Functional Appliances Research Articles

A comparison of treatment effects produced by AdvanSync and forsus fatigue resistant device in growing class II patients - An study

Class II malocclusion second most common malocclusion after class I. The prevalence of Class II malocclusion was reported 19.56% globally(2) and 14.6% in India. Management of class II malocclusion becomes intricate because of its variable etiology and the age at which the patient presents to the orthodontists. During 1900 first fixed functional appliances (FFA) emerged and then plethora of appliances followed. Amongst various appliances AdvanSync™ appears to be the latest addition to FFA in orthodontist’s arsenal whereas Forsus™ Fatigue Resistance Device (FFRD) is the most widely accepted and used FFA. The aim of this study is to compare the differences in the skeletal, dentoalveolar and soft tissue changes produced by AdvanSync™2 and FFRD. The sample comprised of 30 patients presented to the Department of Orthodontics and Dentofacial Orthopaedics, as outpatients. Total 15 patients in each group were treated and analyzed using Lateral cephalograms at two time period, pretreatment and post functional orthodontic treatment. Both the appliances were effective in normalising class II malocclusions with mandibular deficiency. Both the appliances showed more of dentoalveolar effects when compared to skeletal. They both have a positive effect on the profile. The FFRD and AdvanSync™2 both the appliances were effective in treating class II division malocclusion. AdvanSync™2 demonstrated greater headgear effect but less mandibular advancement as compared to FFRD. Both appliances caused significant dentoalveloar changes and soft tissue changes.

Evaluation of clinical effects of Advansync 2 fixed functional appliance in skeletal Class II malocclusion: A retrospective cephalometric study

To evaluate the treatment effects of AdvancSync 2 in patients of skeletal Class II malocclusion in selected skeletal, dental, soft tissue and airway parameters. Pretreatment and post-functional lateral cephalograms of 12 patients (06 males and 06 females with mean age of 14.25+0.75) with skeletal Class II malocclusion treated using AdvanSync 2 were evaluated. Paired t-test and Wilcoxon rank-sum intraclass correlation (ICC) test results were calculated.Statistically significant changes were found in skeletal parameters ofSNB, Wits, maxillo-mandibular differential, Björk’s sum, basal plane angle, Sn-GoGn, lower anterior facial height (LAFH), Na-perp-Pog. Changes in dental parameters U1-NA (angular and linear), L1 to NB (angular and linear), U1-SN angle, IMPA, Inter-incisal angle, L1 to A-Pog and U1 to A-Pog were also observed to be statistically significant at T1. Soft tissue skeletal convexity and nasolabial angle improved significantly post treatment, while, statistically significant change was observed only in posterior pharyngeal airway space among the chosen cephalometric airway parameters.Treatment with AdvanSync 2 corrected the Class II malocclusion by producing skeletal and dentoalveolar changes. Soft tissue facial convexity and nasolabial angle improved with treatment. Further, linear dimension of the posterior pharyngeal airway space showed significant improvement with AdvanSync 2 therapy.

Comparison of treatment effects of herbst and advansync appliances on hyoid bone position and cervical posture in skeletal class II malocclusion – A prospective randomized clinical trial

Mandibular retrusion is the most common cause of Class II Division 1 malocclusion, which needs correction of the underlying skeletal discrepancy. The objective of this study was to evaluate the Hyoid bone position and cervical posture changes following treatment with two fixed functional appliances - Herbst and Advansync (Ormco, Orange, CA, USA) appliances in skeletal Class II malocclusion using pre and post treatment lateral cephalograms.For this randomized controlled trial,40 patients(21males and 19 females) were divided into two groups Group I, Herbst Appliance group (mean age: 12.6 +/- 0.67 years) and Group II, Advansync group (mean age: 12.8 +/- 0.66yrs). Pre and post-treatment (after appliance therapy of 8 months duration) lateral cephalograms were evaluated using Planmeca Romexis software 5.0.0.R version for hyoid bone position and cervical posture changes. The Hyoid bone had displaced anteriorly by 1.64 mm in Group I and in Group II by 1.97 mm. There was downward displacement of hyoid bone by 1.73 mm in Group I and 2.03 mm in Group II with reference to the Frankfort horizontal (FH) plane. The Mandibular plane-Odontoid process tangent angle used for determining upper cervical posture decreased by 7.13 in Group I, while by 0.33in Group II. This study concluded that both Herbst and Advansync appliances showed an improvement in hyoid bone position and the cervical posture while Advansync appliance demonstrated greater uprighting of cervical posture which was statistically significant.

