Comparative Evaluation of Hard-Tissue and Soft-Tissue Changes following Fixed Functional Appliance Treatment in a Skeletal Class II Malocclusion Using Forsus and PowerScope

Abstract

Introduction The purpose of this study was to evaluate and compare the skeletal, dentoalveolar and soft-tissue effects of 2 fixed functional appliance; Forsus Fatigue Resistance Device (FFRD) and PowerScope appliance in treating patients with skeletal class II division 1 malocclusion. Materials and Methods This comparative prospective two-group study included 20 patients with a mean age of 11.2 ± 1.6 years with skeletal class II malocclusion with retrognathic mandible. One group was treated with FFRD, and second group was treated with PowerScope appliance. Lateral cephalograms were evaluated at T1 (pre-functional appliance treatment)) and at T2 (postappliance treatment). Cephalometric values were calculated and assessed to evaluate skeletal, dentoalveolar and soft-tissue changes. Results Sagittal correction of class II malocclusion appeared to be mainly achieved by dentoalveolar changes in the PowerScope group. The FFRD was able to induce both skeletal and dentoalveolar changes. A favorable influence on facial convexity was achieved by both groups. A significant increase in upper pharynx and lower pharynx dimension was seen in the PowerScope group. A statistically significant decrease in upper lip protrusion, increase in lower lip protrusion, increased nasolabial angle, and decrease in inferior labial sulcus were noted in both the groups. Lower incisors proclined more in the PowerScope group. Conclusion Both appliances were effective in correcting class II malocclusion. Forsus had more skeletal effects on the mandible, whereas PowerScope had less skeletal effects on the mandible and more dentoalveolar effects, contributing to class II correction. Both groups showed a significant improvement in soft-tissue profile. PowerScope group showed a significant increase in airway dimensions

Three-dimensional evaluation of the efficacy of Powerscope appliance in treatment of skeletal Class 2 malocclusion: A prospective clinical study

“…Regarding the maxillomandibular relationship, there was a statistically significant (P ≤ 0.05) decrease of ANB angle that accounted for the minimal improvement of the sagittal intermaxillary jaw relationship. This was agreed with the results of studies (11,14,16,17,19,23,24,28) using PowerScope appliance and studies (20,21,22) using MARA, FFRD, and TFBC appliances. While a study (29) using Eureka Spring found no statistically significant change in the ANB angle.…”

“…There was a statistically significant (P ≤ 0.05) decrease in SNA angle which indicated the effect of Powerscope appliance on the restriction of the maxillary base that was agreed with the results reported by other Powerscope studies (23,24,16) in addition to studies (25,26,27) using Churro Jumper, Forsus Nitinol Flat Spring (FNFS), Jasper Jumper (JJ) and Sabbagh Universal Spring 2 (SUS 2) appliances. On the contrary, studies (11,14,18,19,17) using Powerscope appliance and other studies (20,21,22) using Mandibular Anterior Repositioning Appliance (MARA), Forsus Fatigue Resistant Device (FFRD) and Twin Force Bite Corrector (TFBC) appliances showed no statistically significant changes happened to SNA angle and consequently to the maxilla.…”

“…There was a statistically significant (P ≤ 0.05) retroclination of the upper incisor with the decrease in U1-SN, which agreed with the results of Powerscope studies (14,23,24,28) in addition to studies (25,26,21) using Churro Jumper, FNFS, JJ, and FFRD appliances. On the contrary, studies (11,19,16,17) using Powerscope˚ appliance and a study (22) using TFBC showed no change in the upper incisor inclination.…”

“…There was proclination of the lower incisor with a statistically significant increase of IMPA by 8.65˚ ±5.38˚, this agreed with the results of studies (11,23,14,16,17) using Powerscope appliance in addition to studies (20,25,29,21,27,22) using MARA, Churro Jumper, Eureka Spring, FFRD, SUS 2 and TFBC appliances. The findings were against the results of studies (28,24) using the Powerscope appliance, which showed no change in the lower incisor inclination.…”

“…That was in agreement with the results of Powerscope studies ((23,14,19,28,16,17) in addition to the following studies (20,25,26,27) using MARA, Churro Jumper, FNFS, JJ, and SUS 2 appliances. On the contrary, studies (11,24) used the Powerscope appliance, and also studies (21,22) using FFRD and TFBC showed no significant change happened in the anteroposterior position of the mandible.…”