Analysis of efficacy of functional appliances on mandibular growth

Objectively measured compliance during early orthodontic treatment: Do treatment needs have an impact?

“…These findings may help to partially explain the results obtained by some authors, which show considerable differences in the skeletal changes that occur during orthopedic treatment. [19][20][21] Even if these changes are beneficial, substantial standard deviation of the results causes them to lose significance in the statistical analysis in comparison to an untreated control group. Unfortunately, the present study has confirmed this mechanism, showing that the greater the severity of malocclusion, the bigger the difference in the degree to which the patients follow a treatment regimen, leaving orthodontists insufficient control over patient compliance.…”

Mandibular changes produced by functional appliances in Class II malocclusion: A systematic review

“…Studies that used articulare for the measurements of either mandibular length or ramus height were excluded, because that point is not an anatomical landmark that pertains to the mandible exclusively. 9 Because most of the samples in the retrieved studies reported annualized mandibular changes (expressed as annualized mean differences between treated and untreated groups), annualization was applied to the data of the remaining samples (except for samples with a treatment duration that was too short for annualization-less than 9 months). The actual amount of supplementary elongation in total mandibular length after active treatment with the functional appliance was also analyzed.…”

“…These considerations suggest that a rational systematic review should include longitudinal prospective and retrospective controlled clinical trials (CCTs) to broaden the scientific information about the treatment effects of orthodontic appliances. 12 Furthermore, recent investigations on treatment outcomes of functional appliances should be examined to supplement the data analyzed by Chen et al 9 It is advisable also to limit the systematic review to clinical trials that compared treated Class II groups with matched untreated Class II samples. It has been demonstrated that mandibular growth in Class II subjects differs significantly from that of subjects with normal occlusion.…”

“…A previous systematic review on the efficacy of functional appliances on mandibular growth by Chen et al 9 analyzed the relevant literature from 1966 to 1999 in a Medline search strategy limited to randomized clinical trials (RCTs). The results were inconclusive.…”

Early treatment with the twin-block appliance is effective in reducing overjet and severity of malocclusion

“…There is a host of literature available that indicates that overall duration of treatment combining phases 1 and 2 is longer than a comprehensive single-phase treatment and the outcomes are no better. 1,2 The authors concluded that, for a fairly high proportion of patients undergoing early twin-block treatment, the treatment will not be successful because of the non-compliance rate, here recorded to be 16%. Again, to judge the cases with the PAR index would mean a quantification of five specific traits of malocclusion with highest weight ascribed to overjet.…”