Management of skeletal class II malocclusion using bimaxillary skeletal anchorage supported fixed functional appliances

Kochar, Gagan Deep; Londhe, SM; Shivpuri, Anubhav; Chopra, SS; Mitra, Rajat; Verma, Munish

doi:10.1007/s00056-020-00239-1

Cited by 6 publications

(35 citation statements)

References 29 publications

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“…Table 3 presents the risk of bias assessment for the included studies. All studies [ 7 , 32 – 34 ] showed a moderate overall risk of bias. This was mainly due to a lack of randomization, which was only performed in one study, as well as a lack of reporting of the consecutive nature of the sample selection, unlike the case in the study by Manni et al[ 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…This was mainly due to a lack of randomization, which was only performed in one study, as well as a lack of reporting of the consecutive nature of the sample selection, unlike the case in the study by Manni et al[ 33 ]. The control group was inactive controls (observation/untreated) in the studies by Al-Dumaini et al[ 7 ] and Kochar et al[ 34 ], while the other studies compared BMSADs with active controls using either the same appliance [ 33 ] or a different appliance [ 32 ]. The substantial heterogeneity amongst the included studies precluded conducting meta-analyses.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [ 7 , 33 , 34 ] used the cervical vertebral maturation method to assess the skeletal maturation, while one study [ 32 ] used the MP3cap (capping of the epiphysis on the diaphysis of the medial phalanx of the middle finger). Three studies [ 7 , 32 , 34 ] used bi-maxillary miniplates as direct anchorage, and one study [ 33 ] used a miniscrew as indirect anchorage.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [ 7 , 32 , 34 ] used bi-maxillary miniplates as direct anchorage, and one study [ 33 ] used a miniscrew as indirect anchorage. With regard to the control group, Al-Dumaini et al[ 7 ] and Kochar et al[ 34 ] included untreated patients, while Ozbilek et al[ 32 ] treated their control groups with monobloc, and Manni et al[ 33 ] treated them with a standard Herbst appliance without miniscrews. The treatment effects were measured as changes upon comparing pre- and post-treatment/observational two-dimensional lateral cephalograms.…”

Section: Resultsmentioning

confidence: 99%

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Skeletal and dentoalveolar effects of class II malocclusion treatment using bi-maxillary skeletal anchorage: a systematic review

et al. 2022

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Background The goal of this systematic review was to assess the available evidence regarding the skeletal and dentoalveolar effects of bi-maxillary skeletal anchorage devices (BMSADs) used in treating growing class II malocclusion patients. Methods A comprehensive search was conducted on PubMed, Scopus, Science Direct, Web of Science, Cochrane, and LILACS up to November 2021, which was augmented by a manual search. The studies included were clinical trials (RCTs) and/or follow-up observational studies (retrospective and prospective). The outcomes of interest were the skeletal, dentoalveolar, and occlusal treatment-induced changes obtained from pre- and post-cephalometric measurements. The risks of bias of the included studies were assessed using an assessment tool from previous publications. Results Out of 742 screened articles, only 4 were eligible and thus included in the qualitative synthesis. They showed a moderate overall risk of bias. The results are presented as mean changes in both the study and control groups. All studies reported retrusion of the maxillary base and advancement of the mandible (meaning reduced ANB angle). Three of the included studies reported an increase in the vertical jaw relation, which was contrary to what the fourth study reported. Three studies reported an increase in the maxillary incisors’ inclination or position, while one study reported their retroclination. Proclination of the mandibular incisors happened in two studies, whereas the other two studies reported retroclination. The overjet was reduced in all included studies. Conclusion Apart from the protrusive effects on the mandible, retrusive effects on the maxilla, and the consequent reduction of the overjet, BMSADs results in inconsistent skeletal and dentoalveolar effects. However, the current evidence is limited due to the variability in the biomechanics of the intermaxillary components, type of anchorage, and comparable groups in the included studies. Further RCTs with more standardized methodologies are highly encouraged. Clinical relevance BMSADs (using miniscrews or miniplates on both jaws) induces more skeletal than dentoalveolar effects. However, this must be practiced with caution, based on the benefit to risk (surgical insertion) ratio, and the limited evidence available in hand so far. Registration The protocol for this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO, No.: CRD42020199601).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Skeletal and dentoalveolar effects of class II malocclusion treatment using bi-maxillary skeletal anchorage: a systematic review

et al. 2022

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“…Several treatment modalities are viable for Class II correction [1][2][3][4][5][6][7][8][9][10][11]. HG or functional treatment included activator, Bianator or Frankel appliance have been reported favorable outcomes for correction of Class II cases [1,2,3,[8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Changes in the Dentofacial Morphology Between Class Ii Patients Treated With One of the Two Treatment Modalities: Functional Appliance and Headgear. A Retrospective Cephalometric Study

