Forsus Fatigue Resistant Device Group Research Articles

Effect of Fixed and Removable Functional Therapy on Mandibular Anterior Bone Structures: A Fractal Analysis Study.

(1) Background and aim: The effects of functional therapies on dentoalveolar and skeletal structures have been investigated in orthodontics for many years. The aim of this retrospective study was to evaluate the changes caused by fixed and removable functional therapy in the mandibular anterior trabecular structures using fractal dimension (FD) analysis. (2) Methods: A total of 60 patients with skeletal and dental class II malocclusion were included in the study and three groups were formed: the untreated control group (CG), the Forsus fatigue-resistant device group (FFRDG), and the Monoblock group (MBG). Bone areas of interest determined in the buccoapical of the mandibular incisors and the symphysis in the lateral cephalometric radiographs taken before (T0) and after (T1) functional therapy were evaluated using FD analysis. The relationship between the FD and IMPA (Incisor Mandibular Plane Angle) angles was evaluated. Parametric and nonparametric tests were used in statistical analysis according to normality distribution. The statistical significance level was determined as p < 0.05. (3) Results: There was no statistically significant difference between the FD values of all groups at T0 (p > 0.05). At T1, buccoapical FD values were significantly lower in FFRDG and MBG compared to the control group (p < 0.05), while symphyseal FD values were not found to be significant (p > 0.05). The IMPA angle was significantly lower in the FFRDG and MBG than in the control group at T0, while it was higher at T1 (p < 0.05). While a significant negative correlation was observed between the IMPA angle and buccoapical FD values in both FFRDG and MBG (p < 0.05), it was not observed with the symphysis FD values (p > 0.05). (4) Conclusions: Trabecular changes caused by functional therapy in the mandibular anterior bone can be evaluated on lateral cephalometric radiographs with FD analysis. It was concluded that orthodontists should ensure controlled changes in the IMPA angle during functional therapy, especially for the decreases in FDs seen in the buccoapical alveolar region due to the forward movement of the mandibular incisors.

Assessment of the Treatment Outcomes of Skeletal Class III Malocclusion Using Forsus Fatigue Resistant Device Versus Intermaxillary Elastics

Purpose: This research aimed to evaluate the effect of treatment with Forsus Fatigue Resistant Device (FFRD) and traditional Class III elastics in treating class III malocclusion. Patients and Methods: The present study was applied to twenty female patients divided into two groups equally and randomly with age ranged from 14 to 16 years old, Group I treated with inverted FFRD which was attached to the mandibular first molar extra-oral tube and distal to the bracket of the maxillary canine and conventional class III elastics used in Group II. Results: Significant increase revealed in ANB angle in both groups while, there was significant decrease in S-A distance in FFRD group while, in relation to vertical skeletal measurement SN to mandibular plane angle (SN-MP) there was significant decrease in FFRD group and significant increase in intermaxillary elastic group. There was also significant proclination in maxillary anterior teeth and significant retroclination of the mandibular one. Conclusions: In class III malocclusion the use of inverted FFRD and elastics is successful treatment method to improve the maxilla-mandibular relationship by improving anteroposterior relationship (ANB angle). The FFRD is suggested in uncooperative patients as it did not require patient cooperation as class III elastics.

Comparison of twin block appliance and Forsus Fatigue Resistant Device therapies on uvulo-glossopharyngeal dimensions: A retrospective study

Objectives: The aim of this study was to compare the effects of two different functional appliances on skeletal, dental, and uvulo-glossopharyngeal dimensions. Materials and Methods: Pre- and post-treatment lateral cephalograms of 50 adolescent Class II patients with a retrognathic mandible were obtained from an archive and divided into two groups according to functional therapy. Twenty-five patients (14 females, 11 males, mean age: 13.5 ± 2.8) who were treated with Forsus Fatigue Resistant Device (FFRD) and 25 patients (17 females, eight males, mean age: 12.5 ± 0.4) who had received functional therapy through the twin block (TWB) were enrolled. Skeletal, dentoalveolar, tongue, uvula, hyoid position, and oropharyngeal airway parameters were measured using the Dolphin software, and uvulo-glossopharyngeal area measurements were performed with the AutoCAD software. Results: The TWB group exhibited remarkable mandibular advancement compared to the FFRD group (P &lt; 0.05). Both of the treatments proclined mandibular incisors, and tongue dimensions increased significantly in both groups (P &lt; 0.05). While the hyoid point moved forward and the oropharyngeal area increased significantly in the TWB group, no significant changes were observed in the FFRD group. The comparison of the TWB and FFRD groups with regard to uvulo-glossopharyngeal dimensions showed no significant differences between the groups (P &gt; 0.05). Conclusion: Changes in uvulo-glossopharyngeal dimensions did not significantly vary between the two different functional therapies.

