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732
Martins et al 733
Table I.
Sample characteristics
Age at T1 (y)
Group
Controls
Bionator
RHS
Age at T2 (y)
Boys (n)
Girls (n)
Average
Range
Average
Range
Average
Range
8
8
4
9
9
13
8.90
8.22
8.61
6.67-12.30
6.46-10.56
6.91-10.31
10.30
9.87
10.31
7.84-12.72
7.62-13.88
8.61-12.46
1.40
1.65
1.70
0.42-3.55
0.95-3.32
0.90-2.94
734 Martins et al
Fig 3. Modified pitchforks for the molar and incisor regions: upper box symbolizes the maxilla and
lower box the mandible.
Martins et al 735
RESULTS
736 Martins et al
Table II.
Variable
SNA ()
SNB ()
ANB ()
Wits (mm)
MPA ()
L1/U1 ()
L1/MP ()
U1/PP ()
Bionator
RHS
Mean
SD
Mean
SD
Mean
SD
82.67
76.31
6.37
3.59
34.78
113.87
97.27
119.55
2.01
2.72
1.59
2.01
4.46
110/118
4.86
4.48
82.28
77.17
5.11
4.22
29.79
116.25
98.27
122.60
2.08
3.48
2.34
2.28
6.18
110/119
5.00
5.19
82.03
75.17
6.85
3.64
36.54
112.50
97.91
120.71
4.47
4.14
1.75
2.20
3.98
104/119
7.83
4.33
0.85
0.25
0.03*
0.64
0.001*
0.67
0.89
0.17
Fig 4. Modified pitchforks of the posterior region for A, bionator; B, controls; C, treatment changes.
Martins et al 737
Table II.
Continued
T1-T2
Controls
Bionator
RHS
Mean
SD
Mean
SD
Mean
SD
0.00
0.29
0.30
0.04
0.24
0.48
0.73
0.07
0.88
0.07/0.57
0.65
1.17/0.79
0.82
1.91/2.57
2.42
2.23/1.05
0.32
0.76
1.19
2.19
0.39
4.12
1.56
5.08
0.61
0.19/0.99
0.92
3.00/1.39
1.13
2.07/5.13
2.15
6.63/3.00
0.86
0.36
1.01
1.33
0.03
6.72
0.99
4.44
0.64
0.33/0.70
0.83
2.99/0.15
1.28
2.02/14.27
2.67
10.59/1.45
0.004*
0.03*
0.006*
0.001*
0.23
0.29
0.01*
0.001*
Table III. Skeletal and dental changes in molar relationships and positions in patients treated with the bionator and
the RHS and the untreated controls
Bionator
Variable
Molars
Maxillary
Osseous base
Apex
Cusp
Mandibular
Osseous base
Apex
Cusp
Incisors
Maxillary
Osseous base
Apex
Incisal Edge
Mandibular
Osseous base
Apex
Incisal Edge
RHS
Bionator
vs control
Control
RHS vs
control
Bionator
vs RHS
Average
SD
Average
SD
Average
SD
0.65
0.06
0.41
0.71
1.01
1.08
0.42
0.43
1.65
1.29
0.91
1.86
0.82
0.30
0.49
0.64
0.80
0.81
0.462
0.448
0.008*
1.47
1.04
1.18
1.21
1.29
1.02
0.49
1.05
0.81
1.40
0.81
0.62
0.98
0.49
0.59
0.97
0.77
0.81
0.196
0.136
0.066
0.67
0.81
1.56
0.77
0.97
1.04
0.40
0.55
1.74
1.11
0.78
1.93
0.56
0.77
0.64
0.81
0.63
0.89
0.682
0.882
0.001*
0.618
0.325
0.001*
0.399
0.342
0.318
1.19
0.55
0.74
0.62
0.60
0.68
1.38
0.70
0.68
1.07
0.42
0.65
1.12
0.41
0.72
0.191
0.183
0.053
0.265
0.328
0.660
0.025*
0.054
0.098
1.59
0.20
1.15
Significance
0.236
0.011*
0.001*
0.513
0.115
0.004*
0.213
0.030*
0.340
0.027*
0.983
0.159
changes (2.41 mm). The maxillary incisors were retroclined significantly by 2.38 mm (controlled tipping),
and the mandibular incisors maintained their position
(Figs 7 and 8; Table III).
DISCUSSION
738 Martins et al
Fig 5. Modified pitchforks of the posterior region for A, RHS; B, controls; C, treatment changes.
Fig 6. Modified pitchforks of the anterior region for A, bionator; B, controls; C, treatment changes.
Martins et al 739
Fig 7. Modified pitchforks of the anterior region for A, RHS; B, controls; C, treatment changes.
740 Martins et al
lingual tipping of the maxillary incisors. The mandibular incisor edges were proclined approximately twice
as much with the bionator than with the RHS. Keeling
et al27 also showed that headgear corrections were due
to retroclination of the maxillary incisors and approximately twice as much proclination of the mandibular
incisors with the bionator. Importantly, this suggests
that bionators could limit molar correction when the
proclined mandibular incisors contact the retroclined
maxillary incisors.
CONCLUSIONS
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
Martins et al 741