POSITIONAL AND DIMENSIONAL TMJ CHANGES FOLLOWING THE USE OF DIFFERENT CLASS II CORRECTORS IN A SAMPLE OF ERBIL CITY [RANDOMIZED CLINICAL TRIAL]
Main Article Content
Keywords
fixed functional appliance, MRI, Class II, articular disc, Tmj
Abstract
Background: Due to the retrognathic mandible, an orthodontist frequently observes skeletal class II malocclusion in growing patients. The preferred technique for analyzing and monitoring the temporomandibular joint alterations caused by the functional device is magnetic resonance imaging [MRI].
The study aimed to assess and compare changes in the articular disc's dimension and location before and following the use of various class II correctors to correct the class II molar relation using MRI technology. Methods: 39 adolescent patients aged 15-23 years old [24 girls and 15 boys] who were diagnosed with skeletal Class II division 1 malocclusion based on clearly defined criteria underwent treatment with either the power scope II [PS], Sabbagh Advanced Repositioning Appliance [SARA] and or Dynaflex [DF] with fixed appliances. For fixed functional treatment, the average length of treatment was 5-7 months. The changes in the articular disc dimension and position and condylar position were assessed. The study was done at the Department of Orthodontics at the College of Dentistry, Hawler Medical University in Erbil City.
Results: Group DF has a significant effect on the condylar position index and posterior joint space on the closed mouth and disc length on both open and close mouth techniques, and in the group SARA, disc position, and condylar position index on closed mouth technique have shown that significant differences were observed.
Conclusion: Class II malocclusions can be effectively corrected by fixed functional appliances. The statistical significance forward movement of the condyle in the glenoid fossa and the posterior movement of the articular disc concerning the condylar head was observed. The mechanism of action of functional appliances appears to include the forward migration of the C-GF complex.
References
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9. Zhang, Y. et al. [2023] ‘Clinical finite element analysis of mandibular displacement model treated with Twin-block appliance’, American Journal of Orthodontics and Dentofacial Orthopedics, 164[3], pp. 395–405.
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12. Dixit S, Sridhar K , Jain U , Prakash A , Ekka S, D.C. [2018] ‘Evaluation of Temporomandibular Joint Changes with Functional Appliance—An MRI Study. J Contemp Orthod’, J Contemp Orthod, 2[3], pp. 7–13.
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14. Parvathy, R.M., Shetty, S. and Katheesa, P. [2021] ‘Evaluation of changes seen in TMJ after mandibular advancement in treatment of Class II malocclusions, with functional appliances, a CBCT study’, Biomedicine, 41[2], pp. 236–242.
15. Patel, B. et al. [2022] ‘Evaluation of Changes in Soft and Hard Tissues of TMJ among Class II Division 2 Patients after Prefunctional Orthodontics and Twin Block Functional Appliance Therapy: A Prospective MRI Study’, International Journal of Clinical Pediatric Dentistry, 15[5], p. 479.
16. Singh1, S. et al. [2023] ‘MORPHOLOGICAL CONDYLAR CHANGES FOLLOWING FIXED FUNCTIONAL APPLIANCE THERAPY’, Eur. Chem. Bull., 12[4], pp. 2141 –2149.
17. Baccetti, T., Franchi, L. and McNamara Jr, J.A. [2005] ‘The cervical vertebral maturation [CVM] method for the assessment of optimal treatment timing in dentofacial orthopedics’, in Seminars in Orthodontics. Elsevier, pp. 119–129.
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22. Benkherfallah, N. et al. [2017] ‘Sagittal position of the temporomandibular joint disc after treatment with an activator: an MRI study’, Medical Technologies Journal, pp. 140–149.
23. Elfeky, H.Y. et al. [2018] ‘Three-dimensional skeletal, dentoalveolar and temporomandibular joint changes produced by Twin Block functional appliance.’, Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie, 79[4].
24. Jiang, Y. et al. [2020] ‘Three-dimensional cone beam computed tomography analysis of temporomandibular joint response to the Twin-block functional appliance’, Korean Journal of Orthodontics, 50[2], p. 86.
25. Ruf, S. and Pancherz, H. [2000] ‘Does bite-jumping damage the TMJ? A prospective longitudinal clinical and MRI study of Herbst patients’, The Angle Orthodontist, 70[3], pp. 183–199.
