Advertisement

Perioral forces and dental changes resulting from mandibular lip bumper treatment

      Abstract

      This prospective study compares pretreatment and posttreatment forces produced by a lip bumper on the mandibular first molars and determines the dental effects of this appliance after 1 year of treatment. Twenty-five patients, ages 10 to 17 years, received fixed 0.045-inch passive stainless steel lip bumpers positioned at the level of the gingival margin, 2 mm from the labial surface of the teeth as the only form of treatment in the mandibular arch. At the end of 1 year, cephalometric radiographs and dental casts were taken, and lower lip forces remeasured during rest, speech, and swallowing. Lip force measurements were performed using specially designed strain gauges mounted bilaterally in the lip bumper tubes. Measurements of lip forces made before and after treatment were compared to explore the changes, if any, due to muscle adaptation to the appliance. Dental changes were measured from casts and cephalometric radiographs. Correlation analyses were performed to determine whether a relationship existed between initial force levels and resulting tooth movement. Pretreatment and posttreatment forces did not demonstrate a statistically significant difference. On the other hand, measurement of the dental casts revealed a significant increase in arch length caused by incisor proclination and protrusion, combined with molar distalization. The arch width significantly increased at the canines, first and second premolars, and first molars. The amount of force exerted by the lower lip on the molars was not correlated to the degree of tooth movement recorded in this sample. (Am J Orthod Dentofacial Orthop 1998;113:247-55.)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Orthodontics and Dentofacial Orthopedics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Gottleib EL
        • Nelson AH
        • Vogels DS
        1990 study of orthodontic diagnosis and treatment procedures; part 1: results and trends.
        J Clin Orthod. 1991; 25: 145-156
        • O'Connor BM.
        Contemporary trends in orthodontic practice: a national survey.
        Am J Orthod Dentofac Orthop. 1993; 103: 163-170
        • Proffit WR
        Forty year review of extraction frequencies at a university orthodontic clinic.
        Angle Orthod. 1994; 64: 407-414
        • Gianelly AA
        Leeway space and the resolution of crowding in the mixed dentition.
        Semin Orthod. 1995; 1: 188-194
        • Grossen J
        • Ingervall B.
        The effect of a lip bumper on lower dental arch dimensions and tooth positions.
        Eur J Orthod. 1995; 17: 129-134
        • Werner SP
        • Shivapuja PK
        • Harris EF
        Skeletodental changes in the adolescent accruing from the use of the lip bumper.
        Angle Orthod. 1994; 64: 13-22
        • Osborn W
        • Nanda RS
        • Currier GF.
        Mandibular arch perimeter changes with lip bumper treatment.
        Am J Orthod Dentofac Orthop. 1991; 99: 527-532
        • Nevant CT
        • Buschang P
        • Alexander R
        • Steffen J.
        Lip bumper therapy for gaining arch length.
        Am J Orthod Dentofac Orthop. 1991; 100: 330-336
        • Sakuda M
        • Ishizawa M
        Study of the lip bumper.
        J Dent Res. 1970; 49: 677
        • Sather AH
        • Mayfield SB
        • Nelson DH.
        Effects of muscular anchorage appliance on deficient mandibular arch length.
        Am J Orthod. 1971; 60: 68-74
        • Bjerregaard J
        • Bundgaard AM
        • Melson B.
        The effect of the mandibular lip bumper and maxillary bite plate on tooth movement, occlusion and space condition in the lower dental arch.
        Eur J  Orthod. 1980; 2: 257-265
        • Cetlin NM
        • Ten Hoeve AJ
        Nonextraction treatment.
        J  Clin Orthod. 1983; 17: 396-413
        • Moin K.
        Buccal shield appliance for mandibular arch expansion.
        J Clin Orthod. 1988; 22: 588-590
        • Ten Hoeve A.
        Palatal bar and lip bumper in nonextraction treatment.
        J Clin Orthod. 1985; 19: 272-291
        • Ghafari JA.
        A lip activated appliance in early orthodontic treatment.
        J Am Dent Assoc. 1985; 111: 771-774
        • Soo ND
        • Moore R.
        A technique for measurement of intraoral lip pressures with lip bumper therapy.
        Am J Orthod Dentofac Orthop. 1991; 99: 409-417
        • Bergersen EO.
        A cephalometric study of the clinical use of the mandibular lip bumper.
        Am J Orthod. 1972; 61: 578-602
        • Mayfield SB
        Effects of the lip bumper appliance on the mandibular first molars.
        ([Thesis.]) University of Minnesota, Minneapolis1971
        • Denholtz M
        A method of harnessing lip pressure to move teeth.
        Am Soc Study Orthod. 1963; 1: 16-35
        • Hodge JJ
        • Nanda RS
        • Ghosh J
        • Smith D.
        Forces produced by lip bumpers on mandibular molars.
        Am J Orthod Dentofac Orthop. 1997; 111: 518-524
        • McNulty EC
        • Lear CSC
        • Moorees CFA
        Variability in lip adaptation to changes in incisor position.
        J Dent Res. 1968; 47: 537-547
        • Thüer U
        • Ingervall B.
        Pressure from the lips on the teeth and malocclusion.
        Am J Orthod Dentofac Orthop. 1986; 90: 234-242
        • Gould MCE
        • Picton DCA
        A study of pressures exerted by the lips and cheeks on the teeth of subjects with normal occlusion.
        Arch Oral Biol. 1964; 9: 469-478
        • Gould MCE
        • Picton DCA
        A study of pressures exerted by the lips and cheeks on the teeth of subjects with Angle's Class II division 1, Class II division 2, and Class III malocclusions compared with those of subjects with normal occlusions.
        Arch Oral Biol. 1968; 13: 527-541
        • Ingervall B
        • Janson T.
        The value of clinical lip strength measurements.
        Am J Orthod. 1981; 80: 496-507
        • Lear C
        • Moorrees CFA.
        Buccolingual muscle force and dental arch form.
        Am J Orthod. 1969; 56: 379-393
        • Nanda SK
        The developmental basis of occlusion and malocclusion.
        in: Quintessence Publishing Co, Chicago1983: 164
        • Winders RV.
        A study in the development of an electronic technique to measure the forces exerted on the dentition by the perioral and lingual musculature.
        Am J Orthod. 1956; 42: 645-657
        • Winders RV
        Forces exerted on the dentition by the perioral and lingual musculature during swallowing.
        Angle Orthod. 1958; 28: 226-235
        • Winders RV
        Recent findings in myometric research.
        Angle Orthod. 1962; 32: 38-43
        • Kydd WL.
        Maximum forces exerted by the dentition by the perioral and lingual musculature.
        J Am Dent Assoc. 1957; 55: 646-651
        • Sims W.
        The pressure exerted on the maxillary and mandibular central incisors by the perioral and lingual musculature in acceptable occlusion.
        Am J Orthod. 1958; 44: 64-65
        • Gould MCE
        • Picton DCA
        A method of measuring forces acting on the teeth from the lips, cheeks and tongue.
        Br Dent J. 1962; 112: 235-242
        • Proffit WR
        • Kydd WL
        • Wilskie GH
        Intraoral pressures in a young adult group.
        J Dent Res. 1964; 43: 555-562
        • Proffit WR
        Equilibrium theory revisited: factors influencing position of the teeth.
        Angle Orthod. 1978; 48: 175-186