scholarly journals Fixed Functional Appliances

2021 ◽  
Vol 10 (31) ◽  
pp. 2499-2504
Author(s):  
Nandalal Girijalal Toshniwal ◽  
Pooja Changdev Katkade ◽  
Shubhangi Amit Mani ◽  
Nilesh Mote
Keyword(s):  
Class Ii ◽  
Masticatory Muscles ◽  
Mandibular Advancement ◽  
Emg Activity ◽  
Functional Appliance ◽  
Fixed Functional Appliance ◽  
Functional Appliances ◽  
Mandibular Protrusion ◽  
Emg Electrodes ◽  
Class Ii Elastics

Considering the large number of fixed functional appliances, choosing the best device for your patient is not an easy task. To describe the development of fixed functional appliances as well as our 20-year experience working with them. Fixed functional appliances are grouped into flexible, rigid and hybrid. They are different appliances, whose action is described here. Four clinical cases will be reported with a view in illustrating the different appliances. Rigid fixed functional appliances provide better skeletal results than flexible and hybrid ones. Flexible and hybrid appliances have similar effects to those produced by class II elastics. They ultimately correct class II with dentoalveolar changes. From a biomechanical standpoint, fixed functional appliances are more recommended to treat class II in dolichofacial patients, in comparison to class II elastics. The electromyographic (EMG) activity of masticatory muscles was monitored longitudinally with chronically implanted EMG electrodes to determine whether functional appliances produce a change in postural EMG activity of the muscles. Pre-appliance and post-appliance EMG levels in four experiments that had been fitted with functional appliances were compared against the background of EMG levels in controls without appliances. The insertion of two types of functional appliance to induce mandibular protrusion was associated with a decrease in postural EMG activity of the superior and inferior heads of the lateral pterygoid, superficial masseter, and anterior digastric muscles; the decrease in the first three muscles was statistically significant. This decreased postural EMG activity persisted for approximately 6 weeks, with a gradual return towards pre-appliance levels during a subsequent 6-week period of observation. Progressive mandibular advancement of 1.5 to 2 mm every 10 to 15 days did not prevent the decrease in postural EMG activity. KEY WORDS Orthodontics, Class II Malocclusion, Fixed Functional Appliance.

scholarly journals Evaluation of changes seen in TMJ after mandibular advancement in treatment of Class II malocclusions, with functional appliances, a CBCT study

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 236-242
Author(s):  
Ram Mohan Parvathy ◽  
Sandeep Shetty ◽  
Parveen Katheesa
Keyword(s):  
Three Dimensional ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
Functional Appliance ◽  
Functional Therapy ◽  
Twin Block ◽  
Functional Appliances ◽  
Level Of Significance ◽  
Forsus Fatigue Resistant Device

Introduction and Aim: Various functional appliances are developed to remodel the glenoid fossa and, thereby change the position of the mandible and correct Class II malocclusion. Many diagnostic aids have already been used to evaluate the changes ,but Cone Beam computed tomography (CBCT), three -dimensional diagnostic tool is rarely used .So this study was conducted with an aim is to evaluate the changes seen in the temporomandibular joint (TMJ) after mandibular advancement in class II malocclusions with functional appliance therapy, using CBCT, and also to assess and compare the efficacy of Twin Block, Power Scope and Forsus Fatigue Device used for the correction of class II malocclusion.Materials and Methods: The retrospective study was performed using the 52 CBCT scans of 26 patients with class II malocclusion due to retrognathic mandible. The subjects were divided into three groups based on appliance (Twin Block, Power Scope and Forsus Fatigue Resistant Device) used for the treatment. The changes seen in TMJ after mandibular advancement and condylar response to functional therapy was evaluated using the six. Data obtained were subjected to one-way Anova analysis with Posthoc Tukey test. Software SPSS version 20 was used to analyse the data. The level of significance was set at p < 0.05.Results: In subjects treated with Twin Block, the condyle was displaced slightly downwards and anteriorly; and condylar height was reduced. The decrease in the anterior and superior joint spaces were also found. In subjects treated with PowerScope and Forsus Fatigue Resistant Device, there was an increase in condylar height and width with a decrease in anterior and superior joint space.Conclusion: All three appliances were found to bring about changes in TMJ structures, but amongst them the Twin block has proved to be more efficient.

scholarly journals Attractiveness of the facial profile: comparison of Class II patients treated with Twin Force® or intermaxillary elastics

2021 ◽  
Vol 26 (5) ◽  
Author(s):  
Otávio Augusto POZZA ◽  
Rodrigo Hermont CANÇADO ◽  
Fabricio Pinelli VALARELLI ◽  
Karina Maria Salvatore FREITAS ◽  
Renata Cristina OLIVEIRA ◽  
...  
Keyword(s):  
Group Treatment ◽  
Treatment Time ◽  
Class Ii ◽  
Functional Appliance ◽  
Facial Profile ◽  
Fixed Functional Appliance ◽  
Lateral Cephalograms ◽  
Fixed Appliances ◽  
Class Ii Elastics