Effects of fixed twin-block and forsus fatigue resistant device on mandibular third molar angulation – A comparative study

INTRODUCTION: Fixed functional appliances such as fixed twin-block (FTB) and forsus fatigue resistant device (FRD) improve Class II skeletal relationships by increasing the length of the mandible, which subsequently leads to an increase in the retromolar space. This would bring about a positional and angular change in the mandibular third molar. These appliances also produce forward movement of the mandibular buccal segments, which has also been cited as an important factor providing space and therefore improving the angulation and eruption potential of the third molars. OBJECTIVE: To evaluate and compare the effects of FTB and forsus FRD treatment on mandibular third molar angulation. MATERIALS AND METHODS: Pretreatment and posttreatment lateral cephalograms and orthopantomograms of 25 patients with Class II division 1 malocclusion treated with FTB were compared with those of 25 patients treated with forsus FRD. Sagittal and vertical skeletal relationships and mandibular length were assessed on lateral cephalogram, whereas linear parameters such as retromolar space; space width ratio (SWR); distance of Xi point from the distal surface of the lower second molar; and angular parameters such as α, β, and ϒ; and gonial angles were measured using orthopantomograms. Intragroup comparison was done using paired t-test, while unpaired t-test was done for intergroup comparison of the observed changes. RESULTS: Mandibular length increased significantly in the FTB group, whereas mesialization of the mandibular dentition was significantly high in the FRD group. Both groups showed a significant increase in retromolar space, SWR, Xi point to 7 distance, α angle, and a decrease in β angle. These changes were significantly more pronounced in the FTB group. CONCLUSION: There was a significant improvement in the third molar angulation following treatment with fixed functional appliances, which was comparatively more in the FTB group than that in the FRD group, owing to an increase in mandibular length.

Pharyngeal airway, hyoid bone, and soft palate changes after Class II treatment with Twin-block and Forsus appliances during the postpeak growth period

This study aimed to compare cephalometrically the pharyngeal airway, hyoid bone, and soft palate (SP) changes after Class II malocclusion treatments using Twin-block (TWB) and Forsus Fatigue Resistant Device (FFRD) (3M UnitekCorp, 3M Dental Products, Monrovia, Calif) during the postpeak growth period. Forty-two patients with Class II malocclusion treated during the postpeak growth period were randomly and retrospectively included in this study. These patients were divided into 2 treatment groups: TWB and FFRD. The skeletal, dental, pharyngeal airway, hyoid bone position, and SP measurements were obtained from the lateral cephalometric radiographs taken at the beginning and at the end of the treatment. Paired-samples and independent-samples t tests were used for the intragroup and intergroup comparisons, respectively. In the TWB group, the SNB (°), Md1-NB (mm), Md1-NB (°), and McNamara upper and lower pharyngeal airway dimensions significantly increased, whereas the ANB (°), AD1-Ba (mm), AD2-H (mm), adenoidal nasopharyngeal area, and SP angle decreased (P<0.05). In the FFRD group, the SNB (°), Md1-NB (mm), Md1-NB (°), Ptm-Ba (mm), and McNamara upper airway dimensions significantly increased, whereas the ANB (°), AD2-H (mm), and interincisor angle decreased (P<0.05). Moreover, there were statistically significant differences in the Md1-NB angles and SP thicknesses between the 2 groups (P<0.05). The effects of TWB and FFRD treatment on the airway during the postpeak growth period were similar. However, the FFRD caused a greater mandibular incisor protrusion.

Evaluation of the splint-supported Forsus Fatigue Resistant Device in skeletal Class II growing subjects.

