Background: The aim of this study was to compare the cephalometric changes in patients Class II division 1treated with Twin Block and MARA appliances. Material and Methods: The sample comprised 66 patients with Class II malocclusion divided into 3 groups: The Twin Block group consisted of 21 patients, the MARA group of 21 patients and the control group of 24 untreated subjects. Intergroup comparisons were performed at pre- (T1) and posttreatment (T2) stages. The initial and posttreatment measures concerning changes in angular and linear variables were compared using the analysis of variance (ANOVA) and Kruskal-Wallis tests. Results: Both appliances showed improvement of the relation Class II. MARA resulted in a significant increase in FMA and the occlusal plane, 1º more than control. Twin Block revealed significantly greater increase in LAFH than the others. MARA produced a significantly greater amount of labial tipping and protrusion of the mandibular incisors than the others groups. TB showed significant extrusion of the mandibular incisors compared to MARA and extrusion of the mandibular molars in relation to the control. Both treated groups showed improvement in the overjet, overbite and molar relationship. The treatment time for MARA almost was 1 year less than TB. Conclusion: The appliances were effective in the treatment of Class II malocclusion; however, the correction was mainly due to dentoalveolar effects. / Proposição: O objetivo deste estudo foi comparar as alterações cefalométricas em pacientes Classe II divisão 1 tratados com os aparelhos Twin Block e MARA. Material e Métodos: A amostra foi composta por 66 pacientes com má oclusão de Classe II divididos em 3 grupos: o grupo Twin Block composto por 21 pacientes, o grupo MARA constituído por 21 e o grupo controle com 24 indivíduos não tratados. Comparações intergrupos foram realizadas nos estágios pré (T1) e pós- tratamento (T2). As medidas iniciais e pós-tratamento referentes as alterações nas variáveis angulares e lineares foram comparadas pelos seguintes testes: análise de variância (ANOVA) e Kruskal- Wallis. Resultados: Ambos os aparelhos apresentaram melhora na relação de Classe II. O MARA resultou em um aumento significante do FMA e do plano oclusal em relação ao controle. O Twin Block revelou um aumento significantemente maior na AFAI em relação aos outros grupos. O MARA produziu um aumento significantemente maior na inclinação vestibular e protrusão dos incisivos inferiores em relação aos outros grupos. O Twin Block promoveu significativa extrusão dos incisivos inferiores em relação ao MARA e significativa extrusão dos molares inferiores em relação ao controle. Ambos os grupos experimentais resultaram em melhora no trespasse horizontal, vertical e relação molar. O tempo de tratamento do MARA foi próximo de 1 ano a menos em relação ao Twin Block. Conclusão: Os aparelhos foram eficazes no tratamento da má oclusão de Classe II, porém a correção ocorreu em sua maior parte por efeitos dentoalveolares.

No description available.

Background and objectives: The control of anchorage is integral to successful orthodontic treatment. The objective of this research was to undertake three related projects to evaluate methods of increasing anchorage with the aim of adding to orthodontic knowledge and improve methods of treatment delivery. Methods: Two Cochrane systematic reviews were undertaken according to the methods published in the Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0. The influence of functional appliances on tooth position and the extraction decision was performed as a retrospective study using participants from a completed multicentre randomized trial. Results: 1- Statistically and clinically significant differences were found between the mean values of distal molar movement when surgical anchorage and conventional anchorage were compared. 2- Statistically significant differences were found between the mean values of distal molar movement and mesial upper incisor movement when intraoral distalising appliances and cervical headgear were compared.3- Fixed and removable functional appliances are equally effective in anchorage preparation. The type of functional appliance and time spent in Phase I treatment influenced the amount of lower incisor proclination. Conclusions: 1- Surgical anchorage is more effective than headgear without the inherent risks and compliance issues. However, intraoral appliances used in adolescence for distalisation of upper molars do not appear to have any advantages over cervical headgear. 2- Functional appliances reduce the anchorage requirements of a case primarily by reduction of the overjet, both fixed and removable functional appliances are equally effective in obtaining this. However, fixed functional appliances result in greater lower incisor proclination than removable functional appliances. 3- The type of functional appliance (removable or fixed) does not influence the extraction decision, however, this is influenced by overall space requirements.

