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Szkeletaacutelis horgonylatok
szerepe az
aacutellcsontorthopeacutediaacuteban
Dr Nemes Baacutelint Semmelweis Egyetem Gyermekfogaacuteszati eacutes
Fogszabaacutelyozaacutesi Klinika
Szkele
taacutelis
horgo
nylat
ok sz
erepe
III osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Le Fort I advancement
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Konzervatiacutev kezeleacutes
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
RME + ARCMASZK
(Rapid Maxillary Expansion)
Liou EJ Effective maxillary orthopedic protraction for growing Class III patients a clinical application simulates distraction
osteogenesis Prog Orthod 20056(2)154-71
Masucci C1 Franchi L Giuntini V Defraia E Short-term effects of a modified Alt-RAMEC protocol for early treatment of Class
III malocclusion a controlled study Orthod Craniofac Res 2014 Nov17(4)259-69 doi 101111ocr12051 Epub 2014 Jul 7
Alt-RAMEC + ARCMASZK
(Alternating Rapid Maxillary Expansion and Constriction)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Minilemez + arcmaszk
Baek et al 2010 Angle Orthodontist Szk
eletaacutel
is ho
rgony
latok
szere
pe
Alt-RAMEC + arcmaszk + minilemez
Kaya et al 2011 Angle Orthodontist
15 patients with a mean skeletal age of 116 plusmn159 years undergoing 8 weeks of Alt-RAMEC followed by maxillary protraction maxilla moved forward by 2 mm
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-hyrax + mentoplate
Wilmes et al 2011 JCO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hybrid Hyrax Alt-RAMEC
Wilmes et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
III osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Le Fort I advancement
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Konzervatiacutev kezeleacutes
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
RME + ARCMASZK
(Rapid Maxillary Expansion)
Liou EJ Effective maxillary orthopedic protraction for growing Class III patients a clinical application simulates distraction
osteogenesis Prog Orthod 20056(2)154-71
Masucci C1 Franchi L Giuntini V Defraia E Short-term effects of a modified Alt-RAMEC protocol for early treatment of Class
III malocclusion a controlled study Orthod Craniofac Res 2014 Nov17(4)259-69 doi 101111ocr12051 Epub 2014 Jul 7
Alt-RAMEC + ARCMASZK
(Alternating Rapid Maxillary Expansion and Constriction)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Minilemez + arcmaszk
Baek et al 2010 Angle Orthodontist Szk
eletaacutel
is ho
rgony
latok
szere
pe
Alt-RAMEC + arcmaszk + minilemez
Kaya et al 2011 Angle Orthodontist
15 patients with a mean skeletal age of 116 plusmn159 years undergoing 8 weeks of Alt-RAMEC followed by maxillary protraction maxilla moved forward by 2 mm
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-hyrax + mentoplate
Wilmes et al 2011 JCO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hybrid Hyrax Alt-RAMEC
Wilmes et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I advancement
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Konzervatiacutev kezeleacutes
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
RME + ARCMASZK
(Rapid Maxillary Expansion)
Liou EJ Effective maxillary orthopedic protraction for growing Class III patients a clinical application simulates distraction
osteogenesis Prog Orthod 20056(2)154-71
Masucci C1 Franchi L Giuntini V Defraia E Short-term effects of a modified Alt-RAMEC protocol for early treatment of Class
III malocclusion a controlled study Orthod Craniofac Res 2014 Nov17(4)259-69 doi 101111ocr12051 Epub 2014 Jul 7
Alt-RAMEC + ARCMASZK
(Alternating Rapid Maxillary Expansion and Constriction)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Minilemez + arcmaszk
Baek et al 2010 Angle Orthodontist Szk
eletaacutel
is ho
rgony
latok
szere
pe
Alt-RAMEC + arcmaszk + minilemez
Kaya et al 2011 Angle Orthodontist
15 patients with a mean skeletal age of 116 plusmn159 years undergoing 8 weeks of Alt-RAMEC followed by maxillary protraction maxilla moved forward by 2 mm
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-hyrax + mentoplate
Wilmes et al 2011 JCO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hybrid Hyrax Alt-RAMEC
Wilmes et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Konzervatiacutev kezeleacutes
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
RME + ARCMASZK
(Rapid Maxillary Expansion)
Liou EJ Effective maxillary orthopedic protraction for growing Class III patients a clinical application simulates distraction
osteogenesis Prog Orthod 20056(2)154-71
Masucci C1 Franchi L Giuntini V Defraia E Short-term effects of a modified Alt-RAMEC protocol for early treatment of Class
