Outcomes of device-aided only vs. device-aided and surgical treatment of skeletal distal occlusion in adults

Abstract

BACKGROUND: The device-aided and surgical approach is the preferred option for the treatment of skeletal distal occlusion in adults. Despite its advantages, this approach necessitates major surgery, which is associated with intraoperative and postoperative complications. Patients in need of orthodontic treatment are increasingly interested in treatment options that require minimum surgical intervention.

AIM: To assess the outcomes of skeletal distal occlusion treatment in adults using the proposed method vs. the device-aided and surgical approach.

MATERIALS AND METHODS: The study included 104 patients. The treatment group included 44 patients who were treated using the proposed method. The mean age was 32 ± 7.4 years. The control group included 60 patients who were treated using the conventional device-aided and surgical approach. The mean age was 34 ± 5.8 years.

RESULTS: The efficacy of the proposed method vs. the device-aided and surgical approach in the treatment of skeletal distal occlusion in adults was assessed using teleradiography scans. When using a modified Herbst appliance, the mean improvement in ss-n-spm and Wits was 2.06 ± 0.77° and 5.35 ± 1.56 mm, respectively. When using the device-aided and surgical approach, the mean improvement in these parameters was 3.55 ± 0.68° and 6.16 ± 2.10 mm, respectively. An improvement in the mandibular apical base position was 6.32 ± 2.02° and 8.11 ± 2.61° for the modified Herbst appliance and the device-aided and surgical approach, respectively. An improvement in the mental region position was 2.62 ± 2.15° and 6.72 ± 2.51° for the modified Herbst appliance and the device-aided and surgical approach, respectively.

CONCLUSIONS: Using a modified Herbst appliance as an alternative to reconstructive surgery improves occlusion and mandible position in adults without the need for major surgery.

Keywords

Herbst appliance / reconstructive surgery / distal occlusion

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