26. Wadhawan, N. et al. [2008] ‘Temporomandibular joint adaptations following two‐phase therapy: an MRI study’, Orthodontics & craniofacial research, 11[4], pp. 235–250.
27. Cacho, A. et al. [2015] ‘Changes in joint space dimension after the correction of Class II division 1 malocclusion’, European journal of orthodontics, 37[5], pp. 467–473.
28. Cheib Vilefort, P.L. et al. [2019] ‘Condyle‐glenoid fossa relationship after Herbst appliance treatment during two stages of craniofacial skeletal maturation: A retrospective study’, Orthodontics & Craniofacial Research, 22[4], pp. 345–353.
29. Guo, Y. et al. [2020] ‘CBCT analysis of changes in dental occlusion and temporomandibular joints before and after MEAW Orthotherapy in patients with nonlow angle of skeletal class III’, BioMed Research International, 2020.
30. Nindra, J. et al. [2021] ‘Three-dimensional evaluation of condyle-glenoid fossa complex following treatment with Herbst appliance’, Journal of Clinical Medicine, 10[20], p. 4730.
31. Arici, S. et al. [2008] ‘Effects of fixed functional appliance treatment on the temporomandibular joint’, American journal of orthodontics and dentofacial orthopedics, 133[6], pp. 809–814.
32. Kinzinger, G. et al. [2006] ‘Disc-condyle Relationships during Class II Treatment with the Functional Mandibular Advancer [FMA].’, Journal of Orofacial Orthopedics= Fortschritte der Kieferorthopadie: Organ/official Journal Deutsche Gesellschaft fur Kieferorthopadie, 67[5], pp. 356–375.
33. John ZAS, Shrivastav SS, Kamble R, Jaiswal E, Dhande R. Three-dimensional comparative evaluation of articular disc position and other temporomandibular joint morphology in Class II horizontal and vertical cases with Class I malocclusion. Angle Orthod. 2020 Sep 1;90[5]:707-714.
34. Ribeiro, R. et al. [1995] ‘TMJ structural evaluation by MRI in asymptomatic children and young adult volunteers’, Journal of Dental Research, 74[spec.], p. 223.
35.Murakami, S. et al. [1993] ‘Magnetic resonance evaluation of the temporomandibular joint disc position and configuration.’, Dentomaxillofacial Radiology, 22[4], pp. 205–207.
36. Okeson JP [2000] ‘Anatomia funcional e a biomecaˆnica do sistema mastigato´rio’, in O. JP. [ed.] Tratamento das desordens temporomandibulares e oclusa˜o. 4th edn. Sa˜o Paulo, Brazil: Artes Me´dicas;, pp. 3–21.
37. Aidar, L.A. et al. [2009] ‘Effects of Herbst appliance treatment on temporomandibular joint disc position and morphology: a prospective magnetic resonance imaging study’, American journal of orthodontics and dentofacial orthopedics, 136[3], pp. 412–424.
38. Franco, A.A. et al. [2002] ‘Fränkel appliance therapy and the temporomandibular disc: a prospective magnetic resonance imaging study’, American journal of orthodontics and dentofacial orthopedics, 121[5], pp. 447–457.
39. Shen, P. et al. [2019] ‘The effect evaluation of functional appliance used for class II patients with temporomandibular joint anterior disc displacement’, Journal of Craniofacial Surgery, 30[1], pp. e15–e17.
40.Silverstein, R. et al. [1994] ‘MRI assessment of the normal temporomandibular joint with the use of projective geometry’, Oral surgery, oral medicine, oral pathology, 77[5], pp. 523–530.
41. Pereira, M.R.V. [1997] Quantitative Auswertungen bildgebender Verfahren und Entwicklung einer neuen metrischen Analyse für Kiefergelenkstrukturen im Magnetresonanztomogramm.
42. Katzberg, R.W. et al. [1985] ‘Magnetic resonance imaging of the temporomandibular joint meniscus’, Oral surgery, oral medicine, oral pathology, 59[4], pp. 332–335.
43. Arat, Z.M. et al. [2001] ‘Changes in the TMJ disc-condyle-fossa relationship following functional treatment of skeletal Class II Division 1 malocclusion: a magnetic resonance imaging study’, American Journal of Orthodontics and Dentofacial Orthopedics, 119[3], pp. 316–19.
44. Foucart, J.M. et al. [1998] ‘MRI study of temporomandibular joint disk behavior in chilren with hyperpropulsion appliances’, L’Orthodontie Francaise, 69[1], pp. 79–91.
