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Effects of wear time differences of removable functional appliances in class II patients: prospective MRI study of TMJ and masticatory muscle changes

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Abstract

Objectives

The aim of this prospective study was to evaluate the short-term effects of full-time and night-time wear of functional appliances on the temporomandibular joint (TMJ) and masticatory muscles and to compare the differences in craniofacial structures, TMJ, and masticatory muscles with magnetic resonance imaging (MRI).

Methods

The study was carried out using cephalometric radiographs and MRI of 20 Class II patients who were treated with monoblock/twin-block appliances. The patients were divided into 2 groups: ten patients in Group 1 used their appliances all day, while ten patients in Group 2 were instructed to wear the appliances during sleep. After at least 6 months of uninterrupted treatment, post-treatment cephalograms and MRI were obtained for patients whose molar relationship improved by at least a half cusp width. Signal intensity ratios (SIR) of TMJ structures and morphological evaluations of masticatory muscles were done for all patients.

Results

It was found a significant increase in SIR values of the condylar process, articular disc, retrodiscal tissue, and masticatory muscles for all treatment groups. Length of the masseter and medial pterygoid muscles increased to varying degrees which left side of Group 2 was significantly increased (P < 0.05). The volume of all muscles also increased to varying degrees.

Conclusions

The cephalometric and MRI findings of this study show that the treatment effects were similar for both wear schedules.

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Acknowledgements

We would like to express our gratitude to Dr. Oktay Algın, all the officials and staff members of UMRAM, especially MRI technicians Mustafa Delikanlı and Alp Eren Kılıç for their help and patience in taking the MRI. We also thank Prof. Dr. Ensar Başpınar and Dr. Rabia Albayrak for their guidance in completing statistical analysis of this study. This work was supported by the Ankara University, Scientific Research Projects Center (BAP) with Project Number 15B0234003.

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Authors and Affiliations

  1. Department of Orthodontics, Private Practice, Ankara, Turkey

    Emre Cesur

  2. Department of Orthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey

    Orhan Özdiler & Ayşegül Köklü

  3. Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey

    Kaan Orhan

  4. OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium

    Kaan Orhan

  5. Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey

    Umut Seki

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  1. Emre Cesur
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  2. Orhan Özdiler
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Correspondence to Kaan Orhan.

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Conflict of interest

Emre Cesur declares that he has no conflict of interest. Orhan Özdiler declares that he has no conflict of interest. Ayşegül Köklü declares that she has no conflict of interest. Kaan Orhan declares that he has no conflict of interest. Umut Seki declares that he has no conflict of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.

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Cesur, E., Özdiler, O., Köklü, A. et al. Effects of wear time differences of removable functional appliances in class II patients: prospective MRI study of TMJ and masticatory muscle changes. Oral Radiol 36, 47–59 (2020). https://doi.org/10.1007/s11282-019-00379-0

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  • DOI: https://doi.org/10.1007/s11282-019-00379-0

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