Abstract
Objectives: To compare soft tissue changes and improvements in facial esthetics between Activator and mandibular advancement (MA) treatment using three-dimensional (3D) facial images and two-dimensional (2D) cephalometric analysis. Second, to assess dentoskeletal effects of Activator and MA through 2D cephalometric evaluation.
Materials and Methods: A total of 70 growing patients with skeletal Class II malocclusion (Activator: n = 37; MA: n = 33) were included. Lateral cephalograms and 3D facial images (3dMD face system, Atlanta, Georgia, USA) were analyzed to assess dentoskeletal and soft tissue changes before and after treatment. Point-to-point registration followed by a precision best-fit approach was applied to superimpose the 3D photographs, focusing on 3D analysis of the whole face and seven soft tissue regions. Cephalometric analysis was conducted to quantify dentoskeletal and soft tissue effects. The multivariate Hotelling’s T2 test was applied to compare the composite treatment outcomes between MA and Activator groups.
Results: All soft tissue regions except the upper lip significantly increased from pre- to post-treatment. MA produced greater correction of soft tissue convexity (2.57°) and chin with sl-VL increasing 0.97 mm more than the Activator. Skeletal and dental parameters improved over time in both treatments. U1-SN and overjet significantly decreased more in MA (5.57° and 3.49 mm) than Activator (3.51° and 2.25 mm).
Conclusions: Activator and MA effectively advanced the mandible, retracted upper incisors, reduced overjet, and improved soft tissue profile. MA is more effective in improving upper incisor proclination and facial profile esthetics than the Activator.