PubMed · 3474194
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J M Lynn. Functionals/orthodontics/bracketing: 'a simplified approach'.. https://pubmed.ncbi.nlm.nih.gov/3474194/
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While planning treatment of the 30 patients with a dental and skeletal class II anomaly on which this study is based, the primary treatment goals were correction of the dental and skeletal structures and attenuation of vertical growth by means of influencing the maxillary skeletal structures and the resultant mandibular reaction. The desired treatment results were achieved in all patients. Even so, however, the effects on individual patients in respect to skeletal influences were markedly different. It was especially helpful that during therapy simultaneously with exerting influence on the maxillary base plane, the influencing of the occlusal plane occurred in the same direction. Through the additional application of high-pull headgear, maxillary growth was clearly restrained and the inclination of the maxillary base plane inhibited. Even difficult skeletal discrepancies, sagittal as well as vertical, can be treated with the bite-jump appliance in combination with a high-pull headgear. This also makes it possible to achieve protrusive repositioning of the mandible in patients with a pronounced vertical growth pattern without causing on open bite. In retrospective the patients' treatment plans proved to be completely appropriate, however, the fact should not be overlooked that changing the occlusal plane is essential for the realization of a positive therapeutic result.
In this study 95 patients with a malocclusion type Angle class II were treated with a bite jumping appliance and the results achieved were compared with untreated class II patients. A clear improvement in the skeletal and dental relationships was observed. Significant changes were achieved yearly in the following: 1. the angle SNA was reduced (0.82 degrees), 2. the angle SNB was increased (0.57 degrees), 3. the angle ANB was reduced (1.39 degrees). All 3 of these variables are significant. Other skeletal variables, most notably the incline of the maxilla to the line NS, were not influenced nor was the relation of posterior facial height to anterior facial height. The mandibular incisors did not exhibit increased protrusion relative to the mandibular plane. Only the angle of the mandibular incisor to NB was changed by the total protrusion of the mandible. The maxillary incisors in these cases manifested obvious lingual tipping. For this reason the orthodontist must weigh carefully on an individual patient basis, whether the use of adjunctive torque springs is required and necessary.
Pre- and post-treatment lateral radiographs of 120 former patients with skeletal class II, who had been treated with either an Andresen/Häupl type activator or bite jumping plates, were selected for this study. The evaluation results showed that bite jumping plates had a significant inhibition on the forward downward growth and the anterior rotation of the maxilla. The increase of the SNB-angle was significantly higher and there was also more posterior rotation of the maxilla in those patients, who had been treated with an activator. A two-way analysis of variance was carried out and it was possible to show that the independent treatment factors explained only 1/5 to 1/3 of the overall variance of the sample. The differences among the patients seem to depend more on individual growth patterns than just on the type of removable appliance.