Treatment of large overjet in preadolescents. Studies of treatment effects, cost assessment and patient perceptions- a comparison of two removable functional appliances

........................................................................................7 SAMMANFATTNING .....................................................................8 PREFACE .............................................................................................9 ABBREVIATIONS ........................................................................... 11 DEFINITIONS IN SHORT ............................................................. 13 INTRODUCTION ........................................................................... 15 Angle Class II Division 1 .................................................................................. 15 Treatment of large overjet ................................................................................. 16 Removable functional appliances ................................................................... 19 Level of evidence ............................................................................................... 25 AIMS .............................................................................................. 29 PATIENTS AND METHODS ........................................................ 31 Subjects (Paper I-IV) ......................................................................................... 31 Methods .............................................................................................................. 32 Ethical approval ................................................................................................. 39 RESULTS .......................................................................................... 41 Treatment effects Paper I .............................................................................. 41 Discomfort and expectations Paper II ......................................................... 44 Perceptions of the treatment – Paper III ........................................................ 45 Treatment costs Paper IV ............................................................................... 47 DISCUSSION .................................................................................... 49 Limitations and strengths ................................................................................ 49 Subjects .............................................................................................................. 52 Treatment effects .............................................................................................. 52 Patient experience of the treatment ............................................................... 55 Cost evaluation .................................................................................................. 57 Clinical significance of the findings ............................................................... 58 CONCLUSION ................................................................................. 61 FUTURE PERSPECTIVES ............................................................. 63 ACKNOWLEDGEMENTS ............................................................. 65 Grants ................................................................................................................. 67 REFERENCES ................................................................................... 69 APPENDIX I, questionnaire ........................................................... 81 APPENDIX II, paper I-IV .............................................................. 87 Paper I ............................................................................................. 89 Paper II ......................................................................................... 101 Paper III ........................................................................................ 111 Paper IV ........................................................................................ 123