Outcome quality of Class II division 1 Herbst-multibracket appliance treatment: influence of pretreatment Class II severity and skeletal maturity

2020 ◽  
Author(s):  
Niko C Bock ◽  
Julia Jost ◽  
Sabine Ruf
Keyword(s):  
Skeletal Maturity ◽  
Peer Assessment ◽  
Total Sample ◽  
Class Ii ◽  
Outcome Quality ◽  
Division 1 ◽  
Total Observation ◽  
Multibracket Appliance

Summary Background No reliable predictive factors for treatment (Tx) success and outcome quality in Class II:1 Tx have been identified yet. Objective To assess the influence of pre-Tx Class II severity and skeletal maturity on outcome quality after Herbst-multibracket appliance (MBA) Tx. Subjects and methods All Class II:1 patients who completed Herbst-MBA Tx between 1986 and 2014 at University of Giessen, Germany. Pre-Tx (T0), post-Tx (T1), and (if available) post-retention (≥24 months; T2) study casts were evaluated using the Peer Assessment Rating (PAR) index and the Ahlgren scale. Three occlusal severity (mild, moderate, and severe) and four skeletal maturity (pre-peak, peak, post-peak, and adult) subgroup categories were defined. Results Four hundred eight-five patients (age at T0: 14.4 ± 3.2 years) could be evaluated; post-retention (T3) data were available for 230 patients. For the total sample, the median PAR score was 32.4 ± 8.85 at T0, 8.0 ± 4.52 at T1, and 8.8 ± 5.11 at T2. Very low correlations between the subgroup categories (occlusal severity/skeletal maturity) and PAR-score reduction were detected both during Tx (r = 0.12/r = 0.05) and the total observation period (r = 0.17/r = 0.03). The overall outcome quality according to Ahlgren was: 17.0% excellent, 34.8% good, 43.8% acceptable, 2.2% unacceptable, and 2.2% not assessable. The association with the subgroup categories was: p = 0.019 (occlusal severity)/p = 0.820 (skeletal maturity). Limitations Retrospective study design with follow-up data was not available from all subjects and no data from untreated controls. Tx was performed by several physicians using different kind of MBAs. Conclusion Class II:1 Herbst-MBA Tx is an effective and successful Tx approach irrespective of pre-Tx skeletal maturity but dependent—to a certain extent—on Class II severity. Thus, when considering a Herbst appliance for Class II correction, neither of the two variables should considerably limit the indication.

scholarly journals Is Herbst-Multibracket Appliance Treatment More Efficient in Adolescents than in Adults?

2009 ◽  
Vol 79 (1) ◽  
pp. 173-177 ◽  
Author(s):  
Julia von Bremen ◽  
Niko Bock ◽  
Sabine Ruf
Keyword(s):  
Skeletal Maturity ◽  
Peer Assessment ◽  
Class Ii ◽  
Substantial Improvement ◽  
Adult Group ◽  
Adolescent Group ◽  
Division 1 ◽  
The University ◽  
Multibracket Appliance ◽  
Class Ii Division 1

Abstract Objective: To determine whether Herbst treatment is more efficient in adolescent than in adult Class II division 1 subjects. Materials and Methods: All Class II division 1 patients with a full secondary dentition who had been treated at the orthodontic department of the University of Giessen with a Herbst appliance between 1990 and 2000 were considered. The complete records of 77 patients were available. According to their skeletal maturity, as assessed on hand-wrist radiographs, the subjects were divided into an adolescent group (MP3-F to MP3-H; n = 49; mean age 13.5 years) and an adult group (R-IJ to R-J; n = 28; mean age 20.7 years). Pretreatment and posttreatment dental casts were evaluated using the Peer Assessment Rating (PAR) Index. The reductions in PAR scores of the two groups were compared. Results: Before treatment, both groups had a severe Class II division 1 malocclusion. The average PAR score of the adolescent patients was slightly lower (27.8) than that of the adult patients (28.8). After treatment, good results were reached for both groups, and the average PAR scores of the two groups were comparable (adolescents: 4.5; adults: 4.8). The average reductions in PAR score were 82.7% (23.3 points) for the adolescent group and 82.9% (24.0 points) for the adults, indicating great improvement in both groups. Conclusions: Because good treatment results were achieved, with substantial improvement of the pretreatment situation in both groups, Herbst treatment can be considered equally efficient in adolescent and in adult Class II division 1 subjects.

