Abstract
Aim
The goal of the study was the evaluation of opposing intermaxillary elastics concerning potential change in the occlusal plane inclination relative to relevant vertical structures.
Patients and methods
Thirty-two late adolescent, skeletally homogeneous patients (basal-sagittal relationship: neutral; basal-vertical: neutral; no transverse discrepancies) were treated either with Class II (group A; n=16) or Class III elastics (group B; n=16) for unimaxillary space closure. Mean wearing times were 26 (A) and 24 months (B). Cephalograms at the start and end of treatment were analyzed. Changes in the inclination of the occlusal plane (BOP according to Downs) relative to three reference planes (NL, ML, NSL), as well as changes in the reference planes toward each other underwent statistical testing with a two-tailed Student t-test.
Results
The occlusal plane shift differed significantly when opposing elastics were applied (p<0.001). The induced shift with Class II elastics (A) was clockwise, while Class III elastics were counterclockwise (A: NL-BOP: +0.9°, ML-BOP: −2.1°; B: NL-BOP: −3.1°, ML-BOP: +3°). Reference planes NL and ML underwent insignificant change towards one another (A: −1.2°; B: −0.1°). The maxillo-mandibular complex itself rotated counterclockwise toward the anterior cranial base (NSL) (A: NL-NSL: −0.8°, ML-NSL: −2°; B: NL-NSL: −0.6°, ML-NSL: −0.7°). Thus, almost no change in BOP (+0.1°, n.s.) relative to NSL was detected when Class II elastics were applied, whereas the use of Class III elastics led to a significant counterclockwise rotation (−3.7°, p<0.001)
Conclusion
Class III elastics enhance the physiologic inclination of the maxillo-mandibular complex at the level of the occlusal plane, whereas Class II elastics oppose or even eliminate the process.
Zusammenfassung
Ziel
Das Ziel der Studie ist die vergleichende Evaluierung gegenläufiger intermaxillärer Gummizüge (GZ) hinsichtlich einer möglichen Veränderung der Neigung der Okklusalebene relativ zu relevanten Bezugsebenen.
Patienten und Methodik
Zweiunddreißig spätadoleszente, skeletal homogene Patienten (basal – sagittal neutral, basal – vertikal ausgeglichen, ohne transversale Diskrepanzen) wurden wegen eines projektierten unimaxillären Lückenschlusses entweder mit bilateralen Klasse-II- (Gruppe A; n=16) oder Klasse-III-GZ (Gruppe B; n=16) behandelt. Die mittlere Tragedauer betrug 26 (A) bzw. 24 Monate (B). Die Anfangs- und Abschluss-FRS-Bilder wurden einer vergleichenden Analyse unterzogen. Die Veränderungen der Neigungen der Okklusalebene (BOP nach Downs) relativ zu drei Bezugsebenen (NL, ML, NSL) sowie die Neigungen der Bezugsebenen untereinander wurden einer statistischen Überprüfung mittels zweiseitigem t-Test unterzogen.
Ergebnisse
Die Okklusalebene wurde durch gegenläufige GZ signifikant unterschiedlich geschwenkt (p<0,001). Die Schwenkungen erfolgten durch Klasse-II-GZ (A) clockwise, durch Klasse-III-GZ (B) counterclockwise (A: NL – BOP: +0,9°, ML – BOP: −2,1°; B: NL – BOP: −3,1°, ML – BOP: +3°). Die Bezugsebenen NL und ML veränderten sich zueinander nur insignifikant (A: −1,2°; B: −0,1°). Der maxillomandibuläre Komplex rotierte gleichzeitig in toto counterclockwise in Richtung auf die vordere Schädelbasis (NSL) (A: NL-NSL: −0,8°, ML-NSL: −2°; B: NL-NSL: −0,6°, ML-NSL: −0,7°). Deshalb wurde bei der Bestimmung von Winkelveränderungen zwischen BOP und NSL nahezu kein (+0,1°) Unterschied gefunden, wenn Klasse-II-GZ zur Anwendung kamen (n.s.), wohingegen die Anwendung von Klasse-III-GZ zu einer relevanten Verringerung (−3,7°) des Winkels führte (p<0,001).
Schlussfolgerungen
Klasse-III-GZ verstärken den physiologischen Schwenkungsprozess des maxillomandibulären Komplexes auf dem Niveau der Okklusalebene, während Klasse-II-GZ diesem Prozess entgegenwirken und ihn sogar aufheben können.
