Patients with class II malocclusion and retrognathic mandibles will be treated using functional appliances and asses the remodeling that is expected to occur in the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT) images and we will register mandibular movements using electronic axiograph ( a specific apparatus used to record jaw movements in three dimensions). There are three groups : 1. Activator Group 2. Twin block Group 3. Control Group with no treatment. Patients will be allocated to the three groups randomly. Data will be collected using three different approaches: * CBCT images before treatment and 12 months after treatment * Axiograph registrations before treatment and 12 months after treatment
The main purposes of this project are: 1. to evaluate the remodeling effects that would take place in the bone structures of the temporomandibular joint (TMJ) during functional treatment. 2. to evaluate the possible change that may occur in mandibular movements following functional treatment. 3. to evaluate the possible change in the spatial relationship between centric occlusion (CO) and centric relation (CR) following functional treatment
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
66
This appliance is constructed in one piece to guide the position of the mandible on closure
This appliance is constructed in two pieces to guide the position of the mandible on closure
Orthodontic Department, University of Damascus Dental School
Damascus, Syria
Change in Glenoid Fossa Height
Glenoid fossa height: the vertical space between the roof and lowest edge of the fossa. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in Glenoid Fossa Width
Glenoid fossa width: the horizontal space between the anterior and posterior wall of the fossa. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in Articular Eminence Inclination
Articular Eminence inclination: the angle between a horizontal plane and the posterior slope of the articular eminence. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in Condylar Height
Condylar Height: the vertical height of the head of the condyle. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in Condylar Width
Condylar Width: the horizontal width of the head of the condyle. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in Condylar Length
Condylar Length: the mesio-distal length of the head of the condyle. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in Condylar Circumference
Condyle circumference: the outer circumference of the head of the condyle. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in the Anterior Joint Space
Anterior Joint Space: the space between the anterior edge of condyle and the posterior slope of the articular eminence. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in the Superior Joint Space
Superior Joint Space: the space between the superior edge of the condyle and the roof of the fossa. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in the Posterior Joint Space
Posterior joint space: the space between the posterior edge of the condyle and the posterior board of the fossa. This measurement will be done on the 3D software (3D OnDemand) using CBCT images
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in Border Mandibular Movements
Border mandibular movements will be measured on the axiograph apparatus (called Arcosdigma(R)).
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
Change in the Discrepancy between CO and CR
CO-CR discrepancy: we will measure distance between centric relation and centric occlusion in three dimensions (sagittal, coronal and axial ). These measurements will be done by an electronic axiograph (Arcosdigma(R))
Time frame: T1: at one day before the commencement of treatment; T2: after 12 months of treatment
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