To evaluate the use of the Forsus Fatigue Resistant Device (FFRD), supported with bimaxillary splints, in treatment of skeletal Class II malocclusion. Data from 46 skeletal Class II females who received either conventional Forsus alone (FFRD group) (15 patients, 12.54 ± 0.90 years), FFRD and bimaxillary splints (splint-FFRD group) (15 patients, 12.29 ± 0.82 years), or were untreated controls (16 subjects, 12.1 ± 0.9 years) were retrieved from previous clinical trials. FFRD was inserted onto the mandibular archwire in the FFRD group after leveling and alignment with multibracket appliances. In the splint-FFRD group, Forsus was inserted between fixed maxillary and mandibular splints. Treatment continued until reaching an edge-to-edge incisor relationship. Both treatment groups failed to induce significant mandibular skeletal effects compared to the normal growth exhibited by untreated controls. The splint-FFRD group showed significant reduction of SNA (-0.88° ± 0.51°) and ANB (-1.36° ± 0.87°). The mandibular incisors showed significant proclination in the FFRD (9.17° ± 2.42°) and splint-FFRD groups (7.06° ± 3.34°). The newly proposed splint-supported FFRD was equally effective as the conventional FFRD in treatment of Class II malocclusion with dento-alveolar changes and additional maxillary restricting effect. It has an additional advantage of immediate initiation of the Class II correction.

Long-term effects of the Forsus Device in Class II division I patients treated at pre-peak, peak, and post-peak growth periods: A retrospective study

To assess the long-term effects of the Forsus Fatigue Resistant Device (FFRD) for the correction of Class II division 1 malocclusion during pre-peak, peak, and post-peak growth periods. This retrospective study was conducted on 60 patients that received FFRD with concurrent full-fixed orthodontic appliances during pre-peak (n=18), peak (n=21) and post-peak (n=21) maturational stages. The FFRD groups were compared with 60 untreated Class II control subjects obtained from the University of Michigan growth study and matched by skeletal age, sex, and observation periods. Lateral cephalograms were obtained at three time-points: [T1] pre-treatment; [T2] end of comprehensive orthodontic treatment; and [T3] retention (average of 3 years in retention). Nineteen linear and angular measurements were recorded. Short-term (T1- T2) and long-term (T1-T3) treatment changes were analyzed using paired Wilcoxon Signed Rank tests. In the pre-peak group, FFRD caused temporary restraint of maxillary growth and an increase in mandibular length at T1-T2 compared to controls. No significant differences were found at T2-T3 time points. The net changes (T1-T3) included a restraining effect on the maxilla and dentoalveolar compensation. In the peak group, maxillary restraint effect was seen at T1-T2, but this effect relapsed at T2-T3 time points. Similar to the pre-peak group, the net results (T1-T3) included maxillary headgear effect and dentoalveolar compensation. In the post-peak group, the net effects (T1-T3) of treatment included only dentoalveolar compensation. Overall, Class II malocclusion correction with FFRD is stable at three years post-treatment and is mainly achieved by maxillary restraint and dentoalveolar compensation at the pre-peak and peak stages and dentoalveolar compensation during the post-peak stage.

Assessment of Airway Dimensions and Hyoid Bone Position in Class II Patients Treated with Fixed Twin Block and Forsus Fatigue Resistant Device − A Retrospective Cephalometric Study

Introduction: Obstructive Sleep Apnea Syndrome (OSAS) regulate pharyngeal airway volume. Forward displacement of mandibular repositioning appliances has advantage over an improvement of pharyngeal airway space and a change in the hyoid bone position. This study aims to assess the changes in the pharyngeal airway dimensions and hyoid bone position in growing individuals with retrognathic mandible treated with Fixed Twin Block (FTB) and Forsus Fatigue Resistant Device (FRD) to correct the skeletal Class II pattern. Materials and Methods: 40 skeletal Class II pattern patients were included in the study, to assess the pharyngeal airway space at three levels, upper pharyngeal width (UPW), middle pharyngeal width (MPW), and lower pharyngeal width (LPW). Hyoid bone measurements were Vertical dimension H-HOR and Horizontal dimension was H- VER. The study patients were divided into three groups and in each group 20 patients. Group-A treated with FTB appliance and Group-B treated with Forsus FRD appliance and Group C served as control group. At pre and post functional treatment condition, lateral cephalograms were evaluated. Results: Cephalometric analysis revealed a significant increase in the mean change of MPW (P = 0.005) between the FTB and the control group. There was significant, mean change seen of pre, post UPW, mean change of MPW over groups (P

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

To evaluate the use of direct miniplate anchorage in conjunction with the Forsus Fatigue Resistant Device (FFRD) in treatment of skeletal Class II malocclusion. 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. 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%. 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.

