scholarly journals Short-term Anteroposterior Treatment Effects of Functional Appliances and Extraoral Traction on Class II Malocclusion

2007 ◽  
Vol 77 (5) ◽  
pp. 907-914 ◽  
Author(s):  
Gregory Stylianos Antonarakis ◽  
Stavros Kiliaridis

Abstract Objective: To evaluate the anteroposterior short-term skeletal and dental effects on Class II malocclusion in growing patients following treatment with functional appliances (activators or twin block), extraoral traction, or combination appliances (appliances with both functional and extraoral traction components), based on published data. Materials and Methods: A literature search was carried out identifying a total of nine prospective clinical trials. The data provided in the publications underwent meta-analysis using the random effects model with regard to SNA, SNB, ANB, and overjet. Results: All appliance groups showed an improvement in sagittal intermaxillary relationships (decrease in ANB) when compared to untreated subjects. Activators and twin block appliances accomplish this mainly by acting on the mandible (increases in SNB) while twin block appliances also seem to act on the maxilla (decrease in SNA). Extraoral traction appliances achieve this by acting on the maxilla (decreases in SNA). Combination appliances mainly act on the mandible (increase in SNB). Activators, twin block, and combination appliances also reveal a decrease in overjet, which is not the case in the singular use of extraoral traction. Conclusions: Intermaxillary changes being present in all appliance groups, anteroposterior treatment response following the use of functional appliances and/or extraoral traction in growing class II malocclusion patients is most evident in one of the two jaws (mandible for activators and combination appliances and maxilla for extraoral traction) except for the twin block group, which shows changes on both jaws.

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 236-242
Author(s):  
Ram Mohan Parvathy ◽  
Sandeep Shetty ◽  
Parveen Katheesa

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.


2020 ◽  
Vol 47 (3) ◽  
pp. 235-247
Author(s):  
Himchan Kang ◽  
Koeun Lee ◽  
Misun Kim ◽  
Okhyung Nam ◽  
Hyo-seol Lee ◽  
...  

The purpose of this study was to evaluate the skeletal and dentoalveolar effects and optimal timing for treatment of class II malocclusion with functional appliances in children and adolescents.A group of 30 patients with class II malocclusion were divided into 3 groups according to their use of functional appliance: Twin block, Activator, Fränkel appliance. The group was also divided into 2 groups according to the cervical vertebrae maturation method. Lateral cephalometric radiographs were analyzed pretreatment (T0) and posttreatment (T1). Among the functional appliances, treatment with Twin block and Activator showed significant increase in the length of the mandible (Co-Gn) and the lower anterior facial height (ANS to Me), whereas the overjet and overbite were significantly reduced. Treatment with Fränkel appliance showed significant improvement in the relationship of maxilla and mandible. In addition, if the functional appliance was used during the period of pubertal growth peak, there was a significant increase in mandibular length, improvement in the relationship of maxilla and mandible, labial inclination of lower incisors and decrease in overjet compared to the treatment before pubertal growth peak. Therefore, this study indicates that using functional appliances for patients with class II malocclusion is effective and the optimal timing for using functional appliances is during pubertal growth peak.


2008 ◽  
Vol 78 (6) ◽  
pp. 1133-1140 ◽  
Author(s):  
Gregory Stylianos Antonarakis ◽  
Stavros Kiliaridis

Abstract Objective: To use published data to evaluate quantitatively the dental effects of noncompliance intramaxillary appliances in individuals with Class II malocclusion. Materials and Methods: A literature search was carried out identifing 13 prospective or retrospective clinical studies matching inclusion criteria. Only appliances with conventional anchorage designs were considered for the review. The data provided in these publications were grouped and analyzed in terms of molar distalization, tipping and vertical movements, and incisor and premolar mesialization, tipping, and vertical movements. Results: Maxillary first molars showed distal crown movement and tipping greater than the mesial crown movement and tipping shown by incisors and premolars. Vertical movements of incisors and premolars were in general extrusive, but molars were intrusive or extrusive, depending on the study and the type of appliance used. Appliances that acted palatally seemed to display a smaller distal tipping movement, as well as smaller incisor and premolar mesial tipping movements, when compared with those that acted buccally. Friction-free appliances, namely the pendulum, produced a large amount of mesiodistal movement and tipping, if no therapeutic uprighting activation was applied. Conclusions: Noncompliance intramaxillary molar distalization appliances all act by distalizing molars with a concomitant and unavoidable loss of anchorage, as revealed by incisor and premolar mesial movement. Buccal acting and palatal acting appliances demonstrate almost similar results, with palatal acting appliances showing less tipping. Friction-free palatal acting appliances appear to produce better molar distalizing effects, but with a concomitant notable loss of anchorage.


