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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (2): 340-345. doi: 10.19723/j.issn.1671-167X.2022.02.023

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Efficacy of vertical control by using mini-implant anchorage in maxillary posterior buccal area for Angle class Ⅱ extraction patients

LIANG Wei,TANG Yao,HUANG Wen-bin,HAN Bing(),LIN Jiu-xiang   

  1. Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
  • Received:2020-10-10 Online:2022-04-18 Published:2022-04-13
  • Contact: Bing HAN E-mail:kqbinghan@bjmu.edu.cn

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Abstract:

Objective: To investigate the efficacy of vertical control by using conventional mini-implant anchorage in maxillary posterior buccal area for Angle class Ⅱ extraction patients. Methods: Twenty-eight Angle class Ⅱ patients [9 males, 19 females, and age (22.6±2.8) years] were selected in this study. All of these patients were treated by using straight wire appliance with 4 premolars extraction and 2 mini-implant anchorage in maxillary posterior buccal area. In this study, the self-control method was used to measure and analyze the lateral radiographs taken before and after orthodontic treatment in each case, the main cephalometric analysis items were related to vertical changes. The digitized lateral radiographs were imported into Dolphin Imaging Software (version 11.5: Dolphin Imaging and Management Solutions, Chatsworth, California, USA), and marked points were traced. Each marked point was confirmed by two orthodontists. The same orthodontist performed measurement on the lateral radiographs over a period of time. All measurement items were required to be measured 3 times, and the average value was taken as the final measurement result. Results: Analysis of the cephalometric radiographs showed that, for vertical measurements after treatment, the differences of the following measurements were highly statistically significant (P<0.001): SN-MP decreased by (1.40±1.45) degrees on average, FMA decreased by (1.58±1.32) degrees on average, the back-to-front height ratio (S-Go/N-Me) decreased by 1.42%±1.43% on average, Y-axis angle decreased by (1.03±0.99) degrees on average, face angle increases by (1.37±1.05) degree on average; The following measurements were statistically significant (P<0.05): the average depression of the upper molars was (0.68±1.40) mm, and the average depression of the upper anterior teeth was (1.07±1.55) mm. The outcomes indicated that there was a certain degree of upper molar depression after the treatment, which produced a certain degree of counterclockwise rotation of the mandibular plane, resulting in a positive effect on the improvement of the profile. Conclusion: The conventional micro-implant anchorage in maxillary posterior buccal area has a certain vertical control ability, and can give rise to a certain counterclockwise rotation of the mandible, which would improve the profile of Angle Class Ⅱ patients.

Key words: Vertical control, Microscrew implant anchorage, Cephalometry

CLC Number: 

  • R783.5

Figure 1

Position and mechanical effect of mini-implant F0, traction force; F1, vertical force component; F2, horizontal force component."

Table 1

X-ray cephalometric analysis results before and after treatment ( x -±s)"

Items Before treatment After treatment Difference t P
ANB/(°) 5.54±1.73 4.09±1.65 -1.45±1.21 -6.319 <0.001
MP-SN/(°) 36.81±7.05 35.41±6.87 -1.40±1.45 -5.082 <0.001
FMA (MP-FH)/(°) 28.13±6.40 26.54±6.18 -1.58±1.32 -6.324 <0.001
P-A face height (S-Go/N-Me)/% 65.11±5.63 66.53±5.21 1.42±1.43 5.252 <0.001
U6-PP (UPDH)/mm 23.25±1.53 22.57±1.71 -0.68±1.40 -2.556 0.017
U1-PP (UADH)/mm 29.66±2.10 28.59±2.37 -1.07±1.55 -3.363 <0.001
Y-axis (SGn-SN)/(°) 73.66±3.18 72.63±3.29 -1.03±0.99 -5.523 <0.001
Facial plane to SN (SN-NPog)/(°) 76.49±2.71 77.86±2.71 1.37±1.05 6.892 <0.001

Figure 2

Patient's profile before treatment A, frontal image; B, lateral image; C, lateral cephalometric radiograph; D, panoramic radiograph; E, right occlusion image; F, frontal occlusion image; G, left occlusion image; H, maxillary occlusion image; I, mandibular occlusion image."

Figure 3

Patient's profile after treatment A, frontal image; B, lateral image; C, lateral cephalometric radiograph; D, panoramic radiograph; E, right occlusion image; F, frontal occlusion image; G, left occlusion image; H, maxillary occlusion image; I, mandibular occlusion image."

Table 2

Changes of various items of the patient's X-ray cephalometric analysis before and after treatment"

Items Before treatment After treatment Difference Normal
SNA/(°) 80.8 79.8 -1.0 82.0
SNB/(°) 75.7 76.3 0.6 80.9
ANB/(°) 5.1 3.5 -1.6 1.6
Facial angle (FH-NPo)/(°) 82.2 82.5 0.3 88.6
Convexity (NA-APo)/(°) 10.9 7.3 -3.6 4.9
U1-NA/mm 9.7 4.7 -5.0 4.3
U1-NA/(°) 36.7 26.1 -10.6 22.8
L1-NB/mm 13.0 7.0 -6.0 4.0
L1-NB/(°) 41.6 31.4 -10.2 25.3
Interincisal angle (U1-L1) /(°) 96.6 119.0 22.4 130.3
U1-SN/(°) 117.5 105.9 -11.6 102.8
MP-SN/(°) 40.3 37.5 -2.8 33.0
FMA (MP-FH) /(°) 33.7 31.4 -2.3 23.9
IMPA (L1-MP) /(°) 105.6 97.6 -8.0 95.0
PFH/AFH/% 51.5 52.8 1.3 60.0
P-A face height (S-Go/N-Me)/% 61.5 64.7 3.2 65.0
ANS-Me/Na-Me/% 53.6 53.7 0.1 55.0
ANS-Me (perp HP)/mm 61.7 62.2 0.5 60.6
U6-PP (UPDH)/mm 23.3 23.9 0.6 23.0
U1-PP (UADH)/mm 28.6 27.9 -0.7 28.0
L6-MP (LPDH)/mm 30.0 32.3 2.3 31.0
L1-MP (LADH)/mm 42.3 38.7 -3.6 40.0
Y-axis (SGn-SN)/(°) 73.8 73.4 -0.4 47.0
Y-axis-downs (SGn-FH)/(°) 67.3 67.3 0.0 60.3
Pog-NB/mm -0.2 0.3 0.5 2.4
Facial plane to SN (SN-NPog)/(°) 75.6 76.4 0.8 80.5
Occ plane to FH /(°) 11.1 13.9 2.8 6.8

Figure 4

Cephalometric superimposition before and after treatment Based on S-N plane, the red line shows structure before treatment, the blue line shows structure after treatment."

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