Long-term comparison of treatment outcome and stability of Class II patients treated with functional appliances versus bilateral sagittal split ramus osteotomy.
Berger JL, Pangrazio-Kulbersh V, George C, Kaczynski R
Long-term comparison of treatment outcome and stability of Class II patients treated with functional appliances versus bilateral sagittal split ramus osteotomy. Am J Orthod Dentofacial Orthop. 2005 Apr;127(4):451-64
This study suggests that early correction of Class II dentoskeletal malocclusions with functional appliances yields favorable results without the possible deleterious effects of surgery.
The objective of this study was to compare the treatment outcomes and stability of patients with Class II malocclusion treated with either functional appliances or surgical mandibular advancement. MATERIAL: The early-treatment group consisted of 30 patients (15 girls, 15 boys), with a mean age of 10 years 4 months (range, 7 years 5 months to 12 years 5 months), who received either Frankel II (15 patients) or Herbst appliances (15 patients). The surgical group consisted of 30 patients (23 female, 7 male), with a mean age of 27 years 2 months (range, 13 years 0 months to 53 years 10 months). They were treated with bilateral sagittal split ramus osteotomies with rigid fixation. Lateral cephalograms were taken for the early-treatment group at T1 (initial records), T2 (completion of functional appliance treatment), and Tf (completion of comprehensive treatment). In the surgical group, lateral cephalograms were taken at T1 (initial records), T2 (presurgery), T3 (postsurgery), and Tf (completion of comprehensive treatment). The average times from the completion of functional appliance treatment or surgery to the final cephalograms were 35.8 months and 34.9 months, respectively. A mixed-design analysis of variance was used to compare changes within and between groups. RESULTS: In the functional appliance group, the mandible continued to grow in a favorable direction even after discontinuation of the functional appliance. Both groups had stable results over time. Both groups finished treatment with the same cephalometric measurements. Significant skeletal and soft tissue changes were noted in the treatment groups due to either functional or surgical advancement of the mandible. More vertical relapse was noted in the surgical group than in the functional group. CONCLUSIONS: This study suggests that early correction of Class II dentoskeletal malocclusions with functional appliances yields favorable results without the possible deleterious effects of surgery.
Functional regulator treatment of Class II division 1 malocclusions
Chadwick SM, Aird JC, Taylor PJ, Bearn DR.
Functional regulator treatment of Class II division 1 malocclusions. Eur J Orthod. 2001 Oct;23(5):495-505.
The Frankel appliance was thus found to be effective in producing desirable occlusal and dental changes in the majority of patients treated.
This controlled retrospective study aimed to identify the contribution of skeletal and dental changes in the correction of Class II division 1 malocclusions using Frankel’s functional regulator II (FRII), with reference to a concurrently recruited control group. One hundred and thirty-eight patients with Class II division 1 malocclusions were identified, those accepting treatment forming the study group and those declining treatment the control group. The study group (n = 70) were treated with a Frankel appliance. Pre- and post-treatment observation cephalometric radiographs were analysed and compared. Mean values for both skeletal and dental variables in the control group were remarkably consistent throughout the study period; however, this masked individual variations in this group. The skeletal variables in the study group that showed statistically significant differences from the control group were SNB, ANB, BaNA and ANS-Me, but none of these was sufficiently large to be regarded as clinically significant. Dental variables showed clinically and statistically significant differences, including a 10 degree reduction in UI-Max and 3.1 degree increase in LI-Mand. The Frankel appliance was thus found to be effective in producing desirable occlusal and dental changes in the majority of patients treated.
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