Impact of Different Orthodontic Appliances on Mandibular Condyle, Anterior Region of Mandibular, and Maxillary Sinus Using Panoramic Radiography.

BACKGROUND This retrospective study of 44 patients requiring removable functional dental appliances aimed to compare the use of a maxillary expansion device, twinblock/monoblock, face mask, and chincup on maxillary sinus dimensions, mandibular anterior region bone density (MABD), and mandibular condyle head bone formation (MCBF) using panoramic radiography. MATERIAL AND METHODS The patients were divided into 4 groups based on the treatment modalities used: group A, maxillary expansion device (n=11); group B, twinblock/monoblock (n=11); group C, face mask (n=11); and group D, chincup (n=11). MABD and MCBF were assessed using the fractal analysis method, while maxillary sinus dimensions were compared using the ImageJ program. Different groups of patients were tested by the Mann-Whitney U test, with Bonferroni correction. RESULTS Group A showed an increase in MABD, MCBF, and average maxillary sinus indentation base length (MSIL) and a decrease in average planar base length (MSPL) and maxillary sinus area (MSA) (P<0.05). Group B showed an increase in MABD, MSIL, MSPL, MSA, and MCBF (P<0.05). Group C showed an increase in MABD, MSIL, MSPL, and MCBF, with a decrease in MSA (P>0.05). Group D showed an increase in MCBF, MABD, MSIL, and MSA, with a decrease in MSPL at the end of treatment, compared with pretreatment (P<0.05). CONCLUSIONS Orthodontic treatment with different removable functional dental appliances has varying effects on the mandible and maxilla. Possible changes in the maxilla and mandible should be considered before treatments with removable functional dental appliances.

An overview of treatment strategies for class II and class III malocclusions

Class II and class III malocclusions represent common yet complex dental conditions that affect both aesthetics and function. Managing these malocclusions requires an approach tailored to the patient's growth stage, with early interventions focusing on growth modification and adult cases often necessitating surgical solutions. In class II malocclusions, growth modification with functional appliances such as the Twin Block and Herbst appliance promotes mandibular advancement and improves facial harmony in younger patients. For older individuals or those with more severe malocclusions, orthodontic camouflage or mandibular advancement surgery, including bilateral sagittal split osteotomy, is recommended to achieve a balanced occlusal relationship and improve facial proportions. Class III malocclusions, often involving a prognathic mandible or maxillary deficiency, are particularly challenging. For young patients, facemask therapy and rapid maxillary expansion can encourage maxillary growth, while chin cup therapy can control mandibular projection, aiming to improve skeletal balance. In severe adult cases, combined orthodontic-surgical treatments, such as maxillary advancement through Le Fort I osteotomy or mandibular setback procedures, provide durable, functionally stable outcomes. Surgical-orthodontic approaches, including bimaxillary surgery, are particularly advantageous for severe class III cases by effectively addressing the underlying skeletal imbalances and enhancing facial aesthetics. Growth modification techniques emphasize the importance of early diagnosis and intervention, aiming to harness natural growth potential and reduce the need for more invasive treatments later in life. For adult patients, surgical interventions present a definitive solution, delivering substantial improvements in function and appearance. Ongoing advances in both orthodontic and surgical techniques are refining the precision and stability of treatment outcomes, underscoring the need for individualized, age-appropriate strategies in managing class II and class III malocclusions.

Perception of facial esthetics and cephalometric correlations in Class II patients: a comparison between two-phase and one-phase treatments

