Comparison of facial soft tissue changes after treatment with 3 different functional appliances


AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS, vol.158, no.4, pp.518-526, 2020 (SCI-Expanded) identifier identifier identifier


Introduction: This study aimed to evaluate the effects of 3 different fixed or removable functional appliances on the soft tissue changes in patients with Class II Division 1 malocclusion using 3-dimensional images. Methods: A total of 60 patients with Class II Division 1 malocclusion (38 girls and 22 boys; mean age, 12.35 +/- 1.01 years) were treated with 3 different functional appliances, namely, Twin-block (TB) (group TB, n = 20), mono-block (MB) (group MB, n = 20), or Herbst (H) (group H, n = 20) for 9.55 +/- 1.46 months. Three-dimensional photographs of each patient were taken at the baseline and the end of the therapy with a 3dMD Face system (3dMD, Atlanta, Ga). Statistical analyses were performed using the dependent samples t test, 1-way analysis of variance, Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed rank tests. Results: No statistically significant differences were detected for soft tissue changes except for the lower facial width found, at least in group H (P <0.05). Volumetric differences in the mandible were similar between the groups (P >0.05). A statistically significant decrease in total facial height and an increase in convexity angle and facial depth were detected in all groups after treatment compared with the baseline (P <0.05). The upper and lower facial height, lower lip height, and nasal width were statistically significantly increased in the TB and MB groups after treatment compared with the baseline (P <0.05) and similar to those in group H (P >0.05). Conclusions: TB, MB, and H appliances may promote the facial soft tissue profile, including volumetric improvement, in the mandibular region.