Treatment effects produced by the Twin-block appliance vs the Forsus Fatigue Resistant Device in growing Class II patients.

To compare the dentoskeletal changes produced by the Twin-block appliance (TB) followed by fixed appliances vs the Forsus Fatigue Resistant Device (FRD) in combination with fixed appliances in growing patients having Class II division 1 malocclusion. Twenty-eight Class II patients (19 females and 9 males; mean age, 12.4 years) treated consecutively with the TB followed by fixed appliances were compared with a group of 36 patients (16 females and 20 males; mean age, 12.3 years) treated consecutively with the FRD in combination with fixed appliances and with a sample of 27 subjects having untreated Class II malocclusion (13 females and 14 males; mean age, 12.2 years). Mean observation interval was 2.3 years in all groups. Cephalometric changes were compared among the three groups by means of ANOVA and Tukey's post hoc tests. The FRD produced a significant restraint of the maxilla compared with the TB and control samples (SNA, -1.1° and -1.8°, respectively). The TB sample exhibited significantly greater mandibular advancement and greater increments in total mandibular length than either the FRD or control groups (SNB, 1.9° and 1.5°, respectively; and Co-Gn, 2.0 mm and 3.4 mm, respectively). The FRD produced a significantly greater amount of proclination of the mandibular incisors than what occurred with the TB or the control samples (2.9° and 5.6°, respectively). The TB appliance produced greater skeletal effects in terms of mandibular advancement and growth stimulation while the Forsus caused significant proclination of the mandibular incisors.

Treatment effects of the Forsus Fatigue Resistant Device used with miniscrew anchorage

To evaluate the dentofacial effects of the Forsus Fatigue Resistant Device (FRD) used with miniscrew anchorage (FRDMS) and compare them with those of conventional FRD and an untreated Class II control group. The sample consisted of 48 Class II subjects. Sixteen patients (13.68 ± 1.09 years of age) were treated with FRDMS, whereas 17 subjects (14.64 ± 1.56 years of age) were treated with only FRD. Also, a control sample of 15 untreated Class II subjects (14.13 ± 1.50 years of age) was constructed. Angular and linear measurements were made on 96 lateral cephalograms. Paired t, one-way analysis of variance, and Tukey tests were used for statistical analysis. Class I molar relationship and overjet correction were achieved in an average period of 6.5 ± 1.97 and 5.5 ± 1.80 months in the FRDMS and FRD groups, respectively. No skeletal effect was determined in both treatment groups. Greater overbite correction was found in the FRD group. Retrusion and extrusion of maxillary incisors, distalization of maxillary molars, and extrusion of mandibular molars were significant in both treatment groups. Labial tipping of mandibular incisors was significantly greater in the FRD group than in the FRDMS group. Overjet and molar correction was totally dentoalveolar. Unfavorable labial tipping of mandibular incisors was effectively minimized with the usage of miniscrews.

Effectiveness of comprehensive fixed appliance treatment used with the Forsus Fatigue Resistant Device in Class II patients

To assess the dental, skeletal, and soft tissue effects of comprehensive fixed appliance treatment combined with the Forsus Fatigue Resistant Device (FRD) in Class II patients. Thirty-two Class II patients (mean age 12.7 ± 1.2 years) were treated consecutively with the FRD protocol and compared with a matched sample of 27 untreated Class II subjects (mean age 12.8 ± 1.3 years). Lateral cephalograms were taken before therapy and at the completion of comprehensive therapy. The mean duration of comprehensive treatment was 2.4 ± 0.4 years. Statistical comparisons were carried out with the Student's t-test (P < .05). The success rate was 87.5%. The FRD group showed a significant restraint in the sagittal skeletal position of the maxilla (also at the soft tissue level), a significant increase in mandibular length, and a significant improvement in maxillo-mandibular sagittal skeletal relationships. The treated group exhibited a significant reduction in overjet and a significant increase in molar relationship. The lower incisors were significantly proclined and intruded, while the lower first molars moved significantly in a mesial and vertical direction. The FRD protocol is effective in correcting Class II malocclusion with a combination of skeletal (mainly maxillary) and dentoalveolar (mainly mandibular) modifications.