Injuries and Complications Management with Forsus Appliance

Alessandra Lucchese,Costanza Tagliatesta,Luis Huanca Ghislanzoni

doi:10.3126/ojn.v7i2.20164

Abstract

Introduction: Forsus is a useful appliance for non-compliant Class II problems, however various problems can occur when using them.Objective: To demonstrate a comprehensive series of of critical situations that can occur using the Forsus device and to provide the possible solutions of each complication.Materials & Method: The clinical management of the Forsus appliance was analyzed for eighty consecutively treated patients. The Forsus was used five months on average and pictures and clinical record were registered each time a patient had a problem or an injury.Discussion: The most common problem was breakage of the appliance. Breakage could occur as debonding of the lower first premolars or unsoldering of the upper first molar tubes. Lower premolar debonding could be prevented and fixed with an extra layer of flow composite surrounding the bracket base. Lesions of the cheek mucosa were found in several patients. A soft cotton pad used as “wax” was an effective solution to allow soft tissue healing and to prevent spring rubbing against the cheek. Upper molar intrusion occurred mainly when second molars were not included in the upper arch. Some patients experienceddisconnection of the spring and the push rod while opening the mouth wide. They were taught to self-adjust the appliance.Conclusion: The use of the Forsus appliance may lead to relatively frequent problems that the orthodontist can easily preventand manage.

Highlights

Forsus is a useful appliance for non-compliant Class II problems, various problems can occur when using them
The use of the Forsus appliance may lead to relatively frequent problems that the orthodontist can prevent and manage
Patients seem to prefer it to Class II elastics because it is less visible and less demanding, and they do not have to remember to wear it all the time.[3]

Summary

Introduction

Forsus is a useful appliance for non-compliant Class II problems, various problems can occur when using them. Non-compliance appliances to achieve a specific task (such as Class II correction) are becoming increasingly popular because of difficulties in obtaining cooperation from patients and their parents using traditional compliance methods (e.g. elastics, headgear), and mobile functional correctors. Among the several Class II fixed functional correctors, the ForsusTM appliance (3M Unitek, Monrovia, US) is becoming popular. Keim et al reported that it was routinely used by 17% of orthodontists, and occasionally used by 33% in their 2008 survey.[1] This percentage is steadily increasing, reaching 26% for routine use and 35% for occasional use in 2014,2 making it the most used fixed functional appliance in the United States. As with almost all orthodontic appliances, Forsus can present critical clinical conditions that need to be solved Patients seem to prefer it to Class II elastics because it is less visible and less demanding, and they do not have to remember to wear it all the time.[3]

Methods

Findings

Discussion

Conclusion