An effective orthodontic treatment should not only aim for satisfactory occlusal outcomes but also consider its impact on facial esthetics. The study aims to evaluate and compare the perception of profile esthetics of skeletal Class II patients treated with two orthodontic modalities: (1) Two-phase approach involving functional appliances followed by fixed appliances with premolar extractions, or (2) One-phase approach using fixed appliances with premolar extractions. Additionally, the study aims to evaluate the correlation between the perceived esthetics and the corresponding cephalometric measurements. The study included 40 skeletal Class II adolescents who underwent either two-phase (n = 20, mean age = 12.38 ± 1.18) or one-phase (n = 20, mean age = 12.53 ± 0.79) orthodontic treatments. Eighty profile silhouettes (pre- and post-treatment) were assessed by 64 raters, including 23 orthodontists, 21 general dental practitioners, and 20 laypersons. The raters used a visual analog scale (VAS) to access profiles, upper and lower lips, and chin esthetics. At pre-treatment, all three groups of raters gave significantly lower scores to the profile silhouettes of the two-phase group compared to the one-phase group (P < 0.01); however, after treatment, they rated the two-phase group significantly higher (P ≤ 0.001). The two-phase group exhibited greater improvements in profile and upper and lower lip esthetics as perceived by all raters (P ≤ 0.001). Furthermore, cephalometric results revealed greater reductions in SNA, ANB, Wits appraisal, and G’-Sn-Pog’ in the two-phase group compared to the one-phase group (P < 0.05). Five cephalometric parameters (SNB, SNPog, overjet, overbite, and UL-SnPog’) demonstrated significant correlations with VAS scores given by orthodontists (P < 0.05). In conclusion, the two-phase group showed greater subjective and objective improvements in facial esthetics than the one-phase group. Additionally, the anteroposterior mandibular position and upper lip protrusion may be the primary cephalometric parameters correlated with subjective facial profile perceptions.

Stability of unilateral posterior crossbite treatment with the Function Generating Bite appliance : Association with reduction of mandibular clockwise rotation and increased maxillary transversal width measurements.

This observational study aimed to evaluate the stability of unilateral posterior crossbite (UPXB) correction with the functional appliance function generating bite (FGB appliance) during follow-up and its effects on craniofacial growth. Atotal of 102 age- and gender-matched patients were included: 51with UPXB (male [M] = 19; female [F] = 32; mean age ± standard deviation [SD] = 7.6 ± 1.4[years.months]) and 51controls (C; M = 19; F = 32; mean age ± SD = 7.9 ± 1.3). UPXB was corrected with the FGB appliance. Study casts were collected before treatment (T0), after correction (T1), after afollow-up of 3.7 ± 1.6[years.months] (T2) and different transversal measurements were performed with calipers: intermolar (IMD), intermolar gingival (IMGD), intercanine (ICD), and intercanine gingival distances (ICGD). In treated patients, in addition, lateral cephalometric tracings were analyzed at T0 and T2. At T0, all maxillary measurements were significantly smaller in the UPXB group compared to the controls (p < 0.001). Between T0 and T1, all maxillary variables increased significantly in the UPXB group (p < 0.001; IMD +4.3 ± 2.1 mm; ICD +3.1 ± 2 mm). Between T1 and T2, maxillary IMD increased further (p < 0.05; +2.2 ± 2 mm). The mean T0-T2 increases were 6.6 ± 2.6 mm (IMD) and 4.3 ± 2.6 mm (ICD). At T0, the cephalometric analysis showed significantly stronger mandibular clockwise rotation (p < 0.01) in the UPXB group compared to the control group. Between T0 and T2, the UPXB group showed asignificant reduction of mandibular (p < 0.001; SpP-CoOr T0 = -3.47°± 4.38, T2 = -1.14°± 4.01) and occlusal plane (p < 0.01; SpP-Oc T0 = 11.37°± 3.91, T2 = 9.86°± 3.83) clockwise rotation, and of intermaxillary divergence (p < 0.01; SpP-GoGn T0 = 27.8°± 5.39, T2 = 26.65°± 5.49). Treatment of UPXB with the FGB appliance effectively increased maxillary transversal width measurements, especially in the posterior region, even after follow-up, indicating stable results. Concurrently, mandibular clockwise rotation was reduced, indicating control of the vertical dimension.

Effects on Sleep Bruxism Activity of Three Different Oral Appliances: One Year Longitudinal Cohort Study.

