Evaluation of the effects of skeletal anchoraged Forsus FRD using miniplates inserted on mandibular symphysis: A new approach for the treatment of Class II malocclusion

Abstract

Objective: To evaluate the skeletal, dentoalveolar, and soft tissue effects of the Forsus Fatigue Resistant Device (FRD) appliance with miniplate anchorage for the treatment of skeletal Class II malocclusion. Material and Methods: The prospective clinical study group included 17 patients (11 girls and 6 boys; mean age 12.96 6 1.23 years) with Class II malocclusion due to mandibular retrusion and treated with skeletal anchoraged Forsus FRD. After 0.019 3 0.025-inch stainless steel archwire was inserted and cinched back in the maxillary arch, two miniplates were placed bilaterally on the mandibular symphysis. Then, the Forsus FRD EZ2 appliance was adjusted to the miniplates without leveling the mandibular arch. The changes in the leveling and skeletal anchoraged Forsus FRD phases were evaluated by means of the Paired and Student's t-tests using the cephalometric lateral films. Results: The success rate of the miniplates was found to be 91.5% (38 of 42 miniplates). The mandible significantly moved forward (P , .001) and caused a significant restraint in the sagittal position of the maxilla (P , .001). The overjet correction (25.11 mm) was found to be mainly by skeletal changes (A-VRL, 21.16 mm and Pog-VRL, 2.62 mm; approximately 74%); the remaining changes were due to the dentoalveolar contributions. The maxillary and mandibular incisors were significantly retruded (P , .001). Conclusion: This new approach was an effective method for treating skeletal Class II malocclusion due to the mandibular retrusion via a combination of skeletal and dentoalveolar changes. (Angle Orthod. 2015;85:413-419.)

Effects of miniplate anchored and conventional Forsus Fatigue Resistant Devices in the treatment of Class II malocclusion

“…In accordance with our results, Unal et al 12 and Celikoglu et al 13 also reported significant mandibular posterior rotation with a skeletally anchored Forsus appliance. In contrast, Aslan et al 11 reported nonsignificant changes in the mandibular plane angle with miniscrew-supported and conventional Forsus appliances.…”

“…Our results were in accordance with previous studies that have reported similar findings with Forsus appliances. 3,[6][7][8][9][12][13][14]16,17 In contrast, several studies have reported that the Forsus FRD had no significant effect on maxillary growth. 2,5,10,11,18 The effects of the Forsus FRD on mandibular growth were investigated by SNB and Co-Gn measurements.…”

“…7,16 Studies have recently focused on eliminating these undesirable effects. [12][13][14] The effects of the Forsus FRD appliance on maxillary growth were investigated by SNA and Co-A measurements. In both groups, a significant decrease was found in the SNA angle.…”

“…Our results were in accordance with those of previous studies that reported stimulated mandibular growth with Forsus appliances. 2,6,8,[12][13][14][16][17][18] The increase in effective mandibular length in the MA-Forsus group was 3.69 mm, while it was 2.50 mm in the C-Forsus group. The difference between the groups was not statistically significant.…”

“…[12][13][14] However, to our knowledge, no study has compared the skeletal, dentoalveolar, and soft tissue effects of miniplate anchored Forsus FRDs and conventional Forsus FRDs in the treatment of Class II malocclusion. The aim of this prospective study was to compare the skeletal, dentoalveolar and soft tissue effects of miniplate anchored Forsus FRDs and conventional Forsus FRDs in the treatment of Class II malocclusion.…”