Effect of removable functional appliances on mandibular length in patients with class II with retrognathism: systematic review and meta-analysis

Abstract

BackgroundOrthopedic functional devices, are used to improve mandibular length in skeletal class II patients. However, the orthopedic functional device with the best effect to increasing the mandibular length, has not been identified before. Thus, the aim of the present investigation was to evaluate Randomized Controlled Trials (RCT), to determine the best functional appliance improving mandibular length in subjects with retrognathism.MethodsA systematic review and meta-analysis was performed, including studies published and indexed in databases between 1966 and 2016. RCTs evaluating functional appliances’ effects on mandibular length (Condilion-Gnation (Co-Gn) and Condilion-Pogonion (Co-Po)), were included. Reports’ structure was evaluated according to 2010 CONSORT guide. The outcome measure was distance between Co-Gn and/or Co-Po after treatment. Data were analyzed with Cochran Q Test and random effects model.ResultsFive studies were included in the meta-analysis. The overall difference in mandibular length was 1.53 mm (Confidence Interval (CI) 95% 1.15–1.92) in comparison to non-treated group. The Sander Bite Jumping reported the greatest increase in mandibular length (3.40 mm; CI 95% 1.69–5.11), followed by Twin Block, Bionator, Harvold Activator and Frankel devices.ConclusionsAll removable functional appliances, aiming to increase mandibular length, are useful. Sander Bite Jumping was observed to be the most effective device to improve the mandibular length.

Class II functional appliance treatment and dynamic three‐dimensional mimic muscle evaluation

“…Removable functional appliances used to treat growing children with Class II division 1 malocclusion results in the correction of the malocclusion via a considerable amount of dentoalveolar compensation and some skeletal change . These structural changes may also influence the soft tissues, musculature, and consequently facial expressions, as suggested by the present study.…”

Evaluation of changes in the upper airway after Twin Block treatment in patients with Class II malocclusion

“…Similarly, the most important limitation of this study is that the main diagnostic method was lateral teleradiography of the skull, which provides a two‐dimensional (2D) representation, but the UA is a 3D space, limiting the accuracy of the technique because 2D images only show the anteroposterior dimension in the sagittal plane rather than a complete view (Abdelkarim, ; Elfeky & Fayed, ; Li et al, ). However, lateral teleradiography of the skull is commonly used in routine clinical practice due to its relative simplicity, accessibility, low cost, and low radiation exposure (Feng et al, ; Rojas, Corvalán, Messen, & Sandoval, ; Santamaria‐Villegas, Manrique‐Hernandez, Alvarez‐Varela, & Restrepo‐Serna, ). Teleradiography remains a valuable diagnostic tool for evaluating the airways (Ali et al, ; Elfeky & Fayed, ; Ghodke et al, ; Jena et al, ; Pavoni et al, ) and can be used to predict OSA (Armalaite & Lopatiene, ).…”

Evaluation of cervical spine posture after functional therapy with twin-block appliances: A retrospective cohort study

“…This indicates the need for an alternate quantification of the improvement in skeletal relationships. 25,26 The physiologic change in the cervical posture varies in different individuals. M€ uller 27,28 claimed that the mandible acts in close harmony with a chain of muscles to control the position of the head in space and stated that craniofacial growth is evaluated more objectively from the occipital structures at the junction between skull and trunk.…”