Three-dimensional effects of the mini-implant–anchored Forsus Fatigue Resistant Device: A randomized controlled trial

Abstract

Objective: To detect three-dimensionally the effects of using mini-implant anchorage with the Forsus Fatigue Resistant Device (FFRD). Materials and Methods: The sample comprised 43 skeletal Class II females with deficient mandibles. They were randomly allocated into three groups: 16 patients (13.25 6 1.12 years) received FFRD alone (Forsus group), 15 subjects (13.07 6 1.41 years) received FFRD and miniimplants (FMI group), and 12 subjects (12.71 6 1.44 years) were in the untreated control group. Three-dimensional analyses of cone beam computed tomographic images were completed, and the data were statistically analyzed. Results: Class I relationship and overjet correction were achieved in 88% of the cases. None of the two treatment groups showed significant mandibular skeletal effects. In the FMI group, significant headgear effect, decrease in maxillary width, and increase in the lower facial height were noted. In the FMI group, retroclination of maxillary incisors and distalization of maxillary molars were significantly higher. Proclination and intrusion of mandibular incisors were significantly greater in the Forsus group. Conclusions: FFRD resulted in Class II correction mainly through dentoalveolar effects and with minimal skeletal effects. Utilization of mini-implant anchorage effectively reduced the unfavorable proclination and intrusion of mandibular incisors but did not produce additional skeletal effects. (Angle Orthod. 2016;86:292-305.)

Optimization of Class II Malocclusion Treatments Using the Forsus™ Fatigue Resistance Device and Its Post-Treatment Effect in Adult Patients: A Case Report

“…The decision to treat this case using the Forsus hybrid functional appliance was taken due to the patient's main complaint, the characteristics of the malocclusion and, mainly, the facial features that have shown facial asymmetry within the normal standards, i.e., convex profile, but with passive lip seal, harmonic nasolabial angle and horizontal growth pattern [1,2,[4][5][6]8,9,12,25,28,30,33,34,35]. Other treatment options were considered unfavorable due to the presented clinical condition and the patient's main complaint and treatment choice.…”

“…However, due to the need of patient's cooperation [24], another treatment option was considered. The treatment option was, then, the use of the Forsus fixed functional appliance because it is easy to instalatt [10,11,13] and, mainly, because it provides comfort to patient, allowing greater freedom to the eccentric and centric mandible movements [7,[11][12][13][14][15][16][17]33,34], and, also, better resistance [10,13] and performance with light forces (average of 220 to 250g) [15,35]. Other functional appliances, such as the Herbst and the Jasper-jumper, provide, in a long-term run, the same dentoskeletal results as the hybrid appliances [8,11,12,18,19,[21][22][23]25].…”

“…Based on this and supported by the literature, it was possible to consider and suggest some treatment options to the patient, such as a surgical-orthodontic treatment [20,38]; upper first molar extractions [39,40], the use of intermaxillary Class II elastics [24,41], which would need patient cooperation; and the use of fixed functional appliances-rigid [18,19,[21][22][23]25], semi-rigid [8,11,12,37], but, mainly, hybrid appliances as the Forsus™ Fatigue Resistant Device [3,7,11,[13][14][15]17,[32][33][34]35]. The chosen protocol was to use the Forsus™ Fatigue Resistant Device that has shown to be an effective device, providing greater comfort to patients [7,11,[14][15][16][17]33,34] and good resistance [10,13,15,35] when treating Class II malocclusions.…”

“…It is a comfortable device [7], as it does not completely limit the mandible movement and, in the current version, it shows a very low breakage rate [10,14,[32][33][34]. The Forsus appliance, when installed in the upper first molar tube in the lower leveling arch wire, at the distal of the cuspid bracket [3,11,15,17] or, at the distal of the lower first premolar [14], exerts a force of 220 g approximately in both jaws, in opposite directions [15,35].…”

Buccal bone graft with surgically assisted rapid maxillary expansion in young adults: a cone beam computerized tomographic study

“…Recently, systematic reviews [9][10][11] concluded that the skeletal effects of RFAs and FFAs could be considered of negligible clinical importance. This could be attributed to the anchorage loss accompanied by these appliances that could compromise the skeletal correction 12,13 . Several attempts were proposed to counteract the unwanted dento-alveolar side effects of FF As including the use of skeletal anchorage.…”