Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug;27(8):4773-4784.
doi: 10.1007/s00784-023-05105-z. Epub 2023 Jun 23.

Effects of fixed functional orthodontic treatment in hypodivergent and hyperdivergent class II patients-a retrospective cephalometric investigation

Jan Hourfar  1 , Gero Stefan Michael Kinzinger  1 , Linda Frye  1 , Jörg Alexander Lisson  2
Affiliations

Effects of fixed functional orthodontic treatment in hypodivergent and hyperdivergent class II patients-a retrospective cephalometric investigation

Jan Hourfar et al. Clin Oral Investig. 2023 Aug.

Abstract

Objective: To compare skeletal and dentoalveolar changes after orthodontic treatment of class II malocclusion in patients with hypodivergent and hyperdivergent growth patterns through cast splint fixed functional appliances (FFA).

Materials and methods: N = 42 out of n = 47 patients with mandibular plane angles < 34° or ≥ 34° were divided into a hypodivergent (n = 24) and a hyperdivergent (n = 18) group. All patients received a single-step mandibular advancement protocol through an FFA. Lateral cephalograms were analyzed after initial leveling and alignment (T1) and immediately after FFA removal (T2). The therapeutic effect was calculated through comparison with age-matched controls from a growth survey. Statistical significance was set at p < 0.05.

Results: Hypodivergent and hyperdivergent patients showed different treatment outcomes, but significant differences existed only for overbite and interincisal angle. Nearly all measurements suggested similar treatment-related changes for both groups with exception for dentoalveolar parameters.

Conclusion: Treatment with FFA causes similar skeletal and dentoalveolar effects in hypodivergent and in hyperdivergent patients. The correction of overjet and molar relationship is mainly caused by dentoalveolar changes.

Clinical relevance: Hyperdivergent patients do not respond unfavorably to FFA treatment compared to hypodivergent patients. Lower incisor protrusion occurs more pronounced in hypodivergent patients. The growth pattern ought to be considered when choosing FFA for class II treatment.

Keywords: FMA; Fixed functional appliance; Herbst; Hyperdivergent; Hypodivergent.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Skeletal and dental cephalometric measurements. a Horizontal linear: Co(dorsal)−PTV; Ba-PNS; N-ANS on FH; N-Pog on FH. b Vertical linear: S-Co(superior); S-Go; N-Me; N-ANS; N-PNS. c Dentoalveolar linear: U1(incisal)-PTV; L1(incisal)-PTV; U6(dorsal)-PTV; L6(dorsal)-PTV. d Mandibular angular and linear: Co(dorsal)-Pog; Co(superior)-Gn; Ar-Go-Me; Co(dorsal)-Go-Pog (»modified gonial angle«). e Dentoalveolar angular: SN/OP; U1/SN; U1/PP; L1/MP; U1/L1 (interincisal angle); U6/SN; L6/MP
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Moyers RE. Handbook of orthodontics. Chicago: Year Book Med Publishers; 1988.
    1. McSherry PF, Bradley H. Class II correction-reducing patient compliance: a review of the available techniques. J Orthod. 2000;27:219–225. doi: 10.1179/ortho.27.3.219. - DOI - PubMed
    1. Pancherz H, Ruf S. The Herbst appliance: research-based clinical mangement. Chicago: Quintessence; 2008.
    1. Rogers K, Campbell PM, Tadlock L, Schneiderman E, Buschang PH. Treatment changes of hypo- and hyperdivergent class II Herbst patients. Angle Orthod. 2018;88:3–9. doi: 10.2319/060117-369.1. - DOI - PMC - PubMed
    1. Hourfar J, Ludwig B, Ruf S, Kinzinger G, Lisson J. Fixed treatment of retroposition of the mandible - a literature review. Inf Orthod Kieferorthop. 2012;44:183–192.

LinkOut - more resources