Dental and skeletal components of Class II open bite treatment with a modified Thurow appliance

Dental Press J Orthod. 2014 Jan-Feb;19(1):19-25. doi: 10.1590/2176-9451.19.1.019-025.oar.

Abstract

Introduction: Due to the lack of studies that distinguish between dentoalveolar and basal changes caused by the Thurow appliance, this clinical study, carried out by the School of Dentistry--State University of São Paulo/Araraquara, aimed at assessing the dental and skeletal changes induced by modified Thurow appliance.

Methods: The sample included an experimental group comprising 13 subjects aged between 7 and 10 years old, with Class II malocclusion and anterior open bite, and a control group comprising 22 subjects similar in age, sex and mandibular plane angle. Maxillary/mandibular, horizontal/vertical, dental/skeletal movements (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6) were assessed, based on 14 landmarks, 8 angles (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) and 3 linear measures (N-Me, ANS-Me, S-Go).

Results: Treatment caused significantly greater angle decrease between the palatal and the mandibular plane on the experimental group, primarily due to an increase in the palatal plane angle. ANB, SNA and S-N-ANS angles significantly decreased more in patients from the experimental group. PNS was superiorly remodeled. Lower face height (ANS-Me) decreased in the experimental group and increased in the control group.

Conclusions: The modified Thurow appliance controlled vertical and horizontal displacements of the maxilla, rotated the maxilla and improved open bite malocclusion, decreasing lower facial height.

Introdução: devido ao número reduzido de estudos que distinguem entre as mudanças dentoalveolares e ósseas produzidas pelo aparelho de Thurow, esse estudo clínico, conduzido pelo departamento de Ortodontia da Faculdade de Odontologia de Araraquara, foi proposto para avaliar as mudanças dentárias e esqueléticas induzidas pelo aparelho de Thurow modificado.

Métodos: a amostra incluiu um grupo experimental de 13 indivíduos, entre 7 e 10 anos de idade, com má oclusão Classe II e mordida aberta anterior, e um grupo controle de 22 indivíduos, com idades, plano mandibular e má oclusão similares. Com base em 14 pontos cefalométricos, 8 ângulos (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) e 3 medidas lineares (N-Me, ANS-Me, S-Go), foram avaliados movimentos maxilares e mandibulares horizontais e verticais dentários e esqueléticos (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6).

Resultados: o tratamento produziu diminuição significativamente maior no ângulo entre o plano palatino e o plano mandibular do grupo controle, devido ao aumento do ângulo do plano palatino. Os ângulos A-N-B, S-N-A e S-N-ANS diminuíram significativamente mais no grupo tratado. A PNS sofreu remodelação superior. A altura facial inferior (ANS-Me) diminuiu no grupo tratado, ao passo que aumentou no grupo controle.

Conclusões: o aparelho controlou deslocamento vertical e horizontal da maxila, rotacionou a maxila para melhorar a mordida aberta e diminuiu a altura facial inferior.

Keywords: Angle Class II malocclusion; Open bite; Orthopedics.

Publication types

  • Comparative Study

MeSH terms

  • Alveolar Process / pathology
  • Anatomic Landmarks / pathology
  • Case-Control Studies
  • Cephalometry / methods
  • Child
  • Chin / pathology
  • Extraoral Traction Appliances*
  • Female
  • Follow-Up Studies
  • Humans
  • Incisor / pathology
  • Male
  • Malocclusion, Angle Class II / pathology
  • Malocclusion, Angle Class II / therapy*
  • Mandible / pathology
  • Mandibular Condyle / pathology
  • Maxilla / pathology
  • Molar / pathology
  • Nasal Bone / pathology
  • Open Bite / pathology
  • Open Bite / therapy*
  • Orthodontic Appliance Design*
  • Palatal Expansion Technique / instrumentation
  • Palate / pathology
  • Retrospective Studies
  • Rotation
  • Sella Turcica / pathology
  • Tooth Movement Techniques / instrumentation
  • Vertical Dimension