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Randomized Controlled Trial
. 2024 Oct 7;29(5):e242440.
doi: 10.1590/2177-6709.29.5.e242440.oar. eCollection 2024.

Facial soft tissue changes in adolescent patients treated with three different functional appliances: a randomized clinical trial

Nathália Moraes Carvalho Barreto Brandão  1 , Nathália Barbosa Palomares  1 , Tatiana Lima  1 , Cátia Cardoso Abdo Quintão  1 , Klaus Barretto Lopes  1 , José Augusto Mendes Miguel  1
Affiliations
Randomized Controlled Trial

Facial soft tissue changes in adolescent patients treated with three different functional appliances: a randomized clinical trial

Nathália Moraes Carvalho Barreto Brandão et al. Dental Press J Orthod. .

Abstract
in English, Portuguese

Introduction: Patients with Class II, division 1 malocclusion generally seek treatment to improve facial esthetics. Therefore, the orthodontist needs to know the changes in the soft profile produced by functional appliances.

Objective: This study evaluated the soft tissue profile changes in patients treated during the peak of the pubertal growth spurt.

Methods: Thirty selected patients were randomized into three treatment groups: Twin Block (TB), Herbst with dental anchorage (HDA), and Herbst with skeletal anchorage (HSA). All patients had computed tomographic images: pretreatment (T1) and after 12 months of active treatment (T2). Twenty-four soft tissue cephalometric measures were analyzed. The normality of all data was assessed by the Shapiro-Wilk test. Intragroup comparisons were analyzed using the t-paired test; the inter-group comparisons were determined through ANOVA and the post-hoc Tukey test.

Results: At T1, no significant differences were observed between groups. At T2, in the intragroup comparison, facial soft tissue changes were statistically significant in the three groups for the lower lip, sulcus inferioris, facial soft tissue convexity in HDA group and TB group, and H angle in HDA group and HSA group, and soft tissue pogonium in TB group. In the inter-group comparison, no statistically significant differences were observed.

Conclusion: It can be concluded that there were significant changes in soft tissue measurements that benefited Class II, division 1 patient's facial profile treated with the functional appliances Twin Block, Herbst, and Herbst with skeletal anchorage. Nevertheless, no significant differences were detected among the effects obtained by the three treatment protocols.

Introdução:: Pacientes portadores de má oclusão de Classe II, divisão 1, geralmente buscam tratamento para obter melhora da estética facial. Logo, é essencial que o ortodontista conheça as alterações do perfil mole associadas a uma das principais modalidades de tratamento dessa má oclusão: os aparelhos propulsores mandibulares.

Objetivo:: O presente estudo avaliou as alterações nos tecidos moles do perfil facial em pacientes tratados durante o pico do surto de crescimento puberal com aparelhos propulsores mandibulares removível, fixo ou fixo associado à ancoragem esquelética.

Métodos:: Trinta pacientes foram randomizados em três grupos: Twin Block (TB), Herbst com ancoragem dentária (HAD) e Herbst com ancoragem esquelética (HAE). Os pacientes realizaram tomografias computadorizadas pré-tratamento (T1) e após 12 meses de tratamento (T2). Foram analisadas 24 medidas cefalométricas em tecidos moles. A normalidade dos dados foi avaliada pelo teste de Shapiro-Wilk, as comparações intragrupo foram feitas por meio do teste t pareado; as comparações intergrupo, feitas com ANOVA e o teste post-hoc de Tukey.

Resultados:: Em T1, não foram observadas diferenças significativas entre os grupos, confirmando a homogeneidade da amostra. Na comparação intragrupos, foram detectadas alterações estatisticamente significativas nos três grupos, na convexidade facial de tecido mole, sulcus inferioris e pogônio mole; e na comparação intergrupo não foram observadas diferenças estatisticamente significativas.

Conclusão:: Após o tratamento com os aparelhos ortopédicos, foram detectadas alterações significativas que beneficiaram os tecidos moles da face de pacientes Classe II, divisão 1. Porém, não foram detectadas diferenças significativas nos efeitos obtidos entre os três tipos de aparelhos.

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Conflict of interest statement

The authors report no commercial, proprietary or financial interest in the products or companies described in this article.

Figures

Figure 1:
Figure 1:. Intraoral photographs illustrating the TB group, treated with the Twin Block removable appliance.
Figure 2:
Figure 2:. Intraoral photographs illustrating the HDA group, treated with the Herbst fixed appliance.
Figure 3:
Figure 3:. Intraoral photographs illustrating the HSA group, treated with the Herbst fixed appliance with skeletal anchorage.
Figure 4:
Figure 4:. Landmarks used in the study.
Figure 5:
Figure 5:. Soft tissue linear measurements, according to the Appendix 1.
Figure 6:
Figure 6:. Flowchart of patients in study.
See this image and copyright information in PMC

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