References
Bhatia SN, Leighton BC (1993) Growth changes of the occlusal and mandibular plane (Caucasian). In: A manual of facial growth: a computer analysis of longitudinal cephalometic growth data. Oxford University Press, Oxford
Björk A, Skieller V (1972) Facial development and tooth eruption. An implant study at the age of puberty. Am J Orthod Dentofacial Orthop 62:339–383
Björk A, Skieller V (1976) Postnatal growth and development of the maxillary complex. In: McNamara JA Jr (ed) Factors affecting the growth of the midface, monograph 6, craniofacial growth series. Center for human growth and development, University of Michigan, Ann Arbor, pp 61–99
Chang HP, Kinoshita Z, Kawamoto T (1993) A study of the growth changes in facial configuration. Eur J Orthod 15:493–501
Dahlberg A (1940) Statistical methods for medical and biological students. Interscience, New York
Dawson PE (1988) Evaluation, diagnosis, and treatment of occlusal problems, 2nd edn. C.V. Mosby, St. Louis
Downs WB (1948) Variation in facial relationships: their significance in treatment and prognosis. Am J Orthod Dentofacial Orthop 34:812–840
El-Batouti A, Ögaard B, Bishara SE (1994) Longitudinal cephalometric standards for Norwegians between the ages of 6 and 18 years. Eur J Orthod 16:501–509
Ferrario VF, Sforza C, Poggio CE et al (1999) Three-dimensional dental arch curvature in human adolescents and adults. Am J Orthod Dentofacial Orthop 115:401–405
Fushima K, Kitamura Y, Mita H et al (1996) Significance of the cant of the posterior occlusal plane in Class II division 1 malocclusions. Eur J Orthod 18:27–40
Gesch D (2000) A longitudinal study on growth in untreated children with angle Class II, Division I malocclusion. J Orofac Orthop 61:20–33
Han UK, Kim YH (1998) Determination of Class II and Class III skeletal patterns: receiver operating characteristic (ROC) analysis on various cephalometric measurements. Am J Orthod Dentofacial Orthop 113:538–545
Houston WJB (1983) The analysis of errors in orthodontic measurements. Am J Orthod 83:382–390
Ishizaki K, Suzuki K, Mito T et al (2010) Morphologic, functional, and occlusal characterization of mandibular lateral displacement malocclusion. Am J Orthod Dentofacial Orthop 137:454.e1–9
Jost- Brinkmann PG, Miethke RR (1990) Wirkungen und Nebenwirkungen intermaxillärer Gummizüge. Prakt Kieferorthop 4:189
Kagaya K, Minami I, Nakamura T et al (2009) Three-dimensional analysis of occlusal curvature in healthy Japanese young adults. J Oral Rehabil 36:257–263
Kim YH, Vietas JJ (1978) Anteroposterior dysplasia indicator: an adjunct to cephalometric differential diagnosis. Am J Orthod Dentofacial Orthop 73:619–633
Lamarque S (1995) The importance of occlusal plane control during orthodontic mechanotherapy. Am J Orthod Dentofacial Orthop 107:548–558
Langlade M (1978) Upper anterior occlusal plane control. J Clin Orthod 12:656–659
Proffit WR, Fields HW, Sarver DM (2007) In: Contemporary orthodontics, 4th edn. Mosby Elsevier, St Louis, MO, 15:590–592
Riolo ML, Moyers RE, McNamara JA et al (1974) In: An atlas of craniofacial growth: Cephalometric standards from the university school growth study. Center for Human Growth and Development. The University of Michigan, Ann Arbor
Sato S (1994) Case report: developmental characterization of skeletal Class III malocclusion. Angle Orthod 64:105–111
Scheuer H (1993) Die Verwendung intermaxillärer Gummizüge. Kieferorthopädische Mitteilungen 6:39–44
Stahl F, Baccetti T, Franchi L et al (2008) Longitudinal growth changes in untreated subjects with Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop 134:125–137
Stewart CM, Chaconas SJ, Caputo AA (1978) Effects of intermaxillary traction on orthodontic tooth movement. J Oral Rehabil 5:159–166
Tanaka EM, Sato S (2008) Longitudinal alteration of the occlusal plane and development of different dentoskeletal frames during growth. Am J Orthod Dentofacial Orthop 134:602.e1–11
Thayer TA (1990) Effects of functional versus bisected occlusal planes on the Wits appraisal. Am J Orthod Dentofacial Orthop 97:422–426
Thompson WJ (1979) Occlusal Plane and Overbite. Angle Orthod 49:47–54
Xu TM, Lin JX, Huang JF et al (1992) Effects of the vertical force component of Class II elastics on the anterior intrusive force of maxillary archwire. Eur J Orthod 14:280–284
Zimmer B, Rottwinkel Y (2002) Der kieferorthopädische Lückenschluss bei bilateraler Aplasie von zweiten Unterkieferprämolaren ohne Gegenextraktionen. J Orofac Orthop 63:400–421
Zimmer B, Seifi-Shirvandeh N (2009) Routine treatment of bilateral aplasia of upper lateral incisors by orthodontic space closure without mandibular extractions. Eur J Orthod 31:320–326
Conflict of interest
On behalf of all authors, the corresponding author states that there are no conflicts of interest.
Interessenkonflikt
Der korrespondierende Autor gibt für sich und seinen Koautor an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zimmer, B., Nischwitz, D. Therapeutic changes in the occlusal plane inclination using intermaxillary elastics. J Orofac Orthop 73, 377–386 (2012). https://doi.org/10.1007/s00056-012-0100-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00056-012-0100-5