Different oral appliances (OAs) have been proposed to control sleep bruxism (SB) detrimental effects on the stomatognathic system. The aim of the study was to evaluate the effect of different OAs on SB activity and masticatory muscle activity (sMMA) measured by EMG. This longitudinal cohort study was conducted on 51 patients (21 M, 30 F, mean age 26,5 ± 3,5) suffering from SB diagnosed with a validated portable EMG-ECG holter and wearing different OAs: occlusal splints, functional appliance with metallic bites and clear aligners followed after 1 week, 1 month, 3 months, 6 months and 12 months from delivery. A control group of 16 non-treated SB patients (6 M, 10 F mean age 27,1 ± 1,4) was used as a reference. A multiple regression analysis was performed to estimate the differences between groups. The level of significance was set as P value <0,05. Occlusal splint reduced sleep bruxism index after 1 week, 3, 6 and 12 months from delivery while functional appliance only after 12 months. Occlusal splints reduced general phasic contractions only in the first week and sleep bruxism-related phasic contractions at 1 week, 3 and 6 months after delivery with no significant reductions after 12 months. Patients wearing clear aligners showed a reduction in general tonic contractions after 6 and 12 months. Resin and metal bites can reduce sleep bruxism index, while resin bites can reduce sleep bruxism-related phasic contractions. Clear aligners do not influence sleep bruxism index but can reduce tonic contractions.

Exploring the genetic expression of Sdf1, Foxc1 and histologic changes following mandibular advancement and recovery phase in Wistar rats.

PurposeThis study evaluated the impact of mandibular advancement on Sdf1 and Foxc1 gene expression in the mandibular condylar cartilage of young Wistar rats. By examining the changes that occur during a unique one-month recovery period, it highlights the critical role of gene expression and condylar adaptation during the recovery phase. The analysis focused on whether, during the recovery period, reversal changes occur when functional appliances are removed and whether genetic expression important for condyle growth and adaptation downregulates. Material and MethodsThe study involved 30 male Wistar rats divided into 2 control groups Appliance Control and Recovery Control groups, and 2 experimental groups, the Appliance group with mandibular advancement bite-jumping appliance for 30 days, and the Recovery group with appliance for 30 days followed by a 30-day recovery. Molecular analysis of condylar cartilage using real-time RT-PCR and histological assessments was conducted. ResultsSignificant genetic expression alterations were noted in both the experimental groups for Sdf1 (p < 0.05) and Foxc1 (p < 0.05). According to histological investigations, significant alterations with an increase in the proliferative and hypertrophic layer in condylar cartilage were seen. ConclusionMandibular advancement bite-jumping appliances induce proliferative and hypertrophic layer changes in mandibular condylar cartilage, shown by elevated Foxc1 levels and decreased Sdf1 levels. Post-appliance removal, persistent gene expression reveals a true joint stimulation.

Three-Dimensional Assessment of the Effects of Kinesio Taping on Mandibular Condylar Volume with Skeletal Class II Malocclusions

This study aimed to perform a three-dimensional assessment of the effects of Kinesio taping (KT) on mandibular condylar volume during Twin Block (TB) appliance therapy in individuals with skeletal Class II malocclusions. Thirty children (16 female, 14 male) aged between 10 and 15 years (12.80 ± 1.08) who were scheduled for TB therapy were randomly assigned to two groups of 15 patients each. One group (Group 1) received KT on the temporomandibular joint (TMJ) area with TB therapy while the other group (Group 2) only received the TB. KT was applied in cycles of 3 days, followed by 1 day off for 3 months. All patients underwent computed tomography (CT) scanning before KT and TB therapy (T0) and 3 months later (T1). Changes in right and left condylar volumes were measured (cm3) using a GE Advantage Workstation (General Electric Medical Systems, USA) and compared between the two groups using the Mann–Whitney U test and Wilcoxon signed-rank test. The KT group showed a significant differences in condylar volumes for both right (mean 0.13; p = 0.015; [0.04: 0.22]) and left condyle (0.30; p = 0.001; [0.18: 0.42]) from baseline (T0) to 3 months (T1). The comparisons between Group 1 and Group 2 revealed no statistically significant difference in initial and final condylar volumes for both the right (0.13; p &gt; 0.05; [−0.16: 0.09]) and the left condyle (0.30; p &gt; 0.05; [−0.04: 0.42]). Kinesio taping, which demonstrated a relative and slight increase on condylar volume, may provide clinical benefits such as a reduction in the duration of functional appliance use, decreased risk of relapse, and effective correction of overjet.

Mandibular molar protraction: A comparison between fixed functional appliances and temporary anchorage devices.