scholarly journals Stability of Drinking Reductions and Long-term Functioning Among Patients with Alcohol Use Disorder

2020 ◽  
Author(s):  
Katie Witkiewitz ◽  
Henry R. Kranzler ◽  
Kevin A. Hallgren ◽  
Deborah S. Hasin ◽  
Arnie P. Aldridge ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Well Being ◽  
Total Sample ◽  
World Health ◽  
End Of Treatment

Abstract Background The World Health Organization (WHO) categorizes alcohol consumption according to grams consumed into low-, medium-, high-, and very-high-risk drinking levels (RDLs). Although abstinence has been considered the ideal outcome of alcohol treatment, reductions in WHO RDLs have been proposed as primary outcomes for alcohol use disorder (AUD) trials. Objective The current study examines the stability of WHO RDL reductions and the association between RDL reductions and long-term functioning for up to 3 years following treatment. Design and Participants Secondary data analysis of patients with AUD enrolled in the COMBINE Study and Project MATCH, two multi-site, randomized AUD clinical trials, who were followed for up to 3 years post-treatment (COMBINE: n = 694; MATCH: n = 806). Measures Alcohol use was measured via calendar-based methods. We estimated all models in the total sample and among participants who did not achieve abstinence during treatment. Key Results One-level RDL reductions were achieved by 84% of patients at the end of treatment, with 84.9% of those individuals maintaining that reduction at a 3-year follow-up. Two-level RDL reductions were achieved by 68% of patients at the end of treatment, with 77.7% of those individuals maintaining that reduction at a 3-year follow-up. One- and two-level RDL reductions at the end of treatment were associated with significantly better mental health, quality of life (including physical quality of life), and fewer drinking consequences 3 years after treatment (p < 0.05), as compared to no change or increased drinking. Conclusion AUD patients can maintain WHO RDL reductions for up to 3 years after treatment. Patients who had WHO RDL reductions functioned significantly better than those who did not reduce their drinking. These findings are consistent with prior reports suggesting that drinking reductions, short of abstinence, yield meaningful improvements in patient health, well-being, and functioning.

scholarly journals Prevalence, magnitude, and incidence of labial gingival recession with Herbst-multibracket appliance treatment: A retrospective cohort study

2019 ◽  
Vol 89 (4) ◽  
pp. 535-543 ◽  
Author(s):  
Niko C. Bock ◽  
Julia Ruehl ◽  
Sabine Ruf
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Gingival Recession ◽  
Class Ii ◽  
Before And After ◽  
Total Observation ◽  
Multibracket Appliance ◽  
Lower Incisors ◽  
Observation Period

ABSTRACT Objective: To assess the prevalence and magnitude of labial gingival recession (LGR) before and after as well as the incidence during Class II:1 Herbst-Multibracket appliance (Herbst-MBA) treatment (Tx) plus retention in a retrospective cohort study. Materials and Methods: Records of Class II:1 patients who completed Herbst-MBA Tx (mean pre-Tx age 14.4 years) at Department of Orthodontics, University of Giessen, Giessen, Germany were analyzed. Tx consisted of a Herbst phase (mean 8.1 months) and a subsequent MBA phase (mean 16.1 months). Study casts from before and after Herbst-MBA Tx plus ≥24 months of retention were evaluated. Results: A total of 460 pre-Tx and 222 postretention study casts were available (total observation period: 59.2 ± 14.8 months). The overall prevalence for teeth with LGR ≥0.5 mm was 1.1% pre-Tx and 5.3% postretention. The highest prevalence of up to 5.3% (pre-Tx) and 16.4% (postretention) were seen for the lower incisors. Overall, the median magnitude of LGR was 0.0 mm pre-Tx/postretention (mean: 0.05 mm/0.08 mm). Incidence values of 4.0% (all teeth) and 10.0% to 11.4% (lower central incisors) were calculated for LGR ≥0.5 mm. Conclusions: The prevalence of LGR ≥0.5 mm increased from, on average, 1.1% to 5.3% during ≈6 years of Herbst-MBA Tx plus retention. The highest incidence was seen in lower incisors (10.0%–11.4%). However, because of the overall mean magnitude of 0.08 mm postretention, the clinical relevance can be considered as insignificant.

