[Therapeutic evaluation of the correction of the severe bi-maxillary protrusion cases by Tweed-Merrifield technique]. 2016

J Q Huang, and S Y Liu, and J H Jiang
Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China;Department of Stomatology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 51000, China.

OBJECTIVE To evaluate the influence of Tweed-Merrifield technique in correction of severe bimaxillary protrusion adult patients on the measurement of the dental and skeletal changes after orthodontic treatment by Johnston analysis and the regular cephalomatric analysis. METHODS Twelve adolescent patients with severe bimaxillary protrusion were included in this self-control retrospective study. Lateral cephalometric radiographs were taken before and after treatments. All the radiographs were traced and analyzed by the method of Johnston analysis. Other measurements were evaluated using a series of 13 linear and angular measurements including SNA, SNB, ANB, U1-SN, U1-NA, U1/NA, L1-NB, U1/NB, L1/MP, U1-L1, (U1+L1)/2-AB, MP/SN and MP/FH from regular cephalomatric analysis. These measurements were also applied to compare the differences between pre- and post-treatments, which clarify the dental and skeletal changes by Johnston analysis. The effect of orthodontic correction was determined using the non-parameters test. RESULTS The maxillary moved backforward by 1.3 mm according to the stable skull base, while the mandible moved forward by 2.12 mm. The relative position between the maxillary and mandible (ABCH) changed 3.42 mm. The upper and lower incisors retracted significantly. The upper and lower molars moved slightly forward and the relative positions of upper and lower molars and anterior teeth after treatment were 3.44 mm and 4.23 mm respectively. After treatment, the parameters of ANB, U1-NA, U1/NA, U1-SN, L1-NB, L1/NB and L1-M were reduced by -(1.98±1.55)°(P=0.012), - (5.08±4.6) mm (P=0.002), -(11.79±1.21)°(P=0.004), -(13.55±6.32)°(P=0.047), -(3.17±3.07) mm (P=0.010), -(6.84±2.55)°(P=0.038) and -(4.13±2.24)°(P=0.048) on average, whose changes had the statistically significant effects. CONCLUSIONS Tweed-Merrifield technique (directional force technique) can stabilize anchorage molar, retract anterior teeth and significantly improve the hard and soft tissue profile for patients with bimaxillary protrusion, and make a good vertical control which means this technique is applicable to the patients who need strong anchorage. Even for the severe bimaxillary protrusion adult patients, the Tweed-Merrifield technique can control the anchoragewell and make the profiles improved greatly.

UI MeSH Term Description Entries
D007180 Incisor Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth. (Jablonski, Dictionary of Dentistry, 1992, p820) Incisors
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D008437 Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the ORBIT, and contains the MAXILLARY SINUS. Maxillae,Maxillary Bone,Bone, Maxillary,Bones, Maxillary,Maxillary Bones,Maxillas
D008963 Molar The most posterior teeth on either side of the jaw, totaling eight in the deciduous dentition (2 on each side, upper and lower), and usually 12 in the permanent dentition (three on each side, upper and lower). They are grinding teeth, having large crowns and broad chewing surfaces. (Jablonski, Dictionary of Dentistry, 1992, p821) Molars
D009971 Orthodontics, Corrective The phase of orthodontics concerned with the correction of malocclusion with proper appliances and prevention of its sequelae (Jablonski's Illus. Dictionary of Dentistry). Corrective Orthodontics
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D002508 Cephalometry The measurement of the dimensions of the HEAD. Craniometry
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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