This study aimed to compare the efficiency of temporary anchorage devices (TADs) and fixed functional appliances (FFAs) for mandibular molar protraction. Orthodontic records of 1050 consecutively treated patients with molar protraction were screened. Thirty-six records (22 females and 14 males; mean age, 17.4 years) were divided into two groups: TAD (21 subjects with 25 edentulous spaces) and FFA (15 subjects with 24 edentulous spaces). The primary outcome measure was the efficiency of protraction [magnitude and time required for protraction (rate) and anchor loss (AL)]. The secondary outcomes involved measuring the type of tooth movement (TOTM), external apical root resorption (EARR), alveolar bone height change (ABHC), alveolar bone width change (ABWC) and appliance failure. The rate of tooth movement was significantly higher for FFAs (0.83 ± 0.35 mm/month) versus TADs (0.49 ± 0.2 mm/month) (P = .005). Total treatment duration was less for FFAs (34.78 ± 8.1 months) versus TADs (47.72 ± 13.94 months) (P = .002). TOTM was similar for both (P = .909). EARR was 1.42 ± 1.38 mm for TAD and 1.25 ± 0.88 mm for FFA (P = .81). ABHC increased in the FFA group (1.01 ± 3.62 mm) and decreased for the TAD group (0.68 ± 1.66 mm). ABWC increased for both TAD (1.81 ± 1.73 mm) and FFA (1.75 ± 1.35 mm). The failure rate was 50% for FFAs and 33% for TADs. Both systems provided translation of lower molars with comparable anchorage control. However, FFAs were more efficient than TADs for lower molar protraction.

Cephalometric Evaluation of the Pre- and Posttreatment Changes after the Correction of Class II Division 1 Malocclusion with Twin Block Appliance in Mixed Dentition.

To evaluate the pretreatment cephalometric records on the dental, skeletal, soft tissue, and incisor relationship with a twin block functional appliance in class II malocclusion patients in and around Mahe; evaluate the posttreatment cephalometric records on the dental, skeletal, soft tissue, and incisor relationship with a twin block functional appliance in class II malocclusion patients in these children; and to compare cephalometrically certain dental, skeletal, and soft tissue points in pretreatment and posttreatment cephalograms in them. This study was conducted on 20 class II patients in the mixed dentition period, who were treated with twin block therapy. Each had to meet the following criteria-(1) skeletal class II malocclusion with retrognathic mandible; (2) full cusp class II molar relationship; and (3) an angle of ANB of 50 or greater at the start of treatment. All patients wore the appliance 24 hours/day. The pretreatment cephalometric head films for the group were taken using standard cephalometric X-ray equipment. The length of time required to achieve a class I molar relationship was assessed. Appointments during the twin block phase were scheduled at intervals of 8 weeks. Lateral head films were obtained again at the posttreatment follow-up stage. There was a significant increase in effective mandibular length, ramus height, SNB, ANB, overjet, overbite, and I to NA (mm and degrees) after twin block therapy. The maxillary incisor position showed a decrease in its value by 4° in five cases. Thus, in the present study, evidence of skeletal and dentoalveolar changes leading to the correction of class II division 1 malocclusion with the twin block functional appliance has been established. However, further studies with a longer period of follow-up and a larger sample are required to substantiate the results of the present investigation. Bimalrag BR, Ephraim R, Ayilliath A, et al. Cephalometric Evaluation of the Pre- and Posttreatment Changes after the Correction of Class II Division 1 Malocclusion with Twin Block Appliance in Mixed Dentition. Int J Clin Pediatr Dent 2024;17(7):783-789.

Skeletal class Ⅱ adolescent patient treated with Fränkel Ⅱ functional appliance and fixed appliance: a case report

Skeletal class Ⅱ adolescent patient treated with Fränkel Ⅱ functional appliance and fixed appliance: a case report

Orthodontic treatment for malocclusions in mixed dentition

Early orthodontic treatment is an important means of preventing and treating dentofacial deformities during the period of growth and development. In this stage, children have great potential in growth and development, high adaptability of muscles and temporomandibular joint, and good responsiveness to orthodontic force. Therefore, orthodontic intervention and treatment in this stage can prevent and guide the normal growth and development of dentition, occlusion and maxillofacial complex. This article summarizes the commonly used orthodontic techniques and appliances in the mixed dentition, including interceptive treatment of oral habits, application of functional appliances, fixed appliances, clear aligners, as well as management of severe crowding and space maintenance. This article comprehensively explains the application and indications of different orthodontic techniques in design and appliance selection in the treatment of malocclusions in the mixed dentition.

