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Objectives To investigate the skeletal and dental changes during chincup versus facemask treatment, to compare the long-term effects of the two appliances, and to document the impact of each on treatment success. Methods In all, 61 patients with Class III syndrome were retrospectively analyzed at three examination times: 7.8 ± 1.7 years of age (T0, pretreatment), 9.6 ± 2.4 years of age (T1, posttreatment), and around 15–20 years later (T2, long-term follow-up). Results Significant changes of specific cephalometric parameters for all treatment times: T0–T1 (SNA, interbase and gonial angle, Björk’s sum angle, maxillomandibular differential, and distance of upper lip to esthetic line), T1–T2 (NL-NSL, SNB, mandibular-body length, effective mandibular length, and effective maxillary length), and T0–T2 (mandibular-body length, effective mandibular length, effective maxillary length, maxillomandibular differential, SNB, ANB, gonial angle, Björk’s sum angle, and Wits appraisal). The T1–T2 results illustrate that in both treatment groups the typical Class III growth pattern often reappeared after treatment, including gains in SNB angle, condylion-gnathion length, and gonion-menton distance. Conclusions Either a facemask or a chincup may be effectively used to treat Class III malocclusion. There were differences in long-term stability. Maxillary development was similarly favorable in both groups of patients with successful outcome. The subgroup in whom chincup treatment had failed were mainly characterized by excessive mandibular growth, or lack of maxillary catch-up growth, with deterioration of the maxillomandibular relationship notably in the initial phase of treatment. Early chincup treatment did not have an adverse impact on the temporomandibular joints.

Objectives Despite recommendations for early treatment of hereditary Angle Class III syndrome, late pubertal growth may cause a relapse requiring surgical intervention. This study was performed to identify predictors of successful Class III treatment. Materials and methods Thirty-eight Class III patients treated with a chincup were retrospectively analyzed. Data were collected from the data archive, cephalograms, and casts, including pretreatment (T0) and posttreatment (T1) data, as well as long-term follow-up data collected approximately 25 years after treatment (T2). Each patient was assigned to a success or a failure group. Data were analyzed based on time (T0, T1, T2), deviations from normal (Class I), and prognathism types (true mandibular prognathism, maxillary retrognathism, combined pro- and retrognathism). Results Compared to Class I normal values, the data obtained in both groups yielded 11 significant parameters. The success group showed values closer to normal at all times (T0, T1, T2) and vertical parameters decreased from T0 to T2. The failure group showed higher values for vertical and horizontal mandibular growth, as well as dentally more protrusion of the lower anterior teeth and more negative overjet at all times. In adittion, total gonial and upper gonial angle were higher at T0 and T1. A prognostic score-yet to be evaluated in clinical practice-was developed from the results. The failure group showed greater amounts of horizontal development during the years between T1 and T2. Treatment of true mandibular prognathism achieved better outcomes in female patients. Cases of maxillary retrognathism were treated very successfully without gender difference. Failure was clearly more prevalent, again without gender difference, among the patients with combined mandibular prognathism and maxillary retrognathism. Crossbite situations were observed in 44% of cases at T0. Even though this finding had been resolved by T1, it relapsed in 16% of the cases by T2. Conclusion The failure rate increased in cases of combined mandibular prognathism and maxillary retrognathism. Precisely in these combined Class III situations, it should be useful to apply the diagnostic and prognostic parameters identified in the present study and to provide the patients with specific information about the increased risk of failure.

The initial effects of treatment of Class II, Division 1 malocclusion with an activator, according to Herren (27 patients), with an activator-headgear combination (20 patients), or with the Jasper Jumper appliance (25 patients) were studied on lateral cephalograms from before and after 6 to 8 months of treatment. The patients' ages ranged from 9 to 12 years. At the end of the period of observation, the correction in overjet and molar relationship was more complete in the patients with the Jasper Jumper than in the patients with the activator. Whereas all the patients with the Jasper Jumper showed neutral occlusion, this was the case in only 20 of the 47 patients with the activator. The correction of the distal occlusion occurred through a combination of skeletal and dentoalveolar adaptations. Skeletal changes accounted for 42%, 35%, and 48% of the overjet correction by the Herren-type activator, the headgear-activator, and the Jasper Jumper, respectively. The correction of the molar relationship occurred to 55%, 46%, and 38% by skeletal changes in the respective groups. Dentoalveolar compensation (distal movement of the upper molars, mesial movement of the lower molars) appeared to be inversely related to skeletal adaptation. The patients with the Jasper Jumper showed a marked intrusion of the lower incisors with a consequent reduction in overbite. (Am J Orthod Dentofac Orthop 1997;112:19-27.)

Segmental distraction osteogenesis in the maxillary alveolar process makes it possible to close alveolar clefts in patients with cleft lip and alveolus successfully. Dental spaces occurring in the lateral segment can subsequently be fully closed by transplanting teeth into this area. This new method of treatment is advantageous for patients with broad clefts and multiple missing teeth in the maxilla.

