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Prosthodontic rehabilitation of patients with Class II malocclusions.

The Angle's class II malocclusion patient challenges the prosthodontist because optimal treatment may include orthodontic therapy, orthognathic surgery, periodontics, and fixed or removable prosthodontics. Compromises in the treatment plan are necessary when patients cannot accept optimal dental treatment. However, specific prosthodontic principles should be observed. This article discusses Angle's class II malocclusions, including the theories and therapies to treat patients with this malrelationship successfully. Prosthodontic management of the malocclusion is an adjunct to other care rendered.

Dental Occlusion↗

[Anomalies of the inclination of the occlusal plane: early treatment using indirect guide-planes--electromyographic response].

We discuss five cases of ANGLE's malocclusion Classes I, II or III that were rehabilitated basically by: restoration of masticatory function (previously pathological); the use of removable orthopaedic plates with indirect guideplanes. The patients (aged 6-15 years when treatment began) now have symmetrical balanced occlusion. Surface electromyography was used to study the function of the anterior temporal, surface masseter, deep masseter and anterior digastric muscles of 12 patients during rehabilitation of severe malocclusion. Electromyograms were obtained both with and without orthopaedic guideplanes installed. There were no significant differences as regards mean resting myoelectric activity. During maximum voluntary clenching in centric occlusion, the anterior temporal muscles were the most active, followed by the surface masseters. The activity of the anterior temporal muscles during clenching was significantly less (P < 0.01) with guideplanes than without. During lateral displacements, the non-working side anterior temporal muscle exhibited a significantly higher potential than the other muscles monitored, especially with guideplanes installed. The activity was lees with guideplanes during swallowing.

Adolescent↗

[A morphological study of the cranial base and dentofacial structure of Japanese with Angle Class II, div. 1 malocclusion--as compared with American white with Angle Class II, div. 1 malocclusion].

The purpose of this study was to clarify the morphological differences of Angle class II, div. 1 malocclusion between Japanese and American Caucasians by comparing their cranial base and dentofacial morphology. Materials were lateral cephalograms of 61 Japanese (30 males: mean age 12y3m and 31 females: mean age 12y10m) and 67 American Caucasians (27 males: mean age 13y6m and 40 females: mean age 13y) with Angle class II, div. 1 permanent dentition. Results were as follows: 1. The anterior cranial base length in Japanese with Angle class II, div. 1 malocclusion was significantly shorter than that of American Caucasians. 2. The maxillary length in Japanese with Angle class II, div. 1 malocclusion was significantly shorter than that of American Caucasians. 3. Less than SNA, less than SNB and less than ANB showed no significant difference between Japanese and American Caucasians with Angle class II, div. 1 malocclusion. 4. The whole mandibular length in Angle class II, div. 1 malocclusion of Japanese males and American males showed no significant difference. But the mandibular body length of Angle class II, div. 1 malocclusion in Japanese females was significantly shorter than that of American ones. 5. No significant difference was observed in gonial angle when the two groups were studied. 6. As compared with American Caucasians, the backward rotation of the mandible was evidently observed in Japanese with Angle class II, div. 1 malocclusion.

Adolescent↗

An investigation into the relationship between the cranial base angle and malocclusion.

A number of authors have suggested that there is a relationship between the degree of cranial base flexion and type of malocclusion, with the angle becoming increasingly obtuse from class III through class I to class II subjects. A retrospective cephalometric study was carried out to examine the contribution of cranial base angle in the four groups of malocclusion as classified by the British Standards Institution. Results showed that the cranial base flexure does not play a pivotal role in determining malocclusion. Jaw size, however, was significantly different between the main classes of malocclusion. The maxilla was found to be longer in class II subjects and the mandible longer in class III subjects.

Analysis of Variance↗

Prevalence of dentofacial characteristics in a belgian orthodontic population.

The aim of this retrospective study was to provide quantitative information on the prevalence of dentofacial characteristics to find correlations between them and to determine the orthodontic treatment need in a Belgian orthodontic population. Data were acquired from 1,477 patients who had initial records made at the Department of Orthodontics, Katholieke Universiteit Leuven, Belgium between February 1983 and June 1997. The prevalence of Angle Class I, Class II div. 1, Class II div. 2 and Class III malocclusions was, respectively, 31%, 52%, 11% and 6%. The male-to-female ratio was 4:6. Spacing and trauma to teeth occurred more in males than in females. The prevalence of the following dentofacial characteristics was significantly different between the Angle classes: segmental crossbite; crossbite of one tooth; facial asymmetry; protral and lateral mandibular shift; horizontal and vertical growth patterns, impacted teeth; traumatised teeth; ectopically erupting canines; age at first records. No significant difference in the prevalence of the Angle classes between the sexes was found. Several clinically relevant correlations were found between the examined dentofacial characteristics. This Belgian orthodontic population from the Leuven region seems to be comparable to other orthodontic populations in Europe.