2014 ◽  
Vol 20 (4) ◽  
pp. 324-338 ◽  
Author(s):  
Nikhilesh R. Vaid ◽  
Viraj M. Doshi ◽  
Meghna J. Vandekar

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 100-106
Author(s):  
Jagadheeswari Ramamoorthy ◽  
Remmiya Mary Varghese ◽  
Geo Mani

A Removable functional appliance is composed of polished acrylic shields and stainless steel wires prescribed for patients with more pronounced class II malocclusion or open bite. These appliances work comfortably with a patient’s inherent growth to produce the desired Skeletal or Dental development. It can be achieved by dentoalveolar effects, alteration of soft tissue and utilisation of greater Mandibular growth potential. The commonly used Removable functional appliances are Twin Block appliance, Activator, Bionator, Frankel appliance, etc. This study aims to assess the frequency of the usage of removable functional appliances in a hospital based set up. The data of patients undergoing Removable functional appliance therapy was retrieved from the case sheets of the patients.The collected data was tabulated in Excel and statistically analysed with the help of SPSS software. From the results obtained, Twin block appliance was the most prevalent Removable functional appliance with a frequency of 60.6%. Frankel appliance and Activator each had a frequency of 9.1%. Twin block appliances were mostly preferred for males than females whereas Activator is preferred mostly for females. Based on the age, Twin block appliance was preferred for the age group 10-15 years, Frankel appliance for 5-10 years, Activator and Other appliances for 10-15 years. Therefore, within the limits of this study, we observed that Twin block appliance was the most preferred Removable functional appliance used in the management of Class II malocclusion and the most common age group receiving appliance therapy is 10-15 years.


Author(s):  
Fareena Ghaffar ◽  
Abdullah Jan ◽  
Obaid Akhtar ◽  
Alaina T. Mughal ◽  
Rooma Shahid ◽  
...  

Abstract Objective This study aimed to compare dentoskeletal changes in skeletal class-II malocclusion with removable twin block appliance and fixed AdvanSync2 appliance. Materials and Methods A prospective randomized clinical trial was conducted over a span of 1 year at AFID at Rawalpindi. Thirty patients with skeletal class-II malocclusion, 16 males (53.3%) and 14 females (46.6%), were randomly selected and divided in two equal groups (15 each) to be treated with either fixed functional appliances (FFAs) or with removable functional appliances (RFAs). Out of 30 patients, 15 between cervical vertebral maturation (CVM) stages of 2 and 3 were treated with RFA (twin block appliances) and remaining 15 between CVM stages of 4 and 5 were treated with FFA (AdvanSync2 appliances). Pretreatment (T1) and posttreatment (T2), angular variable, and linear variable were measured to compare the dentoskeletal effects between the two groups. Statitical Analysis Paired sample t-test was used to assess significant difference between variables at T1 (Pre-treatment) and T2 (Post-treatment) stage for both RFA and FFA group. Comparison among the RFA and FFA group was made using non-parametric Mann-Whitney U Test. IBM SPSS version 25.0 was used for evaluation. Results No significant difference was found in angular variables between the RFA and FFA groups (p > 0.05) with the exception of linear variables. Sella-posterior nasal spine (S-PNS) length significantly increased and Jarabak's ratio significantly decreased for FFA group (p = 0.010 and 0.045, respectively), when compared with RFA group. Conclusion Both the appliances, twin block (RFA) and AdvanSync2 (FFA), are effective for correction of skeletal class-II malocclusion. Both the appliances produced similar effects in the sagittal plane but for better vertical control twin block should be the appliance of choice. AdvanSync2 appliance could be preferred over twin block appliance when dentoalveolar and slight retrusive effect on the maxilla is desired especially for individuals in postpubertal growth spurt.


Author(s):  
Saima Nizar Hirji ◽  
Irfan Qamruddin ◽  
Muhammad Adeel Mudassar ◽  
Zohaib Khurshid ◽  
Mohammad Khursheed Alam

AbstractAround half of all malocclusions that need orthodontic treatment are class II in nature. Patients with class II malocclusion primarily seek treatment for aesthetic improvement. Most of the skeletal class II malocclusions are because of mandibular deficiency, and can be best treated during the growing phase of development by removable functional appliances. The objective of this review is to evaluate and compare skeletal and dentoalveolar effects of various removable functional appliances in the treatment of class II malocclusion. Manual and electronic databases were searched, and out of 5,711 articles, 221 abstracts were shortlisted and reviewed. A total of 19 articles that fulfilled the selection criteria were then retrieved and analyzed. A significant increase in mandibular length and dentoalveolar effects with an increase in vertical dimension in a short time were observed with Twin-Block appliance treatment, followed by Bionator appliance treatment. The long-term stability of results achieved with Twin-Block appliance treatment is still questionable. In addition, Frankel appliance treatment effects are more skeletal in nature, with better control in the vertical dimension. However, it takes a more extended treatment duration to produce similar effects. Based on available evidence, we are convinced that removable functional appliances are valuable tools for correction of the class II malocclusion at a growing age with horizontal growth pattern.


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