Prediction on the chin advancement of the twin block functional appliance in growing Chinese patients using the cephalometric markers: a retrospective study.

In spite of the widespread use of functional appliances, broad variations were applied the treatment response. The aim of this study is to investigate the pre-treatment cephalometric predictors on the chin advancement of twin-block in growing Chinese patients with class II malocclusion. After screening, 90 patients treated by twin-block were included in the study. The treatment outcome was assessed by the alterations in the distance of skeletal pogonion (Pog) to the vertical reference plane perpendicular to the Frankfurt plane (ΔPog-VRP). Moreover, ΔPog-VRP was divided by the cranial growth indicated by the Nasion to Basion changes (ΔN-Ba) to minimize the growth discrepancy among individuals (adjΔPog-VRP). Patients with ΔPog-VRP/adjΔPog-VRP above the median value were categorized into good response group (GRG/adjGRG, N = 45), while the rest were poor response group (PRG/adjPRG, N = 45). Independent t-test was used to compare the pre-treatment cephalometric measurements between GRG/adjGRG and PRG/adjPRG. Stepwise multivariate regression models were used to determine the pre-treatment cephalometric predictors for the chin advancement. Generally, there were not any significant differences between GRG/adjGRG and PRG/adjPRG regarding age, gender and cervical stage before twin-block treatment. Patients from GRG had significantly reduced cephalometric measurements in the vertical dimensions, including ∠N-Go-Me, ∠Mandibular plane-Occlusal plane (∠MP-OP) and the sum of angles (p < 0.05) in comparison to PRG. When the individual growth was taken account, similar findings were observed. The patients from adjGRG had a significantly lower ∠Sella Nasion line-MP (∠SN-MP), ∠Ar-Go-Me and ∠N-Go-Me, as well as an increased Posterior facial height (PFH)/Anterior facial height (AFH) (p < 0.05) compared with their counterparts. ∠N-Go-Me variable was the independent predictor on Pog advancement with (β = -0.26, 95% CI: -0.06 to -0.01, p = 0.01) and without (β = -0.29, 95% CI: -0.06 to -0.01, p < 0.01) adjustments on individual growth. The results of this study showed that patients with a reduced N-Go-Me angle are more likely to experience a greater chin advancement following twin-block treatment.

Comparison of muscle response in patients treated with rigid and flexible fixed functional appliances.

The present study was undertaken to evaluate and compare muscle activity after the treatment with rigid and flexible fixed functional appliance. The study was conducted on 14 skeletal Class II malocclusion patients in the age group of 13-17 years, divided into two groups comprising 7 patients in each group. Group I was treated with a rigid fixed functional appliance (MPA IV), and Group II was treated with a flexible fixed functional appliance (Churro Jumper). Masseter and anterior temporalis muscle activities were recorded using needle electromyography (EMG) at postural rest, saliva swallowing, and clenching during five intervals (T0 to T4) during fixed functional appliance treatment. Unpaired t-test, Mann-Whitney U, and Wilcoxon sign rank test were applied for statistical analysis, and a P value of <.05 was considered statistically significant. Group I (MPA IV) showed a significant increase in EMG activity during postural rest position (P = 0.003, P = 0.001), swallowing (P = 0.013, P = 0.005), and clenching (P = 0.001, P = 0.002) in masseter and anterior temporalis muscle, respectively. Group II (Churro jumper) also showed a significant increase in EMG activity during postural rest position (P = 0.000, P = 0.000), swallowing (P = 0.001, P = 0.000), and clenching (P = 0.001, P = 0.000) in masseter and anterior temporalis muscle, respectively. Both rigid (MPA IV) and flexible (Churro Jumper) fixed functional appliances caused a significant increase in EMG activity of masseter and anterior temporalis muscle during postural rest position, swallowing, and clenching in 6 months of the observation period, but the flexible appliance (Churro Jumper) showed more significant increase.