45. Hall, M.B., Gibbs, C.C. and Sclar, A.G. [1985] ‘Association between the prominence of the articular eminence and displaced TMJ disks’, CRANIO®, 3[3], pp. 237–239.
46. Solberg, W.K., Hansson, T.L. and Nordström, B. [1985] ‘The temporomandibular joint in young adults at autopsy: a morphologic classification and evaluation’, Journal of oral rehabilitation, 12[4], pp. 303–321.
47. Aidar, L.A.A. et al. [2010] ‘Changes in temporomandibular joint disc position and form following Herbst and fixed orthodontic treatment’, The Angle Orthodontist, 80[5], pp. 843–852.
48. Patti [2010] : ‘Treatment of class II from prevention to surgery’, in Class II and TMJ. Int.Quintessence, pp. 409–446.
2. Booij, J.W. et al. [2022] ‘Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types’, PeerJ, 10, p. e14537.
3. Bakhurji, E.A. et al. [2021] ‘Prevalence and distribution of nonsyndromic dental anomalies in children in eastern Saudi Arabia: A radiographic study’, The Scientific World Journal, 2021, pp. 1–6.
4. Cançado, R.H. et al. [2021] ‘Treatment effects of the Herbst appliance in class II malocclusion patients after the growth peak’, European Journal of Dentistry, 15[01], pp. 39–46.
5. Fouad, A.M., Abu-Shahba, R.Y. and Barakat, E. [no date] ‘Soft Tissue Evaluation of Mandibular Protraction Appliance IV and PowerScope in Treatment of Class II Malocclusion; A Comparative Randomized Clinical Trial’.
6. Kalra, A., Swami, V. and Bhosale, V. [2021] ‘Treatment effects of “PowerScope” fixed functional appliance–a clinical study’, Folia Medica, 63[2], pp. 253–263.
7. Al Hamdany, A.K. et al. [2023] ‘PowerScope 2 functional appliance: A 3D finite element simulation of its action on the mandible’, Journal of Oral Biology and Craniofacial Research, 13[2], pp. 299–305.
8. Mathur S, Raghav P, A. and P. [2019] ‘Advansync 2: A fixed functional class 2 corrector in advanced age, A case report’, Heal Talk A Journal Of Clinical Dentistry., 11[5], pp. 34–35.
9. Zhang, Y. et al. [2023] ‘Clinical finite element analysis of mandibular displacement model treated with Twin-block appliance’, American Journal of Orthodontics and Dentofacial Orthopedics, 164[3], pp. 395–405.
10. Zhang, Y. et al. [2024] ‘Three-dimensional spatial analysis of temporomandibular joint in adolescent Class II division 1 malocclusion patients: comparison of Twin-Block and clear functional aligner’, Head & Face Medicine, 20[1], p. 4.
11. López-Arcas, J.M. et al. [2022] ‘Magnetic Resonance Imaging of the Temporomandibular Joint: Key Point in the Election of Treatment’, Atlas of the Oral and Maxillofacial Surgery Clinics of North America, 30[2], pp. 129–135.
12. Dixit S, Sridhar K , Jain U , Prakash A , Ekka S, D.C. [2018] ‘Evaluation of Temporomandibular Joint Changes with Functional Appliance—An MRI Study. J Contemp Orthod’, J Contemp Orthod, 2[3], pp. 7–13.
13. Deshmukh, S. et al. [2021] ‘Evaluation of Changes in Condylar Cartilage Thickness Using MRI and Ultrasound Imaging in Patients Treated by Mandibular Advancement with Myofunctional Appliance: An In-Vivo Pilot Study’, Cureus, 13[7].
14. Parvathy, R.M., Shetty, S. and Katheesa, P. [2021] ‘Evaluation of changes seen in TMJ after mandibular advancement in treatment of Class II malocclusions, with functional appliances, a CBCT study’, Biomedicine, 41[2], pp. 236–242.
15. Patel, B. et al. [2022] ‘Evaluation of Changes in Soft and Hard Tissues of TMJ among Class II Division 2 Patients after Prefunctional Orthodontics and Twin Block Functional Appliance Therapy: A Prospective MRI Study’, International Journal of Clinical Pediatric Dentistry, 15[5], p. 479.