III malocclusion a controlled study Orthod Craniofac Res 2014 Nov17(4)259-69 doi 101111ocr12051 Epub 2014 Jul 7
Alt-RAMEC + ARCMASZK
(Alternating Rapid Maxillary Expansion and Constriction)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Minilemez + arcmaszk
Baek et al 2010 Angle Orthodontist Szk
eletaacutel
is ho
rgony
latok
szere
pe
Alt-RAMEC + arcmaszk + minilemez
Kaya et al 2011 Angle Orthodontist
15 patients with a mean skeletal age of 116 plusmn159 years undergoing 8 weeks of Alt-RAMEC followed by maxillary protraction maxilla moved forward by 2 mm
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-hyrax + mentoplate
Wilmes et al 2011 JCO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hybrid Hyrax Alt-RAMEC
Wilmes et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
RME + ARCMASZK
(Rapid Maxillary Expansion)
Liou EJ Effective maxillary orthopedic protraction for growing Class III patients a clinical application simulates distraction
osteogenesis Prog Orthod 20056(2)154-71
Masucci C1 Franchi L Giuntini V Defraia E Short-term effects of a modified Alt-RAMEC protocol for early treatment of Class
III malocclusion a controlled study Orthod Craniofac Res 2014 Nov17(4)259-69 doi 101111ocr12051 Epub 2014 Jul 7
Alt-RAMEC + ARCMASZK
(Alternating Rapid Maxillary Expansion and Constriction)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Minilemez + arcmaszk
Baek et al 2010 Angle Orthodontist Szk
eletaacutel
is ho
rgony
latok
szere
pe
Alt-RAMEC + arcmaszk + minilemez
Kaya et al 2011 Angle Orthodontist
15 patients with a mean skeletal age of 116 plusmn159 years undergoing 8 weeks of Alt-RAMEC followed by maxillary protraction maxilla moved forward by 2 mm
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-hyrax + mentoplate
Wilmes et al 2011 JCO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hybrid Hyrax Alt-RAMEC
Wilmes et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Minilemez + arcmaszk
Baek et al 2010 Angle Orthodontist Szk
eletaacutel
is ho
rgony
latok
szere
pe
Alt-RAMEC + arcmaszk + minilemez
Kaya et al 2011 Angle Orthodontist
15 patients with a mean skeletal age of 116 plusmn159 years undergoing 8 weeks of Alt-RAMEC followed by maxillary protraction maxilla moved forward by 2 mm
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-hyrax + mentoplate
Wilmes et al 2011 JCO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hybrid Hyrax Alt-RAMEC
Wilmes et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Alt-RAMEC + arcmaszk + minilemez
Kaya et al 2011 Angle Orthodontist
15 patients with a mean skeletal age of 116 plusmn159 years undergoing 8 weeks of Alt-RAMEC followed by maxillary protraction maxilla moved forward by 2 mm
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-hyrax + mentoplate
Wilmes et al 2011 JCO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hybrid Hyrax Alt-RAMEC
Wilmes et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-hyrax + mentoplate
Wilmes et al 2011 JCO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hybrid Hyrax Alt-RAMEC
Wilmes et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid Hyrax Alt-RAMEC
Wilmes et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
According to the present results TAD-anchored MP might have a greater maxillary advancement effect and might reduce skeletal and dental side effects compared with toothanchored MP (Feng et al Angle Orthod 2012821107ndash1114)
The overall success rate of miniplate anchorage in terms of stability was 97 (De Clerck and Swennen 2011 Angle Orthodontist)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bone Anchored Maxillary Protraction (BAMP)
De Clerck et al 2010 J Oral Maxillofacial Surg Szk
eletaacutel
is ho
rgony
latok
szere
pe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Remodeling of the glenoid fossa at the anterior eminence and bone resorption at the posterior wall De Clerck et al 2012 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
II osztaacutely Szk
eletaacutel
is ho
rgony
latok
szere
pe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Bilateral Saggital Split Osteotomy
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Mandibular changes produced by
functional appliances in Class II
malocclusion a systematic review
bull from January 1966 to January 2005 RCT-s and CCT-s with
untreated Class II controls 22 articles qualified for the final analysis Four RCTs and 18 CCTs were retrieved
bull The amount of supplementary mandibular growth appears to be significantly larger if the functional treatment is performed at the pubertal peak in skeletal maturation
bull The Herbst appliance showed the highest coefficient of efficiency (028 mm per month) followed by the Twin-block (023 mm per month)
Cozza et al AJODO 2006 May129(5)599
