Document Type : Original Article

Authors

1 Associate Professor, Dept of Orthodontics & Dentofacial Orthopedics, The Oxford Dental College, Bangalore, India

2 Professor, Dept. of Orthodontics & Dentofacial Orthopaedics, Kamineni Institute of Dental Sciences, Narketpally, Andhra Pradesh, India

3 Professor & Head, Dept. of Orthodontics & Dentofacial Orthopaedics, BJS Dental College, Ludhiana, Punjab, India

4 General Dental Practitioner, The Dental Clinic, Bangalore, India

5 Consultant Orthodontist, Welcare Dental Clinic, Kalyani-Nadia, West Bengal, India

6 Associate Professor, Department of Periodontics, The Oxford Dental College, Bangalore, India

7 General Dental Practitioner, Max Dental Specialties, Bangalore, India

10.22034/ijo.2021.543902.1014

Abstract

Background: Fixed functional appliances used in the treatment of Class II malocclusion have the advantage of requiring minimal patient compliance, and they can be used simultaneously with fixed orthodontic appliances. The purpose of this retrospective study was to evaluate the treatment effects of the Forsus Fatigue Resistant Device (FFRD) in growing patients with Class II malocclusion.
Methods: A total of 50 pre-treatment (T1) and post-treatment (T2) Lateral Cephalometric Radiographs (LCRs) of 25 patients treated with Forsus fatigue resistant device (mean age = 12 ± 0.54years) for the correction of skeletal class II malocclusion were compared with the 25 untreated class II control patients (mean age 12 ± 0.38 years) who did not undergo any treatment during this period. The skeletal, dental, and soft tissue changes were evaluated using cephalometric measurements, and the treatment changes were analyzed by paired t-test.
Results: The LCRs findings showed that the FFRD produced more dentoalveolar changes with less skeletal changes. The dentoalveolar changes in the FFRD group include significant reduction of overjet & overbite (p<0.001), retroclination of maxillary incisors (p<0.001), proclination and intrusion of the mandibular incisors (p<0.001) and mesialization of mandibular first molars (p<0.001). A significant improvement in the skeletal, dentoalveolar and soft tissue structures of the face was achieved in the FFRD group compared with the control group.
Conclusion: The FFRD is effective in the treatment of Class II malocclusion. The Class II correction was achieved by a combination of skeletal and dentoalveolar effects, and wherein dentoalveolar changes were more predominant compared to the skeletal changes.