ABSTRACT Objective: To compare the facial profile attractiveness of Class II patients treated with Twin Force® or intermaxillary elastics. Methods: Sample comprised 47 Class II patients divided into two groups: G1) TWIN FORCE - 25 patients treated with fixed appliances and Twin Force® fixed functional appliance (mean initial age was 17.91 ± 7.13 years, mean final age was 20.45 ± 7.18 years, and mean treatment time was 2.53 ± 0.83 years); G2) ELASTICS - 22 patients treated with fixed appliances and Class II intermaxillary elastics (mean initial age was 15.87 ± 5.64 years, mean final age was 18.63 ± 5.79 years and mean treatment time was 2.75 ± 0.60 years). Lateral cephalograms from pretreatment and posttreatment were used. Cephalometric variables were measured and silhouettes of facial profile were constructed and evaluated by 48 laypeople and 63 orthodontists, rating the attractiveness from 0 (most unattractive profile) to 10 (most attractive profile). Intergroup comparisons were performed with Mann-Whitney and independent t-tests. Results: At pretreatment, facial profile of the Twin Force® group was less attractive than the Elastics group. Treatment with Twin Force® or Class II elastics resulted in similar facial profile attractiveness, but the facial convexity was more reduced in the Twin Force® group. Orthodontists were more critical than laypeople. Conclusions: Treatment with Twin Force® or Class II elastics produced similar facial profile attractiveness at posttreatment. Profile attractiveness was reduced with treatment in the elastic group, and improved in the Twin Force® group. Facial convexity was more reduced with treatment in the Twin Force® group.

scholarly journals “Effective” TMJ and Chin Position Changes in Class II Treatment

2008 ◽  
Vol 78 (5) ◽  
pp. 813-818 ◽  
Author(s):  
Christos Serbesis-Tsarudis ◽  
Hans Pancherz
Keyword(s):  
Class Ii ◽  
Control Group ◽  
Functional Appliance ◽  
Skeletal Class ◽  
Class Ii Treatment ◽  
Fixed Functional Appliance ◽  
Skeletal Class Ii ◽  
Edge Group ◽  
Multibracket Appliance ◽  
Class Ii Elastics

Abstract Objective: To evaluate the “effective” temporomandibular joint (TMJ) changes (the sum of condylar modeling, glenoid fossa modeling, and condylar position changes within the fossa), and their influence on chin position in patients with a Class II division 1 malocclusion treated orthodontically with a multibracket appliance and Class II elastics (Tip-Edge) and orthopedically with a fixed functional appliance (Herbst). Materials and Methods: Two groups of successfully treated subjects were evaluated: Tip-Edge (n = 24) and Herbst (n = 40). The Bolton Standards served as a control group. Lateral head films obtained before treatment and after an observation period of 2.6 years (Herbst also after 0.6-year period) were analyzed. Results: In comparison with the Herbst and control groups, the Tip-Edge group exhibited less favorable sagittal “effective” TMJ growth and chin position changes necessary for skeletal Class II correction. Conclusions: Orthodontic therapy with a multibracket appliance and Class II elastics seems not to have any favorable sagittal orthopedic effect on the mandible, while bite jumping with the Herbst appliance has a favorable sagittal orthopedic effect on a short-time basis.

scholarly journals Management of Severe Class II Malocclusion with Fixed Functional Appliance: Forsus

2011 ◽  
Vol 12 (3) ◽  
pp. 216-220 ◽  
Author(s):  
PS Vijayalakshmi ◽  
AS Veereshi
Keyword(s):  
Case Report ◽  
Significant Role ◽  
Orthognathic Surgery ◽  
Class Ii ◽  
Permanent Teeth ◽  
Class Ii Malocclusion ◽  
Functional Appliance ◽  
Growth Modulation ◽  
Fixed Functional Appliance ◽  
Functional Appliances

ABSTRACT Background Management of class II malocclusion in adolescent patients by growth modulation is one of the most debated topics in orthodontics. Noncompliance has been a major concern for orthodontists. Case report This case report describes the management of severe class II malocclusion in adolescent patient using functional appliance system—Forsus to correct class II problems, which is clipped on to bands. This appliance has several advantages, as the patient cannot remove it. It acts on the teeth and jaws for 24 hours each day, patient cooperation is not a problem, and as a result the treatment time is short. There is lot of controversy about the use of functional appliances. Conclusion This case report illustrates that even today, functional appliances have a significant role in the management of class II malocclusion by using growth modulation. The growth modulation minimizes the necessity of extraction of permanent teeth and probably orthognathic surgery. Clinical significance Functional appliances have a significant role in the management of class II malocclusion. The growth modulation minimizes the necessity of extraction of permanent teeth and probably orthognathic surgery. How to cite this article Vijayalakshmi PS, Veereshi AS. Management of Severe Class II Malocclusion with Fixed Functional Appliance: Forsus. J Contemp Dent Pract 2011; 12(3):216-220.

