Class II Treatment with Fixed Functional Orthodontic Appliances before and after the Pubertal Growth Peak – A Cephalometric Study to Evaluate Differential Therapeutic Effects

Abstract

Only slight skeletal sagittal effects, which were independent of age, were observed as a result of treatment with fixed functional orthodontic appliances. The younger the patients, the greater any growth-inhibiting effect on the maxilla will be. There is a greater increase in facial height during treatment than would have been expected from growth without any such influence. The compensatory dental effects increase with patient age.

Mechanism of Class II correction in prepubertal and postpubertal patients with Twin Force Bite Corrector

“…The final skeletal outcomes were similar in both groups whether treatment was initiated before or after the growth spurt. These findings suggested that skeletal results of early (prepubertal) treatment are not different from late (postpubertal) treatment and confirmed previous observations 13,20,21 on the similarity of results obtained before and after the pubertal growth spurt. Despite extrusion of upper and lower molars in both groups, there was no change in the vertical parameters.…”

“…Evaluation of the groups at T2 (Table 6) showed no difference in the anteroposterior position of the incisors and molars. Similar results were observed by Frye et al 13 but stand in contrast with those made by Pancherz and Hä gg 12 and Konik et al 20 who noted greater increase in A-P position of the lower incisors in their postpubertal groups. However, observations in both studies were made immediately after removal of the Herbst appliance and not after fixed appliance treatment.…”

“…In contrast to the Herbst appliance, which is a rigid appliance, treatment outcomes produced by semi-rigid FFA might be different. Frye et al 13 evaluated the treatment outcomes in prepubertal and postpubertal groups and concluded that skeletal contributions to sagittal corrections decline with increasing patient age, while dental effects increase. However, they had a mixed sample of Herbst and functional mandibular advancer appliances, and sample distribution was based on chronologic age rather than skeletal maturational methods.…”

Comparison of stepwise vs single-step advancement with the Functional Mandibular Advancer in Class II division 1 treatment

“…Unfortunately, in other studies, patients undergoing either FMA or Herbst treatment were pooled and not evaluated separately. 27,28 None of those studies included clear information regarding appliance activations. 5,27,28 The effects of the MARA has also been investigated in a few studies.…”

“…27,28 None of those studies included clear information regarding appliance activations. 5,27,28 The effects of the MARA has also been investigated in a few studies. 19,29 Therefore, the ability to compare the findings of the present study with previous studies using the FMA and its MARA alternative was limited.…”