Browse > Article
http://dx.doi.org/10.5933/JKAPD.2020.47.3.235

Study of Functional Appliance for Treatments of Children and Adolescents with Class II Malocclusion  

Kang, Himchan (Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University)
Lee, Koeun (Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University)
Kim, Misun (Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University)
Nam, Okhyung (Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University)
Lee, Hyo-seol (Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University)
Kim, Kwangchul (Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University)
Choi, Sungchul (Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University)
Publication Information
Journal of the korean academy of Pediatric Dentistry / v.47, no.3, 2020 , pp. 235-247 More about this Journal
Abstract
The purpose of this study was to evaluate the skeletal and dentoalveolar effects and optimal timing for treatment of class II malocclusion with functional appliances in children and adolescents. A group of 30 patients with class II malocclusion were divided into 3 groups according to their use of functional appliance: Twin block, Activator, Fränkel appliance. The group was also divided into 2 groups according to the cervical vertebrae maturation method. Lateral cephalometric radiographs were analyzed pretreatment (T0) and posttreatment (T1). Among the functional appliances, treatment with Twin block and Activator showed significant increase in the length of the mandible (Co-Gn) and the lower anterior facial height (ANS to Me), whereas the overjet and overbite were significantly reduced. Treatment with Fränkel appliance showed significant improvement in the relationship of maxilla and mandible. In addition, if the functional appliance was used during the period of pubertal growth peak, there was a significant increase in mandibular length, improvement in the relationship of maxilla and mandible, labial inclination of lower incisors and decrease in overjet compared to the treatment before pubertal growth peak. Therefore, this study indicates that using functional appliances for patients with class II malocclusion is effective and the optimal timing for using functional appliances is during pubertal growth peak.
Keywords
Class II malocclusion; Functional appliance; Treatment timing;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Proffit W, Fields H, Larson B, Sarver D : Contemporary Orthodontics, 5th ed. Mosby, St. Louis, 3-22, 2012.
2 Hitchcock HP : A cephalometric description of class II, division 1 malocclusion. Am J Orthod, 63:414-423, 1973.   DOI
3 Franchi L, Pavoni C, Cozza P, et al. : Long-term skeletal and dental effects and treatment timing for functional appliances in class II malocclusion. Angle Orthod, 83:334-340, 2012.   DOI
4 McNamara JA Jr : Components of class II malocclusion in children 8-10 years of age. Angle Orthod, 51:177-202, 1981.
5 McNamara JA Jr : Neuromuscular and skeletal adaptations to altered function in the orofacial region. Am J Orthod, 64:578-606, 1973.   DOI
6 Xiong H, Hagg U, Robinson W, et al. : The effect of continuous bite-jumping in adult rats: A morphological study. Angle Orthod, 74:86-92, 2004.
7 Clark WJ : The twin block technique. A functional orthopedic appliance system. Am J Orthod Dentofacial Orthop, 93:1-18, 1988.   DOI
8 Bjork A : Variations in the growth pattern of the human mandible: Longitudinal radiographic study by the implant method. J Dent Res, 42:400-411, 1963.   DOI
9 Hunter CJ : The correlation of facial growth with body height and skeletal maturation at adolescence. Angle Orthod, 36:44-54, 1966.
10 Ekstrom C : Facial growth rate and its relation to somatic maturation in healthy children. Swed Dent J Suppl, 11:1-99, 1982.
11 Petrovic A, Stutzmann J, Shaye R, et al. : Is it possible to modulate the growth of the human mandible with a functional appliance? Int J Orthod, 29:3-8, 1991.
12 Petrovic A, Stutzmann J, Lavergne J : Mechanism of craniofacial growth and modus operandi of functional appliances: A cell-level and cybernetic approach to orthodontic decision making. Carlson DS, ed. Monograph 23: Craniofacial growth series. University of Michigan, Ann Arbor, 13-74, 1990.
13 Baccetti T, Franchi L, Toth LR, McNamara JA Jr : Treatment timing for Twin-block therapy. Am J Orthod Dentofacial Orthop, 118:159-170, 2000.   DOI
14 Malmgren O, Omblus J, Hagg U, Pancherz H : Treatment with an orthopedic appliance system in relation to treatment intensity and growth periods. A study of initial effects. Am J Orthod Dentofacial Orthop, 91:143-151, 1987.   DOI
15 Hagg U, Pancherz H : Dentofacial orthopaedics in relation to chronological age, growth period and skeletal development. an analysis of 72 male patients with class II division 1 malocclusion treated with the herbst appliance. Eur J Orthod, 10:169-76, 1988.   DOI
16 O'Brien K, Wright J, Shaw I, et al. : Effectiveness of early orthodontic treatment with the Twin-block appliance: A multicenter, randomized, controlled trial. Part 1: Dental and skeletal effects. Am J Orthod Dentofacial Orthop, 124:234-243, 2003.   DOI
17 Greulich WW, Pyle SI : Radiographic atlas of skeletal development of the hand and wrist. Am J Med Sci, 238:393, 1959.   DOI
18 O'Brien K, Wright J, Berk NW, et al. : Effectiveness of early orthodontic treatment with the Twin-block appliance: A multicenter, randomized, controlled trial. Part 2: Psychosocial effects. Am J Orthod Dentofacial Orthop, 124:488-495, 2003.   DOI
19 Tulloch JF, Proffit WR, Phillips C : Outcomes in a 2-phase randomized clinical trial of early Class II treatment. Am J Orthod Dentofacial Orthop, 125:657-667, 2004.   DOI
20 Franchi L, Baccetti T, McNamara JA Jr : Mandibular growth as related to cervical vertebral maturation and body height. Am J Orthod Dentofacial Orthop, 118:335-340, 2000.   DOI
21 Lewis AB, Garn SM : The relationship between tooth formation and other maturational factors. Angle Orthod, 30:70-77, 1960.
