Evaluation of dental and skeletal effects of orthodontic functional appliances associated with skeletal maturation of cervical vertebrae in class II malocclusion

Abstract

Aim: To evaluate the effects produced by functional orthodontic appliances at dental and skeletal level in relation to skeletal maturation level in class II patients. Material and method: A retrospective study was carried out in the orthodontic and dentofacial orthopedic service of the HM Nens Hospital in Barcelona. Patients who had been carrying expansion plates with Sander guides for at least 12 months, whose initial diagnosis (T1) was skeletal class II according to Ricketts cephalometric analysis and for whom lateral cephalograms before and after orthopedic treatment (T2) were selected. Variables studied in T1 and T2 were: facial convexity, inclination of the upper and lower incisors and facial depth. These were related to each other and, by means of the Lamparski analysis, with the maturation stage according to the cervical stage (CVS). Statistical analysis was performed using Shapiro-Wilk, T-student, ANOVA and multiple comparisons tests, taking as a statistically significant reference a p-value <0.05. Results: A final sample of 47 patients was obtained. Statistically significant differences were found in the inclination of the mandibular incisors between T1 and T2 and among the different cervical stages when the functional appliances were placed in CVS1 (p = 0.000), CVS2 (p = 0.04) or CVS5 (p = 0.048). For the rest of the variables, significant differences were also found between T1 and T2, but these changes were similar in all cervical stages, so these differences were not considered significant depending on the stage of maturation. Conclusions: There is a significant proclination of the mandibular incisors when the functional appliance is placed during CVS1, CVS2 or CVS5. Time of placement of the functional appliances was not statically significant for the rest of the variables studied.