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Class II correction in patients treated with
Class II elastics and with fixed functional
appliances A comparative study
In the Begg group the maxilla moved forward 1 mm more than in the Herbst group and the mandible moved 1 mm more in the Herbst group than in the Begg group The skeletal improvement in the Herbst group exceeded the changes in the Begg group by on average 20 mm (P lt 01) The overjet reduction in the Begg group was larger (21 mm P lt 01) than in the Herbst group mostly because of dental movements The skeletal part of the overjet reduction was 4 in the Begg group compared with 51 in the Herbst group The molar correction was similar in both groups but in the Begg group the skeletal improvement was 10 compared with 66 in the Herbst group The overbite correction and the increase in the anterior lower facial height and in the NSLML angle were larger in the Begg group (P lt 05) The conclusions of this study were that the changes contributing to the Class II corrections in Begg and Herbst therapy were skeletal and dental The skeletal changes were however larger in the Herbsttreated group On the other hand favorable and unfavorable vertical changes were more pronounced in the group treated with Class II elastics
Nelson et al Am J Orthod Dentofacial Orthop 2000118142-9
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Correction of Class II malocclusion with
Class II elastics a systematic review
bull Although Class II elastics have been widely used in the correction of Class II malocclusions there is still a belief that their side effects override the intended objectives The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment
Based on the current literature we can state that Class II elastics are effective in correcting Class II malocclusions and their effects are primarily dentoalveolar Therefore they are similar to the effects of fixed functional appliances in the long term placing these 2 methods close to each other when evaluating treatment effectiveness Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment
Janson et al Am J Orthod Dentofacial Orthop 2013
Mar143(3)383-92
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Jumping the bite
Dentaacutelis
Foumllső fogak disztalizaacutelaacutesa Alsoacute fogak mezializaacutelaacutesa Szkeletaacutelis
Kondilaacuteris noumlvekedeacutes Mandibula hossznoumlvekedeacutes Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Intermaxillaacuteris gumihuacutezaacutes
Foumllső front
Disztalizaacutecoacute Extruacutezioacute Alsoacute molaacuteris
Mezializaacutecioacute Extruacutezioacute
Mandibula disztorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Skeletal and dental changes in Class II division 1
malocclusions treated with splint-type Herbst
appliances A systematic review
bull Flores et alAngle Orthod 2007 Mar77(2)376-81
bull Three articles were finally selected and analyzed An individual analysis of these articles was made and some methodological flaws were identified The selected studies all showed statistically significant changes in the anteroposterior length of the mandible vertical height of the ramus lower facial height mandibular incisor proclination mesial movement of the lower molars and distal movement of the upper molars Posttreatment relapse in overjet and molar relationship was also observed
bull CONCLUSIONS
bull Dental changes are as important as skeletal changes to attaining the final occlusal results Long-term prospective double-blinded randomized clinical trials are needed to support these conclusions
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Herbst zsaneacuter
Alsoacute front
Proklinaacutecioacute Foumllső molaacuteris
Disztalizaacutecioacute Intruacutezioacute
Mandibula autorotaacutecioacute In all subjects (n=98) Herbst
treatment resulted in varying degrees of lower-incisor proclination (mean = 89 degrees range = 05 degrees to 195 degrees)
Ruf et alAJODO 1998 Jul114(1)100-6
Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
The Miniscrew-Anchored Herbst
Luzi et al JCO 2012
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniscrew anchored Herbst
The mean increase in lower incisor inclination at the end of treatment was 1deg (range 0deg to 2deg) for the EG and 7deg (range 4deg to 10deg) for the CG n=10 Luzi et al 2103 Szk
eletaacutel
is ho
rgony
latok
szere
pe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
The Miniscrew anchored Herbst
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
This study showed that the Herbst appliance associated to miniscrews allowed a better control of the incisor flaring with a greater
mandibular skeletal effect n=28
Manni et al 2014
