Treatment of Class II Malocclusion With Removable Functional Appliances: A Narrative Review (original) (raw)
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American Journal of Orthodontics and Dentofacial Orthopedics, 2006
The purpose of this study was to evaluate the skeletal and dentoalveolar effects of the Twin-block and bionator appliances in the treatment of Class II Division 1 malocclusions. Methods: Fifty-five girls from North India with Class II Division 1 malocclusion and the same physical growth maturation status were selected for the study. The subjects were divided among a Twin-block group (n ϭ 25), a bionator group (n ϭ 20), and a control group (n ϭ 10). Pretreatment and posttreatment lateral cephalometric radiographs of the treatment group subjects, and prefollow-up and postfollow-up radiographs of the control group subjects, were traced manually and subjected to the pitchfork analysis. Results: Statistical software was used for 1-way analysis of variance and multiple comparisons (post-hoc test, Bonferroni). A P value of .05 was considered statistically significant. Neither the Twin-block nor the bionator appliance significantly restricted forward growth of the maxilla (P ϭ .476). Mandibular growth in the Twin-block subjects was significantly greater than in controls (P ϭ .005). Mandibular growth was comparable in the control and the bionator subjects. Molar correction, overjet reduction, and proclination of the mandibular incisors were significantly greater (P ϭ .000) in the treated subjects compared with the controls.
Dental and Medical Problems
Background. The orthodontic removable traction appliance (ORTA) was introduced as an intraoral removable appliance to treat Class III patients, but the pure treatment effects of ORTA have not been established yet. Objectives. The aim of the study was to evaluate the skeletal, dental and soft tissue changes following the use of ORTA in treating Class III growing patients, and to compare these changes with those observed in an untreated control group (UCG). Material and methods. Forty-two patients with Class III malocclusion (mean age: 9.04 ±0.84 years) were randomly allocated to either the intervention group (ORTA) or UCG with a 1:1 allocation ratio. The patients in the ORTA group were treated until a positive overjet was achieved, whereas those in UCG were observed for an average of 6 months. Lateral cephalograms were obtained before (T1) and at the end of the treatment or observation period (T2). Twenty-six variables were used to evaluate treatment changes. The paired and independent t tests were used to detect significant differences within and between the groups, respectively. Results. Forty-two patients who met the inclusion criteria were included primarily. Two patients in UCG dropped out of the study. Therefore, 40 patients were included in the statistical analyses (ORTA: 21; UCG: 19). The orthodontic removable traction appliance was able to correct Class III malocclusion in a mean treatment time of 4.34 ±2.02 months. The maxilla moved forward by a mean of 1.31°, which was significantly greater than in the case of UCG (i.e., a mean difference of 1.02°). The mandible moved significantly backward in the ORTA group (the mean change in SNB: −1.85°) and significantly forward in UCG (the mean change in SNB: 0.97°), leaving the overall sagittal skeletal change significantly greater in the ORTA group as compared to UCG (the mean change in ANB: 3.81°) (p < 0.001). Conclusions. In the short term, ORTA seemed to be an effective intraoral removable appliance in the treatment of growing Class III patients.
2018
OBJECTIVE The objective of this study was to evaluate and compare the effects of PowerScope and Forsus in the treatment of Class II division 1 malocclusion. MATERIALS AND METHODS This was a 2-arm parallel, double-blind, randomized, controlled trial. A total of 28 Class II division 1 malocclusion patients indicated for treatment with fixed functional appliances were randomized and equally divided (n = 14) among PowerScope (American Orthodontics, Sheboygan, Wis; mean age 14.11 ± 1.3 years) and Forsus (3M Unitek Corp, Monrovia, Calif; mean age 15.5 ± 1.1 years) groups. Skeletal and dentoalveolar effects of PowerScope and Forsus were compared. The secondary outcomes were evaluation of patient comfort and operator convenience. Randomization was accomplished with a 1:1 allocation ratio, and concealment was achieved by sealed opaque envelopes. The participants and data collectors were all blinded to study group allocation. Data were analyzed for 26 patients, 13 in each group, as one patien...