16. Singh1, S. et al. [2023] ‘MORPHOLOGICAL CONDYLAR CHANGES FOLLOWING FIXED FUNCTIONAL APPLIANCE THERAPY’, Eur. Chem. Bull., 12[4], pp. 2141 –2149.
17. Baccetti, T., Franchi, L. and McNamara Jr, J.A. [2005] ‘The cervical vertebral maturation [CVM] method for the assessment of optimal treatment timing in dentofacial orthopedics’, in Seminars in Orthodontics. Elsevier, pp. 119–129.
18. Kaushik, K. et al. [2022] ‘Comparative Three Dimensional Evaluation of Dentoskeletal Parameters using AdvanSync & Herbst Appliance in Class II Malocclusion:“A Randomized Controlled Trial”’, World, 13[3], p. 229.
19. Chavan, S.J., Bhad, W.A. and Doshi, U.H. [2014] ‘Comparison of temporomandibular joint changes in Twin Block and Bionator appliance therapy: a magnetic resonance imaging study’, Progress in orthodontics, 15, pp. 1–7.
20. Chintakanon, K. et al. [2000] ‘A prospective study of Twin-block appliance therapy assessed by magnetic resonance imaging’, American journal of orthodontics and dentofacial orthopedics, 118[5], pp. 494–504.
21. Cheib, P.L. et al. [2016] ‘Displacement of the mandibular condyles immediately after Herbst appliance insertion-3D assessment’, Turkish journal of orthodontics, 29[2], p. 31.
22. Benkherfallah, N. et al. [2017] ‘Sagittal position of the temporomandibular joint disc after treatment with an activator: an MRI study’, Medical Technologies Journal, pp. 140–149.
23. Elfeky, H.Y. et al. [2018] ‘Three-dimensional skeletal, dentoalveolar and temporomandibular joint changes produced by Twin Block functional appliance.’, Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie, 79[4].
24. Jiang, Y. et al. [2020] ‘Three-dimensional cone beam computed tomography analysis of temporomandibular joint response to the Twin-block functional appliance’, Korean Journal of Orthodontics, 50[2], p. 86.
25. Ruf, S. and Pancherz, H. [2000] ‘Does bite-jumping damage the TMJ? A prospective longitudinal clinical and MRI study of Herbst patients’, The Angle Orthodontist, 70[3], pp. 183–199.
26. Wadhawan, N. et al. [2008] ‘Temporomandibular joint adaptations following two‐phase therapy: an MRI study’, Orthodontics & craniofacial research, 11[4], pp. 235–250.
27. Cacho, A. et al. [2015] ‘Changes in joint space dimension after the correction of Class II division 1 malocclusion’, European journal of orthodontics, 37[5], pp. 467–473.
28. Cheib Vilefort, P.L. et al. [2019] ‘Condyle‐glenoid fossa relationship after Herbst appliance treatment during two stages of craniofacial skeletal maturation: A retrospective study’, Orthodontics & Craniofacial Research, 22[4], pp. 345–353.
29. Guo, Y. et al. [2020] ‘CBCT analysis of changes in dental occlusion and temporomandibular joints before and after MEAW Orthotherapy in patients with nonlow angle of skeletal class III’, BioMed Research International, 2020.
30. Nindra, J. et al. [2021] ‘Three-dimensional evaluation of condyle-glenoid fossa complex following treatment with Herbst appliance’, Journal of Clinical Medicine, 10[20], p. 4730.
31. Arici, S. et al. [2008] ‘Effects of fixed functional appliance treatment on the temporomandibular joint’, American journal of orthodontics and dentofacial orthopedics, 133[6], pp. 809–814.
32. Kinzinger, G. et al. [2006] ‘Disc-condyle Relationships during Class II Treatment with the Functional Mandibular Advancer [FMA].’, Journal of Orofacial Orthopedics= Fortschritte der Kieferorthopadie: Organ/official Journal Deutsche Gesellschaft fur Kieferorthopadie, 67[5], pp. 356–375.
33. John ZAS, Shrivastav SS, Kamble R, Jaiswal E, Dhande R. Three-dimensional comparative evaluation of articular disc position and other temporomandibular joint morphology in Class II horizontal and vertical cases with Class I malocclusion. Angle Orthod. 2020 Sep 1;90[5]:707-714.
34. Ribeiro, R. et al. [1995] ‘TMJ structural evaluation by MRI in asymptomatic children and young adult volunteers’, Journal of Dental Research, 74[spec.], p. 223.
