Evaluation Of Dentoalveolar, Skeletal and Soft-Tissue Changes With FFA Including The Multibracket System: A Meta-analysis

Abstract

Objective: To assess skeletal, dentoalveolar, and soft-tissue effects of fixed functional appliances (FFAs), alone or in combination with multibracket appliances (comprehensive treatment), on Class II malocclusion in postpubertal patients. Data Sources: Literature survey was conducted using the Medline, SCOPUS, Latin American and Caribbean Health Sciences, and Scientific Electronic Library Online databases and the Cochrane Library, and through a manual search. No restrictions were set regarding the type of fixed appliance, treatment length, or to the cephalometric analysis used. Data extraction was mostly predefined at the protocol stage by 2 authors. Study Selection: Only double-blind randomized controlled trials (RCTs) of Class II skeletal cases treated by any FFA that had assessed specific skeletal, dental, or soft-tissue parameters were included. Data Synthesis: A total of 8 articles qualified for the final analysis. The studies were composed of late-adolescent or adult patients who were at the end of their postpubertal growth period. This meta-analysis included data from 271 subjects (142 Class II patients and 129 untreated individuals) and 8 RCTs, which assessed linear as well as angular cephalometric changes induced by Class II treatment with FFAs. Conclusions: Based on the data available on postpubertal patients, it was concluded that the fixed functional treatment is effective in Class II malocclusion and shows changes in skeletal, dental, as well as soft tissue.

Evaluation of Clinical Efficacy Between Forsus and Advansync Fixed Functional Appliance for the Treatment of Skeletal Class II Malocclusion Using 3D Cone Beam Computed Tomography (CBCT): A Prospective Randomized Clinical Trial

“…It occurs in about 25% to 30% of the general population. Moreover, mandibular retrognathism has been seen to be the most common causative factor for skeletal Class II malocclusion [ 7 ]. Functional appliances are well established as a means of correcting significant antero-posterior malocclusions [ 8 ].…”

“…A wide range of functional appliances aimed to stimulate mandibular growth by forward posturing of the mandible are available to correct class II skeletal and occlusal disharmony [ 11 ]. FFAs are the most commonly used appliance to correct skeletal discrepancy in a growing stage, but still its enhancement effect on mandibular growth has been questionable [ 7 ].…”

“…FFAs are the most commonly used appliance to correct the skeletal discrepancy in a growing stage, but still, their enhancement effect on mandibular growth has been questionable. All these FFAs correct the skeletal Class II malocclusion by the combined effects of skeletal and dental changes, including the advancement of the mandible, restricting the growth of the maxilla, fanning the lower anterior, and retroclination of the maxillary anterior [ 7 ]. Another literature review on fixed functional appliances suggested that there is a small but statistically and clinically important effect on the skeletal and dentoalveolar parameters of patients treated with fixed functional appliances [ 8 ].…”