Managing dental and skeletal development in patients with hemifacial microsomia

Hemifacial microsomia (HFM) is a congenital condition characterized by the underdevelopment of one side of the face, impacting the ear, mouth, and jaw areas. This anomaly, second only to cleft lip and palate in prevalence, presents significant challenges in dental and skeletal development. Early diagnosis, primarily through advanced imaging techniques such as 3D computed tomography (CT) scans and magnetic resonance imaging (MRI), is crucial for identifying the extent of anomalies and planning effective interventions. The condition involves complex dental issues including malocclusion, missing teeth, and delayed dental eruption, necessitating early and targeted orthodontic treatments. Functional appliances, space maintainers, and braces are commonly used to guide dental arch development and correct alignment, leveraging the natural growth phase of the patient. Surgical interventions play a pivotal role in managing severe skeletal deformities. Preventive strategies, including regular dental check-ups, proper oral hygiene practices, and preventive treatments such as fluoride applications and dental sealants, are vital in minimizing complications and ensuring long-term oral health. Educating patients and their families on the importance of oral hygiene and routine dental care is crucial for maintaining dental health and preventing future issues. Continuous monitoring and follow-ups allow for timely adjustments to treatment plans, enhancing the effectiveness of interventions and supporting optimal growth and development. Overall, the management of dental and skeletal anomalies in hemifacial microsomia involves a combination of early diagnosis, orthodontic and surgical treatments, and preventive care, all of which are integral to improving outcomes and quality of life for affected individuals.

The effect of different functional appliances on the sagittal pharyngeal airway dimension in skeletal class II: a retrospective study

The aim of this study was to compare the changes in the sagittal pharyngeal airway dimension (SPAD) in adolescents with Class II mandibular retrusion treated with Invisalign Mandibular Advancement (IMA), prefabricated Myobrace (MB), and Twin block (TB). For this retrospective study, the pre-treatment and post-treatment lateral cephalograms of 60 patients who underwent myofunctional treatment, using either one of the tested appliances were gathered from the files of treated patients. Changes in the SPAD were measured in each group, and comparisons were carried out between the three study groups. Additionally, sagittal skeletal measurements were carried out. Comparisons of the study variables at T0 and T1 between the three groups were performed using one-way ANOVA, while comparisons of the difference (T1–T0) were performed using Kruskal Wallis test. A significant SPAD increase has been reported using the three tested appliances (p < 0.05), with the least change documented with MB use (p < 0.05). Significant antero-posterior improvements have been found with IMA, MB, and TB with an increase in the SNB°, and a decrease in ANB° and Wits appraisal (p < 0.05). Non-significant FMA° changes have been observed post-treatment in the three test groups (p > 0.05). The IMA, MB, and TB generated significant SPAD and sagittal changes, with both IMA and TB surpassing MB in the airway area improvement post-treatment. Moreover, the three tested Class II functional appliances did not affect the vertical dimension.

Recent developments in orthodontic treatment-an overview

Background: Recent developments in orthodontic treatment have significantly impacted the management of various dental and skeletal issues in preadolescent patients. These advancements encompass a wide range of approaches aimed at addressing problems during the mixed-dentition phase, particularly skeletal discrepancies. Growth modification, camouflage, and orthognathic surgery are primary strategies used to correct these discrepancies. Aim: The aim of this overview is to present a comprehensive summary of recent developments in orthodontic treatment, focusing on growth modification strategies applied to address skeletal and dental issues in preadolescent patients. Methods: This overview examines various orthodontic treatment methods, including growth modification techniques such as the use of headgear, functional appliances, and orthognathic surgery. The discussion also explores the application of these methods to different types of malocclusions and skeletal discrepancies, particularly anteroposterior, transverse, and vertical problems.

Treatment of non-compliant skeletal class II malocclusion with a hybrid appliance – A case report and review literature

The present case describes a case of skeletal deep bite class II malocclusion treated efficiently using the Forsus appliance, and its importance of clinical and biomechanical considerations. Skeletal deep bite class II malocclusions with deficient mandibles are treated with different functional appliances. There are several appliances for its correction in a growing child. However, fixed functional appliances are commonly used in the present clinical scenario for those non-compliant cases, who present late with less residual growth or no growth. This case was treated with a pre-adjusted edgewise appliance supplemented with a device known as Forsus Fatigue Resistant Device (FFRD) (3M Unitek Corp, California, USA). FFRD is a good alternative device for skeletal deep bite class II malocclusions instead of class II elastics in mild cases and place of Herbst appliance in severe cases. Biomechanical principles should be considered for those patients with the Forsus appliance to prevent complications. There are fewer complaints from the patients and treatment time is less.