35.Murakami, S. et al. [1993] ‘Magnetic resonance evaluation of the temporomandibular joint disc position and configuration.’, Dentomaxillofacial Radiology, 22[4], pp. 205–207.
36. Okeson JP [2000] ‘Anatomia funcional e a biomecaˆnica do sistema mastigato´rio’, in O. JP. [ed.] Tratamento das desordens temporomandibulares e oclusa˜o. 4th edn. Sa˜o Paulo, Brazil: Artes Me´dicas;, pp. 3–21.
37. Aidar, L.A. et al. [2009] ‘Effects of Herbst appliance treatment on temporomandibular joint disc position and morphology: a prospective magnetic resonance imaging study’, American journal of orthodontics and dentofacial orthopedics, 136[3], pp. 412–424.
38. Franco, A.A. et al. [2002] ‘Fränkel appliance therapy and the temporomandibular disc: a prospective magnetic resonance imaging study’, American journal of orthodontics and dentofacial orthopedics, 121[5], pp. 447–457.
39. Shen, P. et al. [2019] ‘The effect evaluation of functional appliance used for class II patients with temporomandibular joint anterior disc displacement’, Journal of Craniofacial Surgery, 30[1], pp. e15–e17.
40.Silverstein, R. et al. [1994] ‘MRI assessment of the normal temporomandibular joint with the use of projective geometry’, Oral surgery, oral medicine, oral pathology, 77[5], pp. 523–530.
41. Pereira, M.R.V. [1997] Quantitative Auswertungen bildgebender Verfahren und Entwicklung einer neuen metrischen Analyse für Kiefergelenkstrukturen im Magnetresonanztomogramm.
42. Katzberg, R.W. et al. [1985] ‘Magnetic resonance imaging of the temporomandibular joint meniscus’, Oral surgery, oral medicine, oral pathology, 59[4], pp. 332–335.
43. Arat, Z.M. et al. [2001] ‘Changes in the TMJ disc-condyle-fossa relationship following functional treatment of skeletal Class II Division 1 malocclusion: a magnetic resonance imaging study’, American Journal of Orthodontics and Dentofacial Orthopedics, 119[3], pp. 316–19.
44. Foucart, J.M. et al. [1998] ‘MRI study of temporomandibular joint disk behavior in chilren with hyperpropulsion appliances’, L’Orthodontie Francaise, 69[1], pp. 79–91.
45. Hall, M.B., Gibbs, C.C. and Sclar, A.G. [1985] ‘Association between the prominence of the articular eminence and displaced TMJ disks’, CRANIO®, 3[3], pp. 237–239.
46. Solberg, W.K., Hansson, T.L. and Nordström, B. [1985] ‘The temporomandibular joint in young adults at autopsy: a morphologic classification and evaluation’, Journal of oral rehabilitation, 12[4], pp. 303–321.
47. Aidar, L.A.A. et al. [2010] ‘Changes in temporomandibular joint disc position and form following Herbst and fixed orthodontic treatment’, The Angle Orthodontist, 80[5], pp. 843–852.
48. Patti [2010] : ‘Treatment of class II from prevention to surgery’, in Class II and TMJ. Int.Quintessence, pp. 409–446.
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Apr 23, 2024
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Rebin Ali Mohammedameen, & Omar Fawzi Chawshli. (2024). POSITIONAL AND DIMENSIONAL TMJ CHANGES FOLLOWING THE USE OF DIFFERENT CLASS II CORRECTORS IN A SAMPLE OF ERBIL CITY [RANDOMIZED CLINICAL TRIAL]. Journal of Population Therapeutics and Clinical Pharmacology, 31(4), 1481-1493. https://doi.org/10.53555/jptcp.v31i4.5684
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Author Biographies
Rebin Ali Mohammedameen
Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil 44001, Iraq.
Omar Fawzi Chawshli
Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil 44001, Iraq.
How to Cite
Rebin Ali Mohammedameen, & Omar Fawzi Chawshli. (2024). POSITIONAL AND DIMENSIONAL TMJ CHANGES FOLLOWING THE USE OF DIFFERENT CLASS II CORRECTORS IN A SAMPLE OF ERBIL CITY [RANDOMIZED CLINICAL TRIAL]. Journal of Population Therapeutics and Clinical Pharmacology, 31(4), 1481-1493. https://doi.org/10.53555/jptcp.v31i4.5684