Treatment of Skeletal Class II Malocclusion Using a Fixed Functional Appliance
Journal of Contemporary Dentistry, 2013
Treatment of class II malocclusion has always been an enigma to the orthodontic fraternity. Noncompliant correction of class II malocclusion using fixed functional appliances at the deceleration stage of growth has gained tremendous popularity in the recent times. Aim of the illustrated article is to demonstrate the efficacy of a fixed functional appliance in correction of class II malocclusion. We are reporting a 12-year-old female patient with a skeletal class II malocclusion treated using the Forsus appliance. Forsus FRD was the best option considering age, patient comfort, ease of installation, predictable results and patient compliance. The appliance was worn for 5 months after the initial alignment with fixed mechanotherapy (MBT 0.022"). The mandible was brought forward to a class I skeletal and dental relationship by the end of this phase of treatment. How to cite this article Shah SS, Karandikar GR, Sonawane MS, Kulkarni VS, Burad HJ. Treatment of Skeletal Class II Malo...
2020
Class II malocclusions are particular of utmost familiar complications in orthodontic management. Around is an assortment of effectual and effortless managements to accurate them, for instance fixed orthodontics appliances and headgear. These appliances are largely planned for management of class II deformities through lower arch defect. Accomplishment of management using a functional appliance depend on the patient’s collaboration and favorable lower arch expansion. Subsequent period of management with full-fixed appliances frequently essential to accomplish accurate alignment and excellent interdigitating of the dentition. In the current case, a pre-pubertal 12 year female through a class II malocclusion and retrusive lower arch was cured first using a headgear aimed at 18 months. Headgear productively determined the predicament of retrusive lower arch with encouraging mandible development. It was subsequently nine months of fixed orthodontic management to conclude the occlusion r...
The Angle Orthodontist, 2013
Objective: To analyze the long-term skeletal and dentoalveolar effects and to evaluate treatment timing of Class II treatment with functional appliances followed by fixed appliances. Materials and Methods: A group of 40 patients (22 females and 18 males) with Class II malocclusion consecutively treated either with a Bionator or an Activator followed by fixed appliances was compared with a control group of 20 subjects (9 females and 11 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start of treatment (mean age 10 years), end of treatment with functional appliances (mean age 12 years), and long-term observation (mean age 18.6 years). The treated sample also was divided into two groups according to skeletal maturity. The early-treatment group was composed of 20 subjects (12 females and 8 males) treated before puberty, while the late-treatment group included 20 subjects (10 females and 10 males) treated at puberty. Statistical comparisons were pe...
Class II, Division 1 Malocclusion treated with the Andresen Appliance followed by Fixed Orthodontics
World Journal of Dentistry
Introduction: Mandibular retrognathism is the most common feature in class II malocclusions. Functional appliance therapy focuses on reducing the increased overjet and overbite, establishing better conditions for mandible growth response in phase I. Phase II corrects the position of the teeth and gives an adequate stable occlusal relationship. Aim: (1) To describe a class II, division 1 malocclusion treated with the Andresen activator in a growing patient followed by comprehensive orthodontic fixed appliances, and (2) to take advantage of both approaches performed immediately one after the other in adolescence to obtain better and stable results without tiring the patient and parents, prolonging the treatment time. Case report: A 13-year-old female patient presented with a class II, division 1 malocclusion with increased overjet and deep overbite, due to mandibular retrognathism. She wore the Andresen activator approximately 12 to 14 hours per day during afternoons and nights for 9 months, followed immediately by comprehensive fixed appliances for an extra period of 1 year. Conclusion: Clinical results showed that class II, division 1 malocclusion was corrected, overjet and deep overbite were reduced to normal parameters, and convex profile was improved to a straight one. Clinical significance: These two phases performed one after the other in the early permanent dentition were beneficial for the patient, and due to good results obtained in phase I, phase II with fixed appliances was simplified, focusing on small details of dental movements. The total time of treatment was 21 months.
