Rohit Kulshrestha*, Vinay V Umale, Kamlesh Singh, Aftab Azam and Madhvi Bhardwaj
Published on: 10th March, 2017
Aim: To evaluate sexual dimorphism in horizontal lip position in adults with different skeletal patterns.
Material and Methods: The sample comprised of 120 patients (Females 18 years and above, Males 21 years and above) with no history of previous orthodontic treatment or functional jaw orthopaedic treatment. They were divided into different groups based on the ANB angle and gender. Group I and II included 30 males and 30 females with skeletal class I malocclusion (ANB 0-4 degree). Group III and IV included 30 males and 30 females with skeletal class II malocclusion respectively (ANB above 4 degree).
Results: When comparison between males and females (Class I+Class II) was done S-line (p<0.001), B-line (p<0.001), E-line (p<0.001), Holdaways angle (p<0.001) and Merrifield angle (p<0.001) were found to be statistically significant. S-line (p<0.001), E-line (p<0.001) and Holdaways angle (p<0.001) were found to be statistically significant when comparison was done between males and females (Class I). When comparison was done between males and females (Class II) only Holdaways angle (p<0.001) showed a significant statistical difference.
Conclusion: Sexual dimorphism was found in various lip parameters. Significant amount of differences were found between Class I and Class II (male and female) subjects.
Selective alveolar decortication and periodontal augmentation with a bone graft were the two procedures used for the correction of the skeletal class II malocclusion in the case reported. A 25-year-old male patient presented with a skeletal class II malocclusion with increased bi-maxillary dento-alveolar protrusion, increased overjet, deep bite and imbricated and rotated mandibular incisors with bilateral presence of supernumerary teeth in the maxillary right and left premolar regions. Extraction of supernumerary in the maxillary right and left premolar region, and impacted UL5 was done. Pre-adjusted edgewise appliance, Roth’s prescription (0.022x0.028-inch slot), was bonded and a week later full thickness labial and lingual flaps were reflected in the maxillary and mandibular arches. Circumscribed corticotomy cuts was done and subsequently augmented with a bone graft. Orthodontic treatment was commenced immediately after surgery and orthodontic adjustments were performed every 2 weeks. The entire orthodontic treatment was completed in 9 months. Regional acceleratory phenomenon, triggered by the alveolar decortication, was responsible for the rapid correction of the malocclusion and the augmentation with the bone graft provided adequate bone volume for housing the teeth, thereby decreasing the possibility of subsequent relapse.
Correcting class II malocclusion has always challenged an orthodontist owing to the complex and multifactorial aetiology. Age of patient and selection of the appliance plays an important role in the outcome of the treatment. Growth modification using functional appliances achieves stable results in class II patients. An orthodontist has wide variety of fixed and removable appliances for addressing a class II malocclusion. In this review article an attempt has been made to compile various available fixed functional appliances.
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