissue changes in a group of 90 Class III, Skeletal III children, diagnosed as suitable for treatment by orthodontic means alone. Thirty-two were treated by a combination of upper incisor proclination and headgear to an intact mandibular dentition (Group 1), while in 28 the overjet was corrected with mid-arch extractions and Edgewise mechanics (Group 2). The remaining 30 children acted as controls (Group 3). Children were initially examined as male and female subgroups, and where no significant differences were seen data were pooled. In order to standardize the results, treatment/observation effects were presented as average changes per year. The three groups were essentially comparable pretreatment. Following overjet correction, the lower incisors uprighted in both groups, with an improved relationship to the A-Po line: the upper incisors were proclined in Group 1 only. Underlying skeletal changes were restricted to the mandible, which showed a downward and backward hinging, and an increase in lower face height. The improved mandibular position was significantly greater in the non-extraction group and was accompanied by an improvement in facial convexity. In addition, treatment could be started earlier and was completed in a significantly shorter time (Table 1). It would, therefore, appear that, in the short term at least, a non-extraction/headgear approach has advantages over a standard mid-arch extraction/Edgewise technique.

Adolescent↗
PubMed1990

The relationship between hard and soft tissue changes following treatment of Class II division 1 malocclusions using Edgewise and Fränkel appliance techniques.

Lateral-skull radiographs were used to examine the hard and soft tissue changes following overjet reduction in 62 children with moderately severe Class II division 1 malocclusions. Thirty-two patients were treated by non-extraction methods using Fränkel appliances, and the remainder by a standard Edgewise technique involving extractions and extra-oral traction. The relationships between changes in upper and lower lip positions, naso-labial angle, and labiomental fold with those in the underlying dento-skeletal elements were examined. The ratio between movement of the upper lip prominence and upper incisor crown was also calculated. Finally, the patterns of correlation between the two groups were compared. Both Spearman and partial correlations were calculated. The latter were used in an attempt to separate the true treatment effects from those of growth. This reduced the number of significant correlations considerably, 'sharpening' the results so that expected levels of agreement were enhanced, whereas spurious results were reduced. Few correlations reached a level of r = 0.7 or above. Incisor retraction was correlated with upper lip movement at this level only in the Edgewise group. No correlations were found between changes in naso-labial angle, labio-mental fold, and their underlying hard tissues. The Spearman correlations largely agreed with those of other authors, indicating that most of their apparently concordant hard and soft tissue movement was due to growth rather than appliance therapy. The use of ratios to compare upper lip and maxillary incisor retraction was not relevant in the functional appliance group because the average lip change was very small. It is concluded that the relationship between hard and soft tissue movement is too complex to be examined in a relatively simplistic way.

Activator Appliances↗
PubMed1989

Profile changes in Class II, division 1 malocclusions: a comparison of the effects of Edgewise and Fränkel appliance therapy.

Changes in facial profile following orthodontic treatment were examined, using the lateral skull radiographs of 62 children exhibiting Class II, division 1 malocclusions and an average starting overjet in excess of 11 min. Thirty were treated by the extraction of upper first premolars and Edgewise mechanics whilst the remainder wore Fränkel appliances. Linear and angular measurements were made to record both soft tissue profile and the underlying dento-skeletal structures. In the Edgewise group, overjet reduction was accompanied by a 2.4 degree reduction in SNA together with distal movement of 'A' point and the upper incisor. At the same time both the nose and chin grew forwards. Despite good positioning of the lower incisor with respect to A-Po, both lips finished well behind the aesthetic plane and the resulting profile was undesirably retrusive. By contrast, the Fränkel appliance produced a more pleasing, well-balanced profile with a more ideal relationship of the lips to the aesthetic plane. Maxillary dento-skeletal structures maintained a more prominent position within the face whilst the mandibular structures moved actively forwards.

Activator Appliances↗
PubMed1988

A Class III case--but how severe?

The treatment of a clinically moderately severe, crowded, Class III malocclusion in a pre-pubertal 12-year-old female patient, is described. At diagnosis, some difficulty was experienced in determining the severity of the skeletal element of the malocclusion. A treatment plan was chosen which permitted extensive lingual repositioning of the lower labial segment and the result remained stable several years out of retention. The reasons for this success, and the problems of reconciling cephalometric analysis with clinical judgement, are discussed.

Adolescent↗