The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of conventional and modified facemask therapies on dentofacial structures

변형된 페이스 마스크의 치아 및 골격적 효과

  • Yagci, Ahmet (Department of Orthodontics, Faculty of Dentistry, Erciyes University) ;
  • Uysal, Tancan (Department of Orthodontics, Faculty of Dentistry, Erciyes University, King Saud University)
  • Received : 2010.06.01
  • Accepted : 2010.08.27
  • Published : 2010.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The purpose of this prospective study was to evaluate the dentofacial effects of conventional and modified facemask therapies with rapid maxillary expansion, in a group of Class III patients; and compared with an untreated control group. Methods: The conventional facemask group (Group 1) comprised of 24 patients, 13 girls and 11 boys (mean age, $9.2{\pm}1.4$ years); the modified facemask treatment group (Group 2) comprised of 24 patients, 12 girls and 12 boys (mean age, $9.3{\pm}1.6$ years); and the control group (Group 3) comprised of 21 subjects, 11 girls and 10 boys (mean age, $9.8{\pm}1.9$ years). Treatment and control changes within the groups and the differences between the groups were analyzed statistically. Intra-group comparisons were evaluated using the non-parametric Wilcoxon's test and intergroup changes were analyzed using the Kruskal-Wallis test. The statistical significance of intergroup differences was further assessed with the Mann-Whitney test for independent samples and applying Bonferroni's correction (p < 0.016). Results: In group 1, SNB changes were less than the control. There were increases in SNA, ANB, SN-MP, A to N perp and Upper lip to E plane. In group 2, SNB, U1-NA (mm) U1-NA (${\circ}$) and Pog to N perp (mm) changes were less than the control. There were increases in SNA, ANB, SN-MP, A to N perp and Upper lip to E plane. Conclusions: Modified facemask appliance can be used effectively in Class III patients with a retrognathic maxilla. Facemask therapies with expansion resulted in an anterior advancement and translation of maxilla without rotation; and the mandible moved downward and backward ward in both treatment groups.

이번 연구의 목적은 기존의 페이스 마스크와 변형된 페이스 마스크의 치아 및 골격적 효과를 평가하고자 III급 부정교합환에서 치료군과 비치료군을 비교하였다. 24명의 환자(여자: 13명, 남자: 11)로 구성된 기존의 페이스 마스크 그룹(Group 1, mean age, $9.2{\pm}1.4$ years)과 24명의 환자(여자: 12명, 남자: 12명)로 구성된 변형된 페이스 마스크(Group 2, mean age, $9.3{\pm}1.6$ years); 그리고 21 명(여자: 11 명, 남자: 10명)으로 구성된 대조군 그룹(Group 3, mean age, $9.8{\pm}1.9$ years)으로 분류하였다. 그룹 내 그룹 간에 치료군과 대조군을 통계학적으로 분석하였다. 그룹 내 비교는 비모수적인 방법의 Wilcoxon's test으로 그룹 간의 변화는 Kruskal-Wallis test를 이용하여 분석하였다. 이후 그룹 간의 통계적인 유효성 검증을 위하여 Mann-Whitney test와 Bonferroni's correction 을 시행하였다 (p < 0.016). Group 1에서 SNB 변화가 대조군보다 적었다. SNA, ANB, SN-MP, A to N perp과 Upper lip to E plane이 증가하였다. Group 2에서는 SNB, U1-NA (mm) U1-NA ($^{\circ}$) and Pog to N perp (mm) 변화는 대조군보다 적었다. SNA, ANB, SN-MP, A to N perp과 Upper lip to E plane이 증가하였다. 변형된 페이스 마스크는 상악 열성장이 있는 III급 부정교합 환자에게 효과적으로 사용될 수 있다. 상악궁 확장을 동반한 페이스 마스크를 통하여 상악은 회전을 야기시키지 않고 전방으로 이동하였으며 모든 치료군에서 하악은 후하방으로 이동하였다.