No description available.

Introduction : Le but de cette étude rétrospective est de comparer les changements squelettiques et dento-alvéolaires causés par trois appareils myofonctionnels, soit le Twin Block (TB), le Xbow (Xb) et le Carrière® Motion 3D™ Appliance (CMA), durant la première phase de traitement pour corriger une classe II. Méthodes : Les radiographies céphalométriques latérales prétraitement (T0) et post-traitement myofonctionnel (T1) de 43 adolescents traités par un TB (15), un Xb (7) ou un CMA (21) ont été récupérées et tracées; 12 mesures squelettiques et 10 mesures dentaires ont été analysées. Les différences (T1-T0) ont ensuite été comparées entre les appareils en utilisant l’analyse ANOVA, le test-t indépendant ou le test U de Mann-Whitney. Résultats : Le traitement était, en moyenne, d’une durée de 10,1 ± 3,2 mois avec le TB et de 7,4 ± 2,7 mois avec le CMA. Le groupe TB a connu de plus grands changements au niveau de la longueur et de la position sagittale de la mandibule en augmentant Cd-Pg (3,4 mm), Pg-Go (1,3 mm), N-B (//FH) (1,3 mm) et S-N-B (1,2°) plus que le CMA. Le TB a amélioré le Wits de 2,2 mm plus que le CMA. Le TB a également démontré une plus grande rétroclinaison des incisives supérieures en diminuant U1–FH (4,2°) plus que le CMA. Le CMA a restreint le mouvement antéro-postérieur de la première molaire supérieure tandis que le TB n’a pas eu d’effet significatif sur cette variable. Le seul changement cliniquement significatif résultant du CMA était en lien avec la proclinaison des incisives inférieures, L1–MP (4,1°). Les résultats associés au groupe Xb ont été exclus en raison de la petite taille de l’échantillon. Conclusion : La correction de la classe II est obtenue à l’aide d’une combinaison d’effets squelettiques et dento-alvéolaires avec le TB, mais principalement grâce à des effets dento-alvéolaires avec le CMA. Une taille d’échantillon plus grande est nécessaire afin de mieux comparer les effets du Xb. / Introduction: The objective of this retrospective study is to compare the skeletal and dento-alveolar changes caused by three functional appliances, the Twin Block (TB), the Xbow (Xb), and the Carrière® Motion 3D™ Appliance (CMA), during the first phase of treatment for class II correction. Methods: The pre-treatment (T0) and post-functional treatment (T1) lateral cephalometric radiographs of 43 adolescent patients treated with a TB (15), an Xb (7) or a CMA (21) were recovered and traced, and 12 skeletal and 10 dental measurements were analyzed. The differences (T1-T0) between the appliances will be compared using the ANOVA analysis, independent samples t-tests, or Mann-Whitney U-tests. Results: On average, the treatments lasted 10.1 ± 3.2 months with the TB and 7.4 ± 2.7 months with the CMA. The TB group experienced greater mandibular length and sagittal position changes by increasing Cd-Pg (3.4 mm), Pg-Go (1.3 mm), N-B (//FH) (1.3 mm), and S-N-B (1.2°) more than the CMA. The TB improved the Wits appraisal 2.2 mm more than the CMA. The TB also had a superior retroclining effect on the maxillary incisor inclination and position by reducing U1–FH (4.2°) more than the CMA. The CMA restrained the antero-posterior movement of the maxillary first molar while the TB had no significant effect on this variable. The only clinically significant change that the CMA displayed was in relation to mandibular incisor proclination, L1–MP (4.1°). The results related to the Xb group were excluded due to its very small sample size. Conclusion: Class II correction is achieved by a combination of skeletal and dento-alveolar changes with the TB, but primarily through dento-alveolar effects with the CMA. A bigger sample size is required in order to properly compare the effects of the Xb.