Objectives: To evaluate the use of direct miniplate anchorage in conjunction with the Forsus Fatigue Resistant Device (FFRD) in treatment of skeletal Class II malocclusion. Materials and Methods: Forty-eight females with skeletal Class II were randomly allocated to the Forsus plus miniplates (FMP) group (16 patients, age 12.5 ± 0.9 years), Forsus alone (FFRD; 16 patients, age 12.1 ± 0.9 years), or the untreated control group (16 subjects, age 12.1 ± 0.9 years). After leveling and alignment, miniplates were inserted in the mandibular symphysis in the FMP group. The FFRD was inserted directly on the miniplates in the FMP group and onto the mandibular archwires in the FFRD group. The appliances were removed after reaching an edge-to-edge incisor relationship. Results: Data from 46 subjects were analyzed. The effective mandibular length significantly increased in the FMP group only (4.05 ± 0.78). The mandibular incisors showed a significant proclination in the FFRD group (9.17 ± 2.42) and a nonsignificant retroclination in the FMP group (−1.49 ± 4.70). The failure rate of the miniplates was reported to be 13.3%. Conclusions: The use of miniplates with the FFRD was successful in increasing the effective mandibular length in Class II malocclusion subjects in the short term. The miniplate-anchored FFRD eliminated the unfavorable mandibular incisor proclination in contrast to the conventional FFRD.

Objective: To detect three-dimensionally the effects of using mini-implant anchorage with the Forsus Fatigue Resistant Device (FFRD). Materials and Methods: The sample comprised 43 skeletal Class II females with deficient mandibles. They were randomly allocated into three groups: 16 patients (13.25 6 1.12 years) received FFRD alone (Forsus group), 15 subjects (13.07 6 1.41 years) received FFRD and miniimplants (FMI group), and 12 subjects (12.71 6 1.44 years) were in the untreated control group. Three-dimensional analyses of cone beam computed tomographic images were completed, and the data were statistically analyzed. Results: Class I relationship and overjet correction were achieved in 88% of the cases. None of the two treatment groups showed significant mandibular skeletal effects. In the FMI group, significant headgear effect, decrease in maxillary width, and increase in the lower facial height were noted. In the FMI group, retroclination of maxillary incisors and distalization of maxillary molars were significantly higher. Proclination and intrusion of mandibular incisors were significantly greater in the Forsus group. Conclusions: FFRD resulted in Class II correction mainly through dentoalveolar effects and with minimal skeletal effects. Utilization of mini-implant anchorage effectively reduced the unfavorable proclination and intrusion of mandibular incisors but did not produce additional skeletal effects. (Angle Orthod. 2016;86:292-305.)

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The studies reviewed provide insufficient evidence to form a conclusion regarding the effects of the use of skeletal anchorage with FFA. The available weak evidence suggests that the use of skeletal anchorage with FFA has no superior skeletal effects but is able to reduce proclination of the lower incisors.

Objectives To compare the root resorption resulting from miniscrew-supported maxillary posterior dentoalveolar intrusion using two different force magnitudes. Materials and Methods: Adult patients with skeletal open bite, indicated for maxillary posterior dentoalveolar intrusion, were recruited and randomly assigned to the comparison or intervention groups. The comparison group involved applying 200 g of intrusive force per segment, which measured 20 g per root, while this force was 400 g per segment in the intervention group, measuring 40 g per root. Results Twenty participants were included in the final analysis after 2 patients dropped out, 1 in each group, to end up with 10 subjects (200 roots) per group. There was statistically significant root resorption of 0.84 ± 0.96 mm and 0.93 ± 1.00 mm in the comparison and the intervention groups, respectively. However, there was no statistically significant difference between the groups. Conclusions Root resorption inevitably took place in association with orthodontic intrusion. However, increasing the magnitude of the intrusive force did not increase the amount of root resorption, either statistically or clinically.

Objectives To compare the effects of two different force magnitudes on maxillary posterior segment intrusion using mini-screws. The null hypothesis was that there would be no difference between the two force magnitudes. Materials and Methods Adult patients with skeletal open bite and a dental open bite ranging from 3 to 8 mm were recruited for this trial. The comparator group had 200 g of intrusive force applied for posterior segment intrusion, whereas 400 g of force was applied in the intervention group. Primary outcomes were the amount of posterior teeth intrusion and anterior open bite closure. Results Twenty-two subjects were randomized to include 11 participants in each group. One participant dropped out in each group, leaving us with 10 subjects to be analyzed per group. There was statistically significant posterior teeth intrusion of 2.42 ± 2.06 and 2.26 ± 1.87 mm for the comparator and intervention groups, respectively, with no difference between them. Statistically significant open bite closure was achieved in both groups, measuring 2.24 ± 1.18 and 3.15 ± 1.06 mm in the comparator and intervention groups, respectively, with no difference between them. Conclusions Both the 200 g and 400 g intrusive forces yielded similar outcomes in terms of posterior teeth intrusion and anterior open bite closure.

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Objectives To evaluate anchorage control using miniscrews vs an Essix appliance in treatment of Class II malocclusion by distalization using the Carrière Motion Appliance (CMA). Materials and Methods Twenty-four postpubertal female patients with Class II, division 1 malocclusion were randomly distributed into two equal groups. CMA was bonded in both groups, and one group was treated with miniscrews as anchorage (12 patients, mean age = 18.0 years) while the other group was treated with an Essix appliance as anchorage (12 patients, mean age = 17.8 years). For each patient, two cone-beam computed tomographic scans were obtained: one preoperatively and another after completion of distalization. Results In the Essix appliance group, there was a statistically significant anterior movement (2.2 ± 1.43 mm) as well as proclination of the lower incisor (5.3° ± 4.0°), compared to a nonsignificant anterior movement (0.06 ± 1.45 mm) and proclination (0.86° ± 2.22°) in the miniscrew group. The amount of maxillary molar distalization was higher in the miniscrew group (2.57 ± 1.52 mm) than in the Essix appliance group (1.53 ± 1.11 mm); however, the difference was not statistically significant. Conclusions Miniscrews led to a decrease in the amount of anchorage loss in the mandibular incisors, both in terms of anterior movement and proclination.