scholarly journals A Prospective Study on Risk Factors for Olfactory Dysfunction in Aging

2019 ◽  
Vol 75 (3) ◽  
pp. 603-610 ◽  
Author(s):  
Eva Palmquist ◽  
Maria Larsson ◽  
Jonas K Olofsson ◽  
Janina Seubert ◽  
Lars Bäckman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Healthy Lifestyle ◽  
Total Sample ◽  
Olfactory Dysfunction ◽  
National Study ◽  
Current Smoking ◽  
Ε4 Allele ◽  
A Prospective Study

Abstract Background Olfactory dysfunction (OD) refers to a reduced or absent ability to smell. OD negatively impacts health and quality of life and its prevalence increases with advancing age. Since OD may be an early marker of dementia and impending death, more knowledge regarding risk factors of OD in aging is warranted. The objective was therefore to explore longitudinally which demographic, genetic, clinical, lifestyle, and cognitive factors predict the development of OD. Methods The study included participants aged 60–90 years from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), who did not have OD at baseline and were reassessed with an odor identification task at a 6-year follow-up (n = 1,004). Risk factors of OD were assessed with multivariable logistic regression analyses. Results The percentage of incident OD cases was 14.2% over 6 years in the total sample and this number increased monotonically with age. Increasing age, carrying the ε4 allele of the APOE gene, atrial fibrillation, cerebrovascular disease, and current smoking were found to be risk factors for the development of OD, whereas better olfactory identification and verbal episodic memory proficiency at baseline were identified as protective factors. Conclusions In addition to nonmodifiable factors (age and genetic risk), several modifiable risk factors of OD were identified. This suggests that it might be possible to reduce OD incidence through the management of vascular risk factors and maintenance of a healthy lifestyle.

scholarly journals Comprehensive orthodontic treatment in an adolescent patient with Class II Division 1 malocclusion and ankylosed maxillary central incisors

2019 ◽  
Vol 9 ◽  
pp. 190-197
Author(s):  
Matthew Wen Jian Lau
Keyword(s):  
Poor Prognosis ◽  
Orthodontic Treatment ◽  
Root Resorption ◽  
Class Ii ◽  
Anterior Teeth ◽  
External Root Resorption ◽  
Facial Esthetics ◽  
Division 1 ◽  
Traumatic Episode

While uncommon in orthodontics, the extraction of central incisors may be indicated when such teeth are of poor prognosis. This report details orthodontic treatment of a 13-year and 5-month-old Chinese female, who presented with Class II/1 malocclusion on a Class II skeletal jaw base relationship. Her maxillary central incisors were ankylosed and had undergone severe external root resorption following a previous traumatic episode. Orthodontic treatment involved removal of the maxillary central incisors and the mandibular first premolars. Pre-adjusted edgewise appliances with MBT prescription were used. To enhance anterior esthetics, prosthetic buildup of the four maxillary anterior teeth was performed before appliance removal. Tight intercuspation of teeth and optimal facial esthetics were achieved at appliance debond and maintained at 2-year follow-up.

scholarly journals Transverse maxillary and mandibular growth during and after Bionator therapy: study with metallic implants

2013 ◽  
Vol 18 (3) ◽  
pp. 72-79
Author(s):  
André da Costa Monini ◽  
Luiz Gonzaga Gandini Júnior ◽  
Luiz Guilherme Martins Maia ◽  
Ary dos Santos-Pinto
Keyword(s):  
Class Ii ◽  
Mandibular Growth ◽  
Metallic Implants ◽  
Division 1 ◽  
Before And After ◽  
Long Term Follow Up ◽  
Maxilla And Mandible ◽  
Class Ii Division 1