Keywords

Main Subjects

  1. Baccetti T, Franchi L, Stahl F. Comparison of 2 comprehensive Class II treatment protocols including the bonded Herbst and headgear appliances: a double-blind study of consecutively treated patients at puberty. Am J Orthod Dentofacial Orthop.2009;135(6):698.e1-10. doi:10.1016/j.ajodo.2008.03.015.
  2. McNamara JA Jr. Components of class II malocclusion in children 8-10 years of age.Angle Orthod.1981;51(3):177 202. doi: 10.1043/0003- 3219(1981)051<0177:COCIMI>2.0.CO;2.
  3. Martina R, Cioffi I, Galeotti A, Tagliaferri R, Cimino R, Michelotti A, Valletta R, Farella M, Paduano S. Efficacy of the Sander bite-jumping appliance in growing patients with mandibular retrusion: a randomized controlled trial. Orthod Craniofac Res. 2013;16(2):116-26. doi: 10.1111/ocr.12013.
  4. Pancherz H. Treatment of class II malocclusions by jumping the bite with the Herbst appliance. A cephalometric investigation. Am J Orthod. 1979;76(4):423-42. doi: 10.1016/0002-9416(79)90227-6.
  5. Vogt W. The Forsus Fatigue Resistant Device. J Clin Orthod. 2006; 40:368-358.
  6. El-Sheikh MM, Godfrey K, Manosudprasit M, Viwattanatipa N. Force-deflection characteristics of the fatigue resistant device spring: an in vitro study. World J Orthod. 2007;8(1):30-6. PMID: 17373223.
  7. Bilgiç F, Başaran G, Hamamci O. Comparison of Forsus FRD EZ and Andresen activator in the treatment of class II, division 1 malocclusions. Clin Oral Investig. 2015;19(2):445-51. doi: 10.1007/s00784- 014-1237-y.
  8. Linjawi AI, Abbassy MA. Dentoskeletal effects of the forsus™ fatigue resistance device in the treatment of class II malocclusion: A systematic review and meta-analysis. J Orthod Sci. 2018;7:5. doi: 10.4103/jos.JOS_80_17.
  9. Jacobson A. JacobsonRL. Radiographic cephalometry- From basic to 3D imaging. 2nd edition, Chicago: Quintessence Publishing; 2006. p.60-62.
  10. Rakosi T. An Atlas and Manual of Cephalometric Radiography. London: Wolfe Medical Publications Ltd. 1982; p.35 37.
  11. Heinig N, Göz G. Clinical application and effects of the Forsus spring. A study of a new Herbst hybrid. J Orofac Orthop. 2001;62(6):436-50. doi: 10.1007/s00056-001-0053-6.
  12. Jones G, Buschang PH, Kim KB, Oliver DR. Class II non-extraction patients treated with the Forsus Fatigue Resistant Device versus intermaxillary elastics. Angle Orthod. 2008;78(2):332-8. doi: 10.2319/030607-115.1.
  13. Oztoprak MO, Nalbantgil D, Uyanlar A, Arun T. A cephalometric comparative study of class II correction with Sabbagh Universal Spring (SUS(2)) and Forsus FRD appliances. Eur J Dent. 2012;6(3):302- 10.
  14. Cacciatore G, Alvetro L, Defraia E, Ghislanzoni LT, Franchi L. Active-treatment effects of the Forsus fatigue resistant device during comprehensive Class II correction in growing patients. Korean J Orthod. 2014;44(3):136-42. doi: 10.4041/kjod.2014.44.3.136.
  15. Pancherz H. The mechanism of Class II correction in Herbst appliance treatment. A cephalometric investigation. Am J Orthod. 1982;82(2):104-13. doi: 10.1016/0002-9416(82)90489-4.
  16. Valant JR, Sinclair PM. Treatment effects of the Herbst appliance. Am J Orthod Dentofacial Orthop. 1989;95(2):138 47. doi: 10.1016/0889-5406(89)90392-2.
  17. Hansen K, Pancherz H. Long-term effects of Herbst treatment in relation to normal growth development: a cephalometric study. Eur J Orthod. 1992;14(4):285-95. doi: 10.1093/ejo/14.4.285.
  18. Karacay S, Akin E, Olmez H, Gurton AU, Sagdic D. Forsus Nitinol Flat Spring and Jasper Jumper corrections of Class II division 1 malocclusions. Angle Orthod. 2006;76(4):666-72. doi: 10.1043/0003- 3219(2006)076[0666:FNFSAJ]2.0.CO;2.
  19. Giuntini V, Vangelisti A, Masucci C, Defraia E, McNamara JA Jr, Franchi L. Treatment effects produced by the Twin block appliance vs the Forsus Fatigue Resistant Device in growing Class II patients. Angle Orthod. 2015;85(5):784-9. doi: 10.2319/090514- 624.1.
  20. Eissa O, El-Shennawy M, Gaballah S, El-Meehy G, El Bialy T. Treatment outcomes of Class II malocclusion cases treated with miniscrew-anchored Forsus Fatigue Resistant Device: A randomized controlled trial. Angle Orthod. 2017;87(6):824-833. doi: 10.2319/032717-214.1.
  21. Gunay EA, Arun T, Nalbantgil D. Evaluation of the Immediate Dentofacial Changes in Late Adolescent Patients Treated with the Forsus(™) FRD. Eur J Dent. 2011;5(4):423-32.
  22. Franchi L, Alvetro L, Giuntini V, Masucci C, Defraia E, Baccetti T. Effectiveness of comprehensive fixed appliance treatment used with the Forsus Fatigue Resistant Device in Class II patients. Angle Orthod. 2011;81(4):678-83. doi: 10.2319/102710-629.1.
  23. Turkkahraman H, Eliacik SK, Findik Y. Effects of miniplate anchored and conventional Forsus Fatigue Resistant Devices in the treatment of Class II malocclusion. Angle Orthod. 2016;86(6):1026-1032. doi: 10.2319/122515-887.1.
  24. Li H, Ren X, Hu Y, Tan L. Effects of the Forsus Fatigue-resistant Device on Skeletal Class II Malocclusion Correction. J Contemp Dent Pract. 2020;21(1):105-112.
  25. Elkordy SA, Abdeldayem R, Fayed MMS, Negm I, El Ghoul D, Abouelezz AM. Evaluation of the splintsupported Forsus Fatigue Resistant Device in skeletal Class II growing subjects. Angle Orthod. 2021;91(1):9-21. doi: 10.2319/040320-250.1.