American Journal of Orthodontics and Dentofacial Orthopedics, 2007
In this study, we cephalometrically compared changes in the dentoskeletal and soft tissues after orthodontic treatment of Class II Division 1 malocclusions between the cervical headgear (CHG) and the mandibular protraction appliance (MPA) followed by fixed appliances. Methods: The sample consisted of 50 patients divided into 2 groups of 25 patients each (13 male, 12 female). Group 1 patients were treated with CHG and fixed appliance, and group 2 patients were treated with the MPA and fixed appliances. The patients were matched according to sex, age, treatment time, and initial cephalometric variables. The groups were compared regarding pretreatment stage and treatment changes, with t tests, at P Ͻ.05. Results: The CHG group showed statistically greater restriction of the anterior displacement of the maxilla, improvement of the skeletal Class II relationship, decreased facial convexity, extrusion and distalization of the maxillary first molar, and extrusion of the mandibular incisors. The MPA group had statistically greater increases in maxillary length, mandibular protrusion, maxillary incisor retrusion, mesial displacement of the mandibular first molars, and protrusion of the lower lip. Conclusions: The changes in Class II malocclusion correction between the CHG and the MPA were that the CHG corrected the Class II malocclusion primarily through greater action on the maxillary skeletal and dentoalveolar structures as compared with the MPA, which corrected the malocclusion through greater action on the mandibular dentoalveolar structures. (Am J Orthod
The European Journal of Orthodontics, 2014
Objectives: The current parallel group, randomized controlled trial aimed to compare the dentoalveolar and skeletal changes resulting from treatment using two popular functional appliances: the Bite-Jumping Appliance (BJA) and the Twin-Block Appliance (TBA). Study design: This study is designed as a parallel-group, randomized controlled trial. Materials and methods: Patients were screened from the patients who were seeking treatment at the Department of Orthodontics, Al-Baath University. Eligibility criteria included skeletal Class II division 1 malocclusion resulting from the retrusion of the mandible. A computer-generated randomization list was used to randomly divide the patients into two equal groups to be treated with either the BJA or the TBA. Blinding was applicable for outcome assessment only. Fortyfour patients (22 male and 22 female) aged 10.2-13.5 years were randomized in a 1:1 ratio to either the BJA or the TBA groups, and four patients were lost to follow-up (two from each group). Lateral cephalometric radiographs were obtained before treatment and after 12 months of active appliance therapy. Inter-group differences were evaluated with two-sample t-tests, and intra-group differences were assessed with paired-sample t-tests at the P <0.05 level. Results: Forty patients (20 in each group) were available for the statistical analysis. Baseline characteristics were similar between groups. Similar changes were observed in the sagittal plane, including a significant increase in the SNB angle. No significant changes were observed in the maxilla. The lower incisors were significantly proclined, and the upper incisors significantly retruded. In the vertical plane, BJA induced mandibular clockwise rotation, and the SN:MP angle increased by 2.14 ± 2.97° (P = 0.002). Conversely, no significant changes took place in this angle in the TBA group 0.75 ± 2.37° (P = 0.096). Similarly, Jarabak ratio decreased significantly in the BJA group by −1.78 ± 0.85% (P = 0.002) and increased significantly in the TBA group by 1.26 ± 0.76% (P = 0.032), with significant differences between the two groups (P ≤ 0.001). No serious harm was observed. Limitations: A limitation of this research is a lack of an untreated control group. However, the resulting differences between the two groups can be attributed to the appliance differences, which fulfil the aim of the current research. Conclusions: Each of the two appliances is recommended for the functional treatment of skeletal Class II malocclusion resulting from the retrusion of the mandible. The BJA is recommended when clockwise rotation is desired, whereas the TBA is recommended to inhibit vertical development.
International Journal of Applied Dental Sciences, 2020
Objective: The objective of this study was to compare effects on soft tissue profile and dentoalveolar changes in class II patients after treatment with either Herbst appliance or Korn mandibular advancer as fixed functional appliances. Materials and methods of study: The sample of study consisted of (30) patients divided into two groups (G1):group one included (15) patients was treated by Korn mandibular advancer appliance, and (G2): group two included (15) patients was treated by Herbst appliance. In both groups fixed functional appliances were applied concurrently with fixed orthodontic appliance. Lateral cephalograms were taken and analyzed before treatment and after treatment. Statistical analyses were used to analyze data by (Kolmogorov smirnov, K-S) and student's t tests. Statistical significance was set at P