INTRODUCTION: This study evaluated posteroanterior cephalograms before and after treatment and long term follow-up of Class II division 1 patients treated with bionator. OBJECTIVE: The objective was to demonstrate the transverse growth of maxilla and mandible during and after bionator therapy. METHODS: Measurement of transverse dimensions between posterior maxillary and mandibular implants, as well as the distances between the buccal, gonial and antegonial points were recorded. Measurements were analyzed at three periods: T1 = before bionator therapy, T2 = after bionator therapy and T3 = 5.74 years after T2. RESULTS: There was statistically significant transverse increase due to growth and/or treatment for all variables, except for the distance between the anterior maxillary implants. CONCLUSIONS: During the study period only the anterior maxillary area did not show transverse growth.

scholarly journals EFFECTS OF AN ART GALLERY INTERVENTION IN PEOPLE LIVING WITH DEMENTIA: A PILOT STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S52-S52
Author(s):  
Nathan M D'Cunha ◽  
Andrew J McKune ◽  
Stephen Isbel ◽  
Ekavi N Georgousopoulou ◽  
Jane Kellett ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Interleukin 6 ◽  
Controlled Trial ◽  
Total Sample ◽  
Post Intervention ◽  
Art Gallery ◽  
Physiological Outcomes ◽  
Pituitary Adrenal Axis

Abstract Art gallery programs tailored to the needs of people living with dementia are becoming more popular worldwide. This study aimed to observe the effects of six consecutive weekly discussion-based small group visits to the National Gallery of Australia Art and Dementia program on the salivary cortisol (SC) diurnal rhythm, salivary interleukin-6, quality of life (QoL), depressive symptoms, and cognitive function. Twenty-five participants (17 female; mean age 84.6 ± 7.27 years) completed the study with data collection at baseline, post-intervention, and at a six-week follow-up. Statistical methods were selected based on data distribution. The waking to evening (WE) SC ratio was altered (p = 0.016) (Baseline: 1.35 (1.19, 1.64), Post-intervention: 1.72 (1.54, 1.96), Follow-up: 1.44 (1.22, 1.79)) in the 22 participants who provided viable saliva samples. The WE SC ratio was higher post-intervention compared with baseline (p = 0.011), indicating a more dynamic SC rhythm, but returned to baseline levels at follow-up (p = 0.020). Interleukin-6 levels were unchanged (p = 0.664). In the total sample, no improvements in QoL (Proxy) (p = 0.165) were observed. However, self-reported depressive symptoms differed (p = 0.006), decreasing post-intervention (2.00 (1.00, 2.00)) compared with baseline (3.00 (2.00, 4.50)) (p = 0.015), and verbal fluency was affected (p = 0.027), improving from baseline (2.00 (0.00, 3.00)) to post-intervention (2.00 (0.50, 4.00)) (p = 0.027). Art and Dementia programs appear to have quantifiable benefits, including improved hypothalamic-pituitary-adrenal axis function, justifying a longer controlled trial inclusive of physiological outcomes.

Changes in Molar Occlusion after Extraction of All First Pre-molars: A Follow-up Study of Class II Division 1 Cases Treated with Removable Appliances

1980 ◽  
Vol 7 (3) ◽  
pp. 139-144 ◽  
Author(s):  
C. D. Stephens ◽  
T. G. Lloyd
Keyword(s):  
Orthodontic Treatment ◽  
Class Ii ◽  
Division I ◽  
Follow Up Study ◽  
Division 1 ◽  
Spontaneous Improvement ◽  
Removable Appliance ◽  
Removable Appliances ◽  
Class Ii Division 1

Spontaneous improvement in molar occlusion is often assumed to accompany orthodontic treatment of the Class II Division I case where all pre-molars have been removed. The investigation shows that while the buccal occlusion generally improves after the completion of removable appliance treatment this is seldom enough to correct a Class II molar relationship.

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