Kılıç¹,

Erdem²,

Tunç³

2021

Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

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Changes in the dentofacial morphology between Class II patients treated with one of the two treatment modalities: functional appliance and headgear. A retrospective cephalometric study Objective: To compare changes in dentofacial morphology between Angle class II patients treated with one of two treatment modalities: functional appliance and headgear. Material and Methods: Activator group comprised 14 Class II patients (mean age, 13.54 years), headgear (HG) group 15 Class II patients (mean age, 11.56 years) and control group 14 Class I subjects (mean age, 11.57 years). Pre-treatment/baseline (T1) and posttreatment/observation (T2) lateral cephalograms were retrospectively analyzed using a standard cephalometric analysis. Data were analyzed by paired t test, analysis of variance (ANOVA) and Tukey HSD tests. Results: A point moved forward 0.50 and 0.51 mm in activator and control groups, but moved backward 0.37 mm in HG group, with no significant difference between groups. B point moved forward 3.32, 1.27 and 0.96 mm in activator, HG and control groups respectively, that significantly greater in activator group compared to other groups (p< .01).U1-SN angle decreased (7.39 degree) and IMPA increased (5.14 degree) significantly activator group, whereas U1-SN angle and IMPA showed small and insignificant changes (less than one degree) in HG and control groups. No significant difference observed between the groups in regard to changes in upper lip position, nasolabial angle, mandibular plane angle and mandibular body length. Favorable soft tissue facial profile changes were observed in the groups, but the changes are prominent in activator group (p< .05). Conclusion:HG group showed small and insignificant dentofacial changes. Functional appliance group showed favorable skeletal but unfavorable dentoalveolar changes. However, this group experienced more prominent and positive effects on soft tissue facial profile.

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Evaluation of Effects of Bimaxillary Anchored Fixed Functional Appliance on Temporomandibular Joint and Maxillomandibular Complex in Late Adolescents: An MRI Study

Gandhi,

Rai,

Tripathi

et al. 2023

J Indian Orthod Soc

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Objective To evaluate and assess changes in temporomandibular joint (TMJ), dental, skeletal and soft tissue changes following bimaxillary anchored fixed functional appliance (FFA) treatment of skeletal Class II malocclusion using Magnetic Resonance Imaging. Methods The prospective single-arm clinical trial included 15 patients (8 males, 7 females; mean age 15.71 + 1.81years) with Class II Division 1 malocclusion treated with bimaxillary anchored Forsus FRD. Four miniplates were placed bilaterally in maxilla and mandible. Then Forsus FRD L pin module was attached to miniplates without levelling of the arches. Pre-treatment (T1) and post-functional (T2) lateral cephalograms and MRI of TMJ were recorded. A total of 7 parameters were used to assess TMJ in all the 3 planes using MRI. Student’s t-test was carried out to compare pre- and post-treatment-induced changes. Results The mandible significantly moved forward (SNB, 3.71 + 0.91°; SND, 3.21 + 1.25°; Pg-OLp, 2.61 + 0.66mm, p<0.001) and there was distalizing effect on maxilla (SNA, –0.79 + 0.89°; A-OLp, –0.57 + 0.47mm, <0.001). Mean overjet correction of 4.43mm was achieved, of which 71.8% were skeletal changes. 65% of skeletal changes contributed to molar relationship correction. The forward positioning of mandible seems to be because of condylar and glenoid fossa remodelling, with condyle moving in anterior position within glenoid fossa (3.28 + 2.29) and articular disc moved posteriorly relative to condylar head (2.27 + 1.62°). Conclusion Significant skeletal changes and TMJ remodelling were observed with bimaxillary anchored FFA in correcting skeletal Class II malocclusion.

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Management of skeletal class II malocclusion using bimaxillary skeletal anchorage supported fixed functional appliances

Cited by 6 publications

References 29 publications

Skeletal and dentoalveolar effects of class II malocclusion treatment using bi-maxillary skeletal anchorage: a systematic review

Skeletal and dentoalveolar effects of class II malocclusion treatment using bi-maxillary skeletal anchorage: a systematic review

Changes in the Dentofacial Morphology Between Class Ii Patients Treated With One of the Two Treatment Modalities: Functional Appliance and Headgear. A Retrospective Cephalometric Study

Evaluation of Effects of Bimaxillary Anchored Fixed Functional Appliance on Temporomandibular Joint and Maxillomandibular Complex in Late Adolescents: An MRI Study

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