22 Tanner JM : Growth at adolescence, 3rd ed. Springfield, Illinois, 1962.
23 O'Reilly MT, Yanniello GJ : Mandibular growth changes and maturation of cervical vertebrae: A longitudinal cephalometric study. Angle Orthod, 58:179-184, 1988.
24 Lamparski D : Skeletal age assessment utilizing cervical vertebrae. Thesis. The University of Pittsburgh, Pennsylvania, 179-184, 1972.
25 Charlier JP, Petrovic A, Herrmann-Stutzmann J : Effects of mandibular hyperpropulsion on the prechondroblastic zone of young rat condyle. Am J Orthod, 55:71-74, 1969.   DOI
26 Petrovic AG : Mechanisms and regulation of mandibular condylar growth. Acta Morphol Neerl Scand, 10:25-34, 1972.
27 Toth LR, McNamara JA Jr : Treatment effects produced by the twin-block appliance and the FR-2 appliance of Frankel compared with an untreated class II sample. Am J Orthod Dentofacial Orthop, 116:597-609, 1999.   DOI
28 McNamara JA Jr, Connelly TG, McBride MC : Histological studies of temporomandibular joint adaptations. McNamara JA Jr ed. Monograph 4: Craniofacial growth series, University of Michigan, Ann Arbor, 209-227, 1975.
29 Creekmore TD, Radney LJ : Frankel appliance therapy: Orthopedic or orthodontic? Am J Orthod, 83:89-108, 1983.   DOI
30 Mills JR : The effect of functional appliances on the skeletal pattern. Br J Orthod, 18:267-275, 1991.   DOI
31 Varlik SK, Gultan A, Tumer N : Comparison of the effects of twin block and activator treatment on the soft tissue profile. Eur J Orthod, 30:128-134, 2008.   DOI
32 Mills CM, McCulloch KJ : Treatment effects of the twin block appliance: A cephalometric study. Am J Orthod Dentofacial Orthop, 114:15-24, 1998.   DOI
33 Illing HM, Morris DO, Lee RT : A prospective evaluation of bass, bionator and twin block appliances. part I-the hard tissues. Eur J Orthod, 20:501-516, 1998.   DOI
34 Mills CM, McCulloch KJ : Posttreatment changes after successful correction of class II malocclusions with the twin block appliance. Am J Orthod Dentofacial Orthop, 118:24-33, 2000.   DOI
35 Trenouth M : Cephalometric evaluation of the twin-block appliance in the treatment of class II division 1 malocclusion with matched normative growth data. Am J Orthod Dentofacial Orthop, 117:54-59, 2000.   DOI
36 Perillo L, Castaldo M, Cannavale R, et al. : Evaluation of long-term effects in patients treated with Frankel-2 appliance. Eur J Paediatr Dent, 12:261, 2011.
37 Basciftci FA, Uysal T, Buyukerkmen A, Sari Z : The effects of activator treatment on the craniofacial structures of class II division 1 patients. Eur J Orthod, 25:87-93, 2003.   DOI
38 Malta LA, Baccetti T, McNamara Jr JA, et al. : Long-term dentoskeletal effects and facial profile changes induced by bionator therapy. Angle Orthod, 80:10-17, 2010.   DOI
39 O'Brien K, Wright J, Conboy F, et al. : Effectiveness of early orthodontic treatment with the twin-block appliance: A multicenter, randomized, controlled trial. part 1: Dental and skeletal effects. Am J Orthod Dentofacial Orthop, 124:234-243, 2003.   DOI
40 Turkkahraman H, Sayin MO : Effects of activator and activator headgear treatment: Comparison with untreated class II subjects. Eur J Orthod, 28:27-34, 2005.   DOI
41 Toth LR, McNamara JA Jr : Treatment effects produced by the Twin-block appliance and the FR-2 appliance of Frankel compared with an untreated Class II sample. Am J Orthod Dentofacial Orthop, 116:597-609, 1999.   DOI