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Miniplate anchored Forsus
Although both appliances were successful in correcting the skeletal Class II malocclusion the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors n=32 Celikoglu et al Angle Orthodontist Vol 86 No 2 2016
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
I Osztaacutely nyitott
harapaacutes
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Le Fort I Impakcioacute
Steinhaumluser et al 2008 J Orofac Orthoped
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Gurton et al 2004 Szk
eletaacutel
is ho
rgony
latok
szere
pe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Rapid Molar Intruder Appliance
Cinsar et al 2007
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Sherwood et al 2002 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Kuroda et al 2004
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Edgewise vs Molar intrusion
From the cephalometric values in the non-
IA group open-bite patients were generally treated by extrusion of the maxillary and
mandibular incisors that resulted in clockwise rotation of the mandibular plane angle In the IA group intrusion of the
maxillary and mandibular molars that resulted in counterclockwise rotation was noted (n=30 with 2 years followup) Deguchi et al 2011 AJODO
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Xun et al 2007 Angle Orthodontist
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Foot et al 2014 Progress in Orthodontics
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Stabil Deguchi et al 2011 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=15) Scheffler et al 2014 AJODO 2 eacuteves utaacutenkoumlveteacutessel (n=33) Dalci et al 2015 EOS Venice OP44 36 eacutev utaacutenkoumlveteacutessel (n=30)
Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior
open bites but 05 to 15 mm of reeruption of these teeth is likely to occur Controlling the vertical
position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height Scheffler et al 2014 AJODO Szk
eletaacutel
is ho
rgony
latok
szere
pe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Transverzaacutelis
elteacutereacutesek
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
SARME ndash palat szutura elcsontosodaacutesa utaacuten
bull Altataacutesos műteacutet bull Melleacutekhataacutesok (műteacuteti dentaacutelis
Hyrax-naacutel) bull Boumllcsesseacutegfogak eltaacutevoliacutetaacutesa 6
hoacutenappal a műteacutet előtt bull Időigeacutenyes (szaacutejsebeacuteszekkel valoacute
egyezteteacutes 2-4 nap bentfekveacutes) bull Disztraktor eseteacuten 2 műteacutet bull Koumlltseacutegek Szk
eletaacutel
is ho
rgony
latok
szere
pe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Fog elhorgonyzaacutesuacute RME
időziacuteteacutese
Graber Contemporary Orthodontics 2012 Ch 14 Optimizing Orthodontic and Dentofacial Orthopedic Treatment Timing
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hybrid-Hyrax mit vaacuterunk tőle
- Kombinaacutelt csont- eacutes fogelhorgonyzaacutes - Fogvaacuteltaacutes koumlzben is alkalmazhatoacute - Az erők koumlzvetlenuumll hatnak a palatinaacutelis
csontra - Nagyobb szkeletaacutelis hataacutes mert az
erőhataacutes koumlzelebb esik a maxilla rezisztenciakoumlzpontjaacutehoz
- Kevesebb olyan melleacutekhataacutes mint a
fenesztraacutecioacute eacutes a bukkaacutelis dőleacutes - Irodalom hateacutekony expanzioacutes moacutedszer Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hyrax vs Hybrid hyrax
20 growing girls (ages 12 6 06 years) There were significant increases in facial and maxillary widths for the BBME group and in nasal width for the TBME group Both expanders produced basal bone expansion at the level of the hard palate The TBMEs produced more dental expansion buccal rolling and a greater increase in nasal width than did the BBMEs Szk
eletaacutel
is ho
rgony
latok
szere
pe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
Hyrax vs Hybrid hyrax
Toklu et al 2015 AJODO
143 plusmn23 years 138 plusmn 22 years
1 Both tooth-borne and tooth-bone-borne RME are effective methods for the treatment of maxillary constriction 2 The hyrax and the hybrid hyrax expanders resulted in similar skeletal effects 3 The hyrax appliance resulted in greater expansion in the premolar region than did the hybrid hyrax 4 Both appliances reduced the buccal bone thickness and increased the palatal bone thickness in the molar area 5 Buccal bone thickness decreased in the premolar area in the purely tooth-borne group whereas the buccal bone thickness in the hybrid hyrax group was maintained
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe
MICRO 4 MICRO 6
Winsauer et al 2013 JCO (n=31)
Szkele
taacutelis
horgo
nylat
ok sz
erepe