Adolescent↗

Postpharyngeal lymphoid tissue in Angle Class I and Class II malocclusions.

Opinions differ with regard to the relationship of adenoids and type of malocclusion. To study this possible relationship, xeroradiographic lateral cephalograms were made of eighty Class I (Angle) and sixty-four Class II, Division 1 (Angle) malocclusions to obtain reliable measures of the epipharyngeal lymphoid tissue, the nasopharyngeal airway, the nasopharynx, and certain cephalometric landmarks. Xeroradiographic cephalograms provide superior visualization with edge-enhancement effect for both soft and hard tissues. Electronic digitization and a comprehensive computer analysis were used to assess the head films. Significant differences were found for some of the linear and angular cephalometric criteria between the two malocclusion categories. A sexual dimorphism was observed. These skeletal and dental differences were anticipated in this mixed malocclusion sample, as prior cephalometric studies which compare different classes of malocclusion have shown. Airway space did not appear to vary with the type of malocclusion. Some low-level correlations were found between the size of the nasopharyngeal area and certain skeletal characteristics. These correlations depended on both the malocclusion type and the sex of the individual. The lateral, two-dimensional cephalogram does not seem to offer satisfactory information relating the nasopharyngeal area to Class I or to Class II, Division 1 malocclusions.

Cephalometry↗

Treatment of Class II high angle malocclusions with the Herbst appliance: a cephalometric investigation.

The purpose of this study was to examine the results of treatment of Class II malocclusions by using two different designs of the Herbst appliance. Cephalometric records from lateral headplates of 19 consecutively treated Class II cases were evaluated. The headplates were taken before and after the treatment stage in which the Herbst appliance was used. The patients were divided into two groups: the first group, normohypodivergent, was treated with the Herbst appliance attached to bands; the second group, hyperdivergent, was treated with the Herbst appliance attached to acrylic splints in which a high-pull headgear was also used. The results were compared between these groups and with a control group age-matched from Bolton standards to match the changes in the Herbst samples against what might be expected in case of normal growth during similar periods of time. The results of the investigation revealed the following: (1) 9 months of treatment resulted in Class I dental arch relationships in all 19 cases; (2) the Herbst appliance attached to bands did not significantly modify the vertical growth pattern of the normohypodivergent patients; and (3) in hyperdivergent patients, the use of a Herbst appliance attached to acrylic splints in conjunction with the use of a high-pull headgear allowed a better control of the vertical dimension, as assessed by the cephalometric parameters (FA, FMA, Go-Gn-SN). The clinician should be aware of the different dentofacial changes induced in the vertical plane by different designs of the Herbst appliance to better program treatment strategy.

Adolescent↗

Craniofacial morphology in children with Angle Class II-1 malocclusion with and without deepbite.

The craniofacial morphology of children with Class II-1 malocclusion with and without deepbite was studied and compared with that of a control group of children with normal occlusion. Common for the Class II-1 children was a short mandibular corpus, which was probably the main reason these children had a distal basal jaw relationship. The Class II children with deepbite differed from the control group in ways. They had: 1) a distal relationship between points A and B; 2) a distal relationship between points A and pogonion; and 3) a discrepancy in length between the corpora of the two jaws. These deviations discriminated nearly 95% correct between the deepbite group and the controls. The most characteristic deviations in the Class II children without deepbite, in relation to the controls, were: 1) a distal relationship between points A and B; 2) a small angle between the nasal plane and the anterior cranial base; and 3) a long mental process. These deviations discriminated about 95% correct between the experimental group and the controls. Many of the craniofacial differences between the Class II groups could, theoretically, be explained by the MP-SN angle being, on average, 9 degrees larger in the children without deepbite. Most typical was that this group has 1) a larger lower anterior face height, 2) larger maxillary and mandibular incisal heights, and 3) a more obvious distal relationship between points A and pogonion. In combination, these differences discriminated correctly between the Class II groups in 90% and 97% of the cases.

Adolescent↗