Additional appointments and discomfort associated with compliance-free fixed Class II corrector treatment: a systematic review

Abstract

Summary Objective A critical analysis of the literature to determine the prevalence and type of emergency/additional appointments, and discomfort levels associated with fixed Class II correctors. Methods Studies examining patient’s sources of discomfort or emergency appointments associated with compliance-free Class II correctors were included. Comprehensive searches up to July 2018 were conducted using the following databases: MEDLINE (OvidSP), PubMed, Web of Science, and Embase. A partial grey literature search was taken using Google Scholar and OpenGrey. Two reviewers independently performed the selection process and risk of bias assessment. The Newcastle-Ottawa Scale for cross-sectional studies were used. A summary of the overall strength of evidence was presented using ‘Grading of Recommendations, Assessment, Development and Evaluation’ (GRADE) tool. Included studies were evaluated according to their design, study quality, consistency, and directness. Results The selected studies were published between 2001 and 2018, and the number of patients per studied group ranged from 8 to 182. One thousand five hundred forty-two patients were evaluated in total. The patients’ mean age at start of treatment ranged from 10 to 16.9 years and the fixed Class II corrector treatment duration ranged from 4 to 12 months. The included studies in this systematic review were too clinically heterogeneous (different appliances, different data recollection processes) to justify a meta-analysis. Limitations This review was not previously registered. A low level of evidence was observed among the two randomized trials, the 10 cohorts and three cross-sectional studies identified. Conclusions The main source of discomfort from Forsus-type appliances appears to be soreness in the cheeks (low level of evidence with a weak recommendation strength). Most evaluated patients treated with a Herbst appliance, regardless of design, will experience complications (fractures and/or dislodging) requiring emergency appointments (low level of evidence with a weak recommendation strength). Registration The review protocol was not registered.

Complications encountered during Forsus Fatigue Resistant Device therapy

“…In other words, 36/58 patients experienced various complications during the appliance therapy, with an incidence of 62%. This percentage is similar to the one reported by Phuong et al 12 in their systematic review. The mean number of complications per patient was 1.4 when calculated over the whole sample.…”

“… 8 - 11 A recent systematic review investigated the prevalence of complications with fixed functional appliances, and stated that the incidence of complications is relatively high. 12 Studying the complications induced by orthodontic appliances has two main aspects: the clinician’s observations and the patients’ responses to assessment questionnaires. Regarding fixed functional appliances, the clinical perspective was previously reported with the Herbst appliance.…”

Sabit fonksiyonel aygıtların bireylerin ağzıyla ilgili yaşam kalitesine etkisi

“…Again, the main source of discomfort associated with FFRD appliances was identified as soreness in the cheeks. 36 With regard to our results, total OHIP score revealed a non-significant increase after one month wear of FFRD, declaring initial discomforts for eating/chewing and pain. The scores revealed that patients noted more issues with mastication than pain.…”

Effects of Removable Functional Appliances on the Dentoalveolar Unit in Growing Patients

“…All of these FFA could successfully achieve class II correction even though patient discomfort and difficulties in daily clinic management may reduce their use. Removable functional appliances (RFA) have an extensive literature background with many advantages for the patient and few side effects; compliance remains the greatest problem with RFA that can ultimately lead to unfavorable results [34][35][36][37][38][39].…”