scholarly journals Three-dimensional evaluation of changes in upper airway volume in growing skeletal Class II patients following mandibular advancement treatment with functional orthopedic appliances

2018 ◽  
Vol 88 (5) ◽  
pp. 552-559 ◽  
Author(s):  
Stig Isidor ◽  
Gabriele Di Carlo ◽  
Marie A. Cornelis ◽  
Flemming Isidor ◽  
Paolo M. Cattaneo
Keyword(s):  
Upper Airway ◽  
Class Ii ◽  
Class I ◽  
Mandibular Advancement ◽  
Functional Appliance ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Partial Volumes ◽  
Functional Appliances ◽  
Age Range

ABSTRACT Objectives: The aim of this study was to assess three-dimensionally the upper airway changes following functional appliance treatment in growing Class II patients. Materials and Methods: Pre-and post-treatment Cone beam computed tomography scans of 20 patients (age range: 9 to 12; mean: 11.4 ± 1.0 years) were retrieved from the list of patients previously treated with functional appliances in the Postgraduate Clinic at the Section of Orthodontics, Aarhus University, Denmark. Total and partial volumes of the upper airway (ie, lower nasopharynx, velopharynx, and oropharynx) were calculated. To rule out the effect of growth, the changes in the functional appliance group were compared to an age-matched Class I group of 18 patients (age range: 8 to 14; mean: 11.8 ± 1.4 years). Results: In the functional appliance group, all the partial and total volumes were significantly larger at the end of treatment when compared to the start of treatment (P &lt; .003). On the other hand, when comparing the changes for the total and partial volumes of the upper airway in the functional appliance group with the Class I group, a statistical difference was seen only for the oropharynx (P = .022) and total volume (P = .025), with the functional appliance group showing a larger volume increment. Conclusions: An increase in the upper airway volume was found after treatment with functional appliances. This difference was mainly related to the changes at the oropharynx level, which differed significantly from what was observed in the Class I group.

scholarly journals Skeletal Class II Malocclusion Treated with AdvanSync 2 - A Case Report

2021 ◽  
Vol 10 (34) ◽  
pp. 2951-2953
Author(s):  
Namrata Dogra ◽  
Archana Jaglan ◽  
Sidhu M. S. ◽  
Seema Grover ◽  
Suman Suman
Keyword(s):  
Case Report ◽  
Treatment Success ◽  
Class Ii ◽  
Orthodontic Appliances ◽  
Class Ii Malocclusion ◽  
Functional Appliance ◽  
Fixed Functional Appliance ◽  
Skeletal Class Ii ◽  
Fixed Orthodontic Appliances ◽  
Functional Appliances

Treatment of complex malocclusion poses a challenge for the orthodontist because of its multifactorial aetiology. Class II malocclusion is the most frequently encountered and treated malocclusion in orthodontic practice and affects approximately 14.6 % of the North Indian population.1 A common reason for Class II malocclusion is mandibular skeletal retrusion which is the most common characteristic, as reported by McNamara.2 This can be caused by genetic or hereditary factors. When evaluating treatment options for Class II patients, the extent of the skeletal discrepancy and the skeletal maturity of the patient needs to be considered. Treatment may range from dental compensation including camouflage with extractions to surgical procedures targeted at moving the jaw at fault. In growing patients, growth modification with functional appliances offers an intermediate treatment option. Functional appliances are basically of two types; Removable and Fixed. Removable functional appliances such as Activator, Bionator, Frankel Function regulator and Twin Block appliance change Class II relationship by the transmission of soft tissue tension to the dentition. Treatment success with these appliances relies heavily on patient compliance. Therefore, in non-compliant patients, fixed Class II correctors in conjunction with fixed orthodontic appliances are the best choice.3 Fixed functional appliances generate continuous stimuli for mandibular growth without break and permit better adaptation to functions like mastication, swallowing, speech and respiration.1 The Herbst fixed functional appliance has been used routinely for Class II patients and has undergone many design variations over time.4 The AdvanSync2 Class II corrector is a recently introduced fixed functional appliance. It has a much smaller size than the conventional Herbst appliances, is easier to place, activate and remove and most importantly, can be used in conjunction with full-arch fixed appliances throughout.3 Here we describe a case report of a patient treated with the AdvanSync2 Class II corrector and the findings observed in the sagittal and vertical dimensions

scholarly journals Management of Class II Division 1 Subdivision malocclusion using unilateral bicuspid extractions and fixed functional appliance: A Two Year Follow-Up