The analysis of all examined transplant cases combined treated with orthodontics shows a success rate of 76%. It must be underlined that the germ development at the time of the transplantation is of utmost importance. The best possible time proved to be at a root development of 2/3 to 3/4. Exact indication position, a careful atraumatic operation method and a short time of operation are also important factors of a successful transplantation. If all these preconditions are met, this method can be recommended.

The aim of this research was to examine the effect of the chin cap on mandibular prognathism (Angle class III) with or without a Fränkel appliance. 30 class III patients were examined. Head plates and casts made before and after active treatment were evaluated. The patients were divided into group I (initial X-ray incisivi decidui ID) and group II (initial X-ray incisivi permanentes IP). Group I (ID) showed a stronger skeletal response. Group II (IP) already showed more severe prognathic values in the initial X-rays. In group I (ID) a decrease of the gonial angle, SNB- and SNPog angle as well as an increase of both the ANB- and articulare angle were observed, however not in group II (IP) or at least not to the same extend. Overbite and overjet values reached the ideal values. In both groups dental compensation was observed.

The control of vertical development, in particular in the maxillary molar region, has often been suggested as a method of implementing sagittal change in treatment of Class II skeletal discrepancies. A group of twenty-eight Italian children in the early mixed-dentitional stage, with increased overjet and distal molar relationship, were treated orthodontically with a combination of a removable maxillary splint and high-pull extraoral traction. While only slight dorsal repositioning of the maxilla could be observed, an effective retardation of the vertical maxillary development was recorded, as well as a pronounced forward displacement of the mandibular symphysis. Distal movement of the maxillary dentition contributed likewise to the elimination of overjet observed clinically. The center of mandibular rotation was evaluated for each patient and displayed a pronounced variation illustrating different responses to the same type of appliance by different patients. The clinical implications of the above findings are discussed, and the necessity for constant appraisal of results during treatment is stressed.

Skeletal maturity was assessed in 637 Austrian children from 7 to 16 years of age. The Greulich - Pyle and the Tanner- Whitehouse -2 ( RUS and TW 20-bone) methods were used. The GP ages showed some major deviations at and after puberty, especially in boys. The RUS and 20-bone ages conformed more closely to the standards although a general advancement in RUS ages was seen in girls after the age of 10 1/2. A similar pattern in RUS ages has been reported for other populations and may indicate a secular trend.

In patients with mesial bite the outcome of treatment by chin caps and/or Fränkel's functional appliance was evaluated. Of 30 patients with Angle class III anomalies pre- and posttreatment telemetric films and models were reviewed. Patient were subdivided in 2 groups: Group I with deciduous teeth on their pretreatment films (ID) and group II with permanent teeth on their pretreatment films (IP). In group I (ID) patients treatment produced more extensive skeletal modifications than in group II (IP) patients, who had shown severer abnormalities before treatment. In group I (ID), the modifications obtained by treatment appeared to be more persistent than in group II (IP). Patients in group I (ID) showed reduction of the gonion angle, shortening of the ramus, reduction of the SNB and SNPog angles and increase of the ANB angle. In group II these parameters were not substantially improved. Overbite and overjet readings were ideal in group I (ID). Signs of dental compensation were seen in both groups.

During a one-year observation period eleven patients treated with fixed appliances and 164 brackets which had been bonded in pairs, were checked at periodic intervals. Every patient had brackets positioned on the teeth in the first and fourth quadrant without graphite marking and in the second and third quadrant with graphite marking. In a parallel in-vitro study with eight pairs of teeth the above described conditions were applied. These specimens were examined in an universal testing machine in order to determine the magnitude of the shear forces. In the in-vivo as well as in the in-vitro study no statistically significant correlations were revealed between the graphite marking and the durability of adhesion as well as the required shear force of the examined brackets. Utilising light microscopy studies, the penetration of adhesive was determined in relation to the position of the graphite marking in etched enamel; at was harmlessness of the reference medium.

The normal development of the periodontal structures was confirmed histologically on young beagle dogs following tooth germ transplants. In humans, clinical and radiographic examinations revealed no pathology of the periodontium following transplantation of tooth germs. The grafted teeth could be moved orthodontically in the same way as any other teeth. No precautions need to be taken. This paper describes the most common indications for transplanting the tooth germs of canines, bicuspids and molars.

The use of a lower headgear-yoke-Class II mechanism on an average works faster than a maxillary headgear. The distal tipping of the molars is greater with HGY-II which may be the result of the quicker tooth movement. The speed of distalization is probably due to the effect of the constant force of the Class II elastics. An orthopedic change on the maxilla could be seen if one can draw any conclusions from a change of only 1 degrees. A reduction of the SNA angle and a slight clockwise rotation of the palatal plane was noticed. These results agree with earlier investigations about cephalometric changes with headgear therapy. We have come to the conclusion that both methods are indicated. We use the upper headgear especially at a time when a complete therapy is not possible because of noneruption of the permanent teeth. The HGY-II mechanism is indicated when most permanent teeth are available and thus the therapy can be completed in one treatment period.