Keywords

References

  1. Ngan P, Hagg U, Yiu C, Merwin D, Wei SH. Soft tissue and dentoskeletal profile changes associated with maxillary expansion and protraction headgear treatment. Am J Orthod Dentofacial Orthop 1996;109:38-49. https://doi.org/10.1016/S0889-5406(96)70161-0
  2. Guyer EC, Ellis EE 3rd, McNamara JA Jr, Behrents RG. Components of class III malocclusion in juveniles and adolescents. Angle Orthod 1986;56:7-30.
  3. Ellis E 3rd, McNamara JA Jr. Components of adult Class III malocclusion. J Oral Maxillofac Surg 1984;42:295-305. https://doi.org/10.1016/0278-2391(84)90109-5
  4. Jackson GW, Kokich VG, Shapiro PA. Experimental and post-experimental response to anteriorly directed extraoral force in young Macaca nemestrina. Am J Orthod 1979;75:318-33. https://doi.org/10.1016/0002-9416(79)90278-1
  5. Kambara T. Dentofacial changes produced by extraoral forward force in the Macaca irus. Am J Orthod 1977;71:249-77. https://doi.org/10.1016/0002-9416(77)90187-7
  6. Keles A, Tokmak EC, Erverdi N, Nanda R. Effect of varying the force direction on maxillary orthopedic protraction. Angle Orthod 2002;72:387-96.
  7. Mermigos J, Full CA, Andreasen G. Protraction of the maxillofacial complex. Am J Orthod Dentofacial Orthop 1990;98:47-55. https://doi.org/10.1016/0889-5406(90)70031-7
  8. McNamara JA Jr, Brudon WL, Orthodontic and orthopedic treatment in the mixed dentition. Ann Arbor, MI: Needham Press; 1993. p. 285-93.
  9. Hickham JH. Maxillary protraction therapy: diagnosis and treatment. J Clin Orthod 1991;25:102-13.
  10. Ishii H, Morita S, Takeuchi Y, Nakamura S. Treatment effect of combined maxillary protraction and chincap appliance in severe skeletal Class III cases. Am J Orthod Dentofacial Orthop 1987;92:304-12. https://doi.org/10.1016/0889-5406(87)90331-3
  11. Hata S, Itoh T, Nakagawa M, Kamogashira K, Ichikawa K, Matsumoto M, et al. Biomechanical effects of maxillary protraction on the craniofacial complex. Am J Orthod Dentofacial Orthop 1987;91:305-11. https://doi.org/10.1016/0889-5406(87)90171-5
  12. Nanda R. Biomechanical and clinical considerations of a modified protraction headgear. Am J Orthod 1980;78:125-39. https://doi.org/10.1016/0002-9416(80)90055-X
  13. Alcan T, Keles A, Erverdi N. The effects of a modified protraction headgear on maxilla. Am J Orthod Dentofacial Orthop 2000;117:27-38. https://doi.org/10.1016/S0889-5406(00)70245-9
  14. Goyenc Y, Ersoy S. The effect of a modified reverse headgear force applied with a facebow on the dentofacial structures. Eur J Orthod 2004;26:51-7. https://doi.org/10.1093/ejo/26.1.51
  15. Petit H. Adaptations following accelerated facial mask therapy. In: McNamara JA Jr, Ribbens KA, Howe RP, editors. Clinical alteration of the growing face. Monograph no. 14, Craniofacial growth series. Ann Arbor: Center for Human Growth and Development, University of Michigan; 1983. p. 48-59.
  16. Erbay EF, Caniklioglu CM, Erbay SK. Soft tissue profile in Anatolian Turkish adults: Part I. Evaluation of horizontal lip position using different soft tissue analyses. Am J Orthod Dentofacial Orthop 2002;121:57-64. https://doi.org/10.1067/mod.2002.119780
  17. Swlerenga D, Oesterle LJ, Messersmith ML. Cephalometric values for adult Mexican-Americans. Am J Orthod Dentofacial Orthop 1994;106:146-55. https://doi.org/10.1016/S0889-5406(94)70032-X
  18. Takada K, Petdachai S, Sakuda M. Changes in dentofacial morphology in skeletal Class III children treated by a modified maxillary protraction headgear and a chin cup: a longitudinal cephalometric appraisal. Eur J Orthod 1993;15:211-21. https://doi.org/10.1093/ejo/15.3.211
  19. Kapust AJ, Sinclair PM, Turley PK. Cephalometric effects of face mask/expansion therapy in Class III children: a comparison of three age groups. Am J Orthod Dentofacial Orthop 1998;113:204-12. https://doi.org/10.1016/S0889-5406(98)70141-6
  20. Kajiyama K, Murakami T, Suzuki A. Comparison of orthodontic and orthopedic effects of a modified maxillary protractor between deciduous and early mixed dentitions. Am J Orthod Dentofacial Orthop 2004;126:23-32. https://doi.org/10.1016/j.ajodo.2003.04.014
  21. Baccetti T, Franchi L, McNamara JA Jr. Treatment and posttreatment craniofacial changes after rapid maxillary expansion and facemask therapy. Am J Orthod Dentofacial Orthop 2000;118:404-13. https://doi.org/10.1067/mod.2000.109840
  22. Baik HS. Clinical results of the maxillary protraction in Korean children. Am J Orthod Dentofacial Orthop 1995;108:583-92. https://doi.org/10.1016/S0889-5406(95)70003-X
  23. Yuksel S, Ucem TT, Keykubat A. Early and late facemask therapy. Eur J Orthod 2001;23:559-68. https://doi.org/10.1093/ejo/23.5.559
  24. Merwin D, Ngan P, Hagg U, Yiu C, Wei SH. Timing for effective application of anteriorly directed orthopedic force to the maxilla. Am J Orthod Dentofacial Orthop 1997;112:292-9. https://doi.org/10.1016/S0889-5406(97)70259-2
  25. Proffit WR, Fields HW. Contemporary orthodontics. St Louis: Mosby; 1993. p. 456-9.
  26. Haas AJ. The treatment of maxillary deficiency by opening the midpalatal suture. Angle Orthod 1965;35:200-17.
  27. Kilicoglu H, Kirlic Y. Profile changes in patient, with class III malocclusions after Delaire mask therapy. Am J Orthod Dentofacial Orthop 1998;113:453-62.
  28. Battagel JM, Orton HS. Class III malocclusion: the post-retention findings following a non-extraction treatment approach. Eur J Orthod 1993;15:45-55. https://doi.org/10.1093/ejo/15.1.45
  29. Macdonald KE, Kapust AJ, Turley PK. Cephalometric changes after the correction of class III malocclusion with maxillary expansion/facemask therapy. Am J Orthod Dentofacial Orthop 1999;116:13-24. https://doi.org/10.1016/S0889-5406(99)70298-2
  30. Ngan P, Wei SH, Hagg U, Yiu CK, Merwin D, Stickel B. Effect of protraction headgear on Class III malocclusion. Quintessence Int 1992;23:197-207.