RESUMEN
INTRODUCTION: The Twin-block (TB) and the van Beek Headgear-Activator (vBHGA) are indicated for patients with Class II malocclusion with a retrognathic mandible. Although the former is commonly prescribed for horizontally growing patients, the latter is often recommended for those growing vertically. This study aimed to compare the skeletal, dentoalveolar, and soft-tissue short-term effects of TB and vBHGA, taking growth patterns into account. METHODS: Immediate prefunctional (T1) and postfunctional appliance (T2) lateral cephalometric radiographs were retrospectively obtained for vBHGA (n = 46), TB (n = 45), and untreated control (n = 45) groups. The interaction of several variables at T1, T2, and T2 - T1, as well as the resultant treatment effect, were analyzed using the analysis of covariance regression models at the 5% significance level. RESULTS: Except for a greater reduction in Wits measurement (3.0 mm; P <0.0001) in the TB group, no anteroposterior (AP) skeletal difference was observed between the 2 appliances (ANB, 0.530; P = 0.07) (Harvold, 0.13 mm; P = 0.81). Both improved the AP skeletal relationship (ANB and Harvold) compared with the control (P <0.05). Although this mostly occurred because of the forward positioning of the mandible with the TB (SNB, 0.960; P = 0.01), the maxillary restriction was the main mechanism with the vBHGA (SNA, 1.590; P <0.01). Dentoalveolar compensations were more pronounced with the TB (IMPA, 1.92; P = 0.02), leading to greater overbite and overjet correction. Only the inclination of the maxillary incisors showed interaction with the growth pattern, with the TB horizontal growers experiencing more retroclination (U1-NA°. 3.620; P = 0.0067). CONCLUSIONS: Both appliances produced similar modest AP skeletal changes that, together with dentoalveolar compensations, were able to correct the Class II malocclusion regardless of growth pattern.
Asunto(s)
Maloclusión Clase II de Angle , Sobremordida , Humanos , Estudios Retrospectivos , Maloclusión Clase II de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/terapia , Mandíbula/diagnóstico por imagen , Cefalometría , MaxilarRESUMEN
INTRODUCTION: This study evaluated the factors influencing potential orthodontic patients' choice between an orthodontist, general dentist (GD), and direct-to-consumer (DTC) aligners for their treatment and their choice of orthodontic appliance type and explored their motivating factors for seeking orthodontic treatment and preference for appliance type. METHODS: An electronic survey was administered to 330 Canadian adults to determine demographic background, choice of the orthodontic treatment provider, the preferred mode of treatment, orthodontic issues they wished to address, and motivation for treatment. RESULTS: When participants were asked their preference in provider type, 49.4% of participants selected an orthodontist, 19.2% would follow the recommendation of their GD, 18.9% selected a GD, and 12.5% selected DTC aligners. Younger adult participants (P = 0.037) and those living in metropolitan areas (P = 0.0005) were significantly more likely to select an orthodontist than GD or DTC aligners. When asked about their preference in the mode of orthodontic treatment, 45.4% selected clear braces, 34.1% selected clear aligners, 14.3% selected metal braces, and 6.1% indicated they currently have no interest in orthodontic treatment. Older participants (P = 0.0005) and those in moderate-sized population centers (P = 0.001) were significantly more likely to select clear braces or aligners. CONCLUSIONS: Adults in Canada have a high preference for orthodontic treatment performed by orthodontists, especially among younger participants and those in metropolitan areas. Although all ages preferred clear braces, younger adult participants tended to be more open to metal braces, whereas older participants' preference for clear braces was the strongest. Preference for clear aligners is positively correlated to increased community size.