2021 ◽  
Vol 8 (1) ◽  
pp. 12-19
Author(s):  
Sarvraj Kohli ◽  
Virinder Kohli ◽  
Gagan Deep Kochhar
Keyword(s):  
Class Ii ◽  
Mandibular Advancement ◽  
Treatment Modalities ◽  
Functional Appliance ◽  
Skeletal Class ◽  
Fixed Functional Appliance ◽  
Skeletal Class Ii ◽  
Division 1 ◽  
Unique Approach ◽  
Class Ii Division 1

Introduction:  Management of Class II Subdivision cases pose a clinical dilemma and require a careful diagnosis to ascertain the source of asymmetry. Various treatment modalities involving: different protocols of tooth extractions; molar distalization; fixed functional appliances or orthognathic surgery have been proposed for the same. Objective:       This article reports a unique approach for management of a severe skeletal Class II with Angle’s Class II Division 1 subdivision malocclusion using unilateral bicuspid extractions in mandibular and maxillary arches  and a fixed functional appliance. Results:         A 13 year 1 month old male in CVMI transition stage was successfully treated. Extraction of #44 was done to alleviate crowding in the mandibular anterior region and #15 was extracted to protract #16 to achieve a Class II molar relationship. A pre-functional Class II molar and canine relationship with co-incident midlines was achieved. The functional phase consisted of a fixed functional appliance (Forsus FRD) for mandibular advancement to correct the severe skeletal Class II. Class I molar and canine relationships were achieved with reduction of facial convexity and overjet. Result remained stable 24 months after treatment. The improvement can be quantified by the reduction in scores of orthodontic indices measured pre and post treatment. Conclusions:                        Management of Class II subdivision malocclusion requires careful planning. This paper presents a unique approach utilizing unilateral extractions and fixed functional appliance to address severe skeletal Class II discrepancy and the subdivision dilemma.

scholarly journals Treatment of Skeletal Class II Malocclusion Using a Fixed Functional Appliance

2013 ◽  
Vol 3 (3) ◽  
pp. 153-158
Author(s):  
Manish Suresh Sonawane ◽  
Girish Ramchandra Karandikar ◽  
Shaili Sanjay Shah ◽  
Vinayak Shridharrao Kulkarni ◽  
Hitesh Jagadish Burad
Keyword(s):  
Female Patient ◽  
Class Ii ◽  
Patient Comfort ◽  
Class Ii Malocclusion ◽  
Initial Alignment ◽  
Functional Appliance ◽  
Skeletal Class ◽  
Fixed Functional Appliance ◽  
Skeletal Class Ii ◽  
Functional Appliances

ABSTRACT 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 Malocclusion Using a Fixed Functional Appliance. J Contemp Dent 2013;3(3):153-158.

scholarly journals Influence of Lateral Cephalometric Radiographs on Orthodontic Treatment Planning of Class II Patients

2018 ◽  
Vol 12 (1) ◽  
pp. 296-302
Author(s):  
Irina Stupar ◽  
Enver Yetkiner ◽  
Daniel Wiedemeier ◽  
Thomas Attin ◽  
Rengin Attin
Keyword(s):  
Treatment Planning ◽  
Orthodontic Treatment ◽  
Class Ii ◽  
Functional Appliance ◽  
Fixed Functional Appliance ◽  
Routine Manner ◽  
Knowing That ◽  
Signed Rank ◽  
Minor Influence ◽  
University Of Zurich

Background:Lateral Cephalometric Radiographs (LCR) are a common decision-making aid in orthodontic treatment planning and are routinely used in clinical practice. The aim of this present study was to test the null hypothesis that LCR evaluation does not alter specific components of orthodontic treatment planning in Class II patients.Materials and Methods:Records of 75 patients, who had been treated at the Department of Orthodontics, Centre of Dental Medicine, University of Zurich comprised the study material. Inclusion criteria were: (1) adolescents between the age of 12-15, (2) permanent dentition with Class II buccal segment relationship (3) absence of craniofacial and dento-alveolar malformations. Fifteen orthodontists from the dental faculties of Istanbul University, Istanbul and Ege University, Izmir filled out Likert-type linear scale questionnaires without knowing that they would repeat the same procedure with and without LCRs at two different time points. Equivalence and clinical relevance were assessed using (%95 CI) Wilcoxon signed rank tests.Results:Extraction decision did not differ between groups (p=0.68). Preference of functional appliance use (p=0.006) and inter-maxillary fixed functional appliance (p=0.043) was different among groups.Conclusion:LCR evaluation has minor influence on treatment planning procedure of Class II patients. It might be beneficial to consider its prescription not in a routine manner but as a supplementary tool considering possible reduction of radiation exposure.

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