Evaluation of the miniplate-anchored Forsus Fatigue Resistant Device in skeletal Class II growing subjects: A randomized controlled trial

Abstract

Objectives: To evaluate the use of direct miniplate anchorage in conjunction with the Forsus Fatigue Resistant Device (FFRD) in treatment of skeletal Class II malocclusion. Materials and Methods: Forty-eight females with skeletal Class II were randomly allocated to the Forsus plus miniplates (FMP) group (16 patients, age 12.5 ± 0.9 years), Forsus alone (FFRD; 16 patients, age 12.1 ± 0.9 years), or the untreated control group (16 subjects, age 12.1 ± 0.9 years). After leveling and alignment, miniplates were inserted in the mandibular symphysis in the FMP group. The FFRD was inserted directly on the miniplates in the FMP group and onto the mandibular archwires in the FFRD group. The appliances were removed after reaching an edge-to-edge incisor relationship. Results: Data from 46 subjects were analyzed. The effective mandibular length significantly increased in the FMP group only (4.05 ± 0.78). The mandibular incisors showed a significant proclination in the FFRD group (9.17 ± 2.42) and a nonsignificant retroclination in the FMP group (−1.49 ± 4.70). The failure rate of the miniplates was reported to be 13.3%. Conclusions: The use of miniplates with the FFRD was successful in increasing the effective mandibular length in Class II malocclusion subjects in the short term. The miniplate-anchored FFRD eliminated the unfavorable mandibular incisor proclination in contrast to the conventional FFRD.

Three-Dimensional Evaluation of Pharyngeal Airway Volume Following Treatment of Post-Pubertal Patients with Skeletal Class II Malocclusion via Miniplate-Anchored Herbst Appliance

“…In this study, reconstructive miniplates were used for directly anchoring the Herbst appliance without bonding the mandibular arch, in line with previous reports, that supposed to offer more reliable anchorage over mini-screws upon application of orthopedic forces (14,16) . Although Herbst appliance was categorized as the most commonly used FFA, (2,32) to the present knowledge, miniplates-anchored Herbst had not been evaluated that warrants further investigation.…”

“…Moreover, statistical significance was achieved indicating that the treatment effect was large enough to be detected in the sample. Finally, gender limitation to females was adopted because of the recognized biological variations between males and females, rendering the validity of grouping of their outcomes could be questionable (16) .Furthermore, past researches regarding the influence of gender on airway dimensions has produced conflicting results. Abramson et al (33) reported no effect of gender on measured airway parameters, whereas Tan et al (34) found larger airway volumes, particularly the oropharyngeal, in males.…”

“…All patients in the current study were treated by Herbst type IV appliance (Dentaurum GmbH &Co. KG, Germany) that consisted of a bilateral telescope mechanism attached to upper and lower jaws keeping the mandible in an anterior jumped position. (26) The appliance was anchored by two miniplates plates (Universal reconstructive plates 2.3mm, 4 holes, Stryker, USA) inserted bilaterally in the mandible between the canine and first premolar teeth, (16,26) while attached to the maxilla through dental splints utilizing orthodontic bands ( Fig.1). The reconstruction plates were pre-bended using a 3-jaw contouring and bending plier to be adapted to 3D printed (Anycubic Chiron 3D Printer, China) mandibular model that was extracted from pretreatment CBCT of each patient on the predetermined location between mandibular canine and 1 st premolar bilaterally.…”

“…Patients were recalled one day following appliance insertion then every two weeks, to check for the followings: mucosal irritation, oral hygiene monitoring, plates' looseness, easy sliding of the telescopic rods inside the tubes, correct position of the c-clasp, and any signs of TMJ problems. The Herbst appliances were removed after nine months with the reconstruction plates through a second surgery (16) .…”

“…(11)(12)(13) Alternatively, miniplates were shown to be well accepted by patients and became to some extent popular for use in various applications. Lately, they were used for direct loading of FFAs for correction of skeletal Class II malocclusion (14)(15)(16) .…”