Dentoskeletal Changes Produced by Growth Modification Appliances in Treatment of Skeletal Class II Malocclusion
Condition: Class II Division 1 Malocclusion; Mandibular Retrognathism
MeSH terms: Retrognathia; Malocclusion; Malocclusion, Angle Class II; Overbite
Study type: Observational

Summary: 
      To compare dentoskeletal changes in patients with skeletal class II malocclusion induced due
      to treatment with orthodontic appliances; removable twin block appliance and fixed AdvanSync2
      appliance in two different age group patients.
    

Detailed description: 
      41% of total orthodontic cases in Pakistani population are of class II malocclusion. Class II
      malocclusion is referred as maxillary protrusion, or mandibular retrusion, or combination of
      both, which can be corrected by treating the skeletal and dento-alveolar discrepancies. Out
      of many recommended treatment options, one can make use of either removable and/or fixed
      functional appliances. In the past, headgear has been used as a classic appliance for the
      correction of class II malocclusion. Other removable functional appliances (RFA) include
      Frankel, bionator and sander bite jumping appliances. Jasper jumper, Herbst appliance and
      mandibular protraction appliance (MPA) are the some of the fixed functional appliances (FFA)
      used. All these modalities are designed to modify the arches by re-orienting their position
      in both sagittal and vertical dimensions to bring about correction of main features of class
      II malocclusion.

      AdvanSync2 (Ormco Co., Glendora, Calif) is a FFA being introduced recently as an advancement
      of Herbst appliance. It is a molar-to-molar appliance, connected by a telescopic rod, which
      allow for simultaneous treatment with braces. It is much smaller in size than the
      conventional Herbst appliance and reduces treatment duration up to six to nine months. It is
      much more acceptable by the patients as they complain less about sores and discomfort, and is
      esthetically pleasant since it's not visible in the mouth. Short arms of this appliance help
      to decrease irritation and discomfort of the patient, and helps to advance the mandible in a
      constant forward direction to encourage growth, and reduce malocclusion.

      Twin block appliance (RFA) was introduced by William Clark in 1988. Many modifications for
      this appliance have been introduced lately. It has been named twin block for the
      characteristic of two unattached maxillary and mandibular plates with acrylic bite blocks,
      which makes 70o angle when come in contact with each other. This appliance is another
      treatment modality for cases with class II malocclusions, which can be carried out at an
      early age as well as the delayed treatment. However, delayed treatment was found to be much
      better for the patients in terms of less orthodontic visits.

      AdvanSync2 appliance is a new treatment modality in orthodontics, and through thorough
      literature search, no study could be found in regard to this appliance in Pakistani
      population yet.Hence, the objective of this study was to compare dentoskeletal changes in
      skeletal class II malocclusion induced due to treatment with removable twin block appliance
      and fixed advanSync2 appliance in Pakistani population.
    

Intervention name(s): Removable Twin Block; Fixed Functional , AdvanSync Appliance
Intervention type(s): Device; Device
Intervention description(s): Twin block appliance (RFA) was introduced by William Clark in 1988. Many modifications for this appliance have been introduced lately. It has been named twin block for the characteristic of two unattached maxillary and mandibular plates with acrylic bite blocks, which makes 70o angle when come in contact with each other. Delta clasps are added for better retention of the appliance. This appliance plays a vital role in the treatment of mandibular retrognathia; AdvanSync2 (Ormco Co., Glendora, Calif) is a FFA being introduced recently as an advancement of Herbst appliance. It is a molar-to-molar appliance, connected by a telescopic rod, which allow for simultaneous treatment with braces. It is much smaller in size than the conventional Herbst appliance and reduces treatment duration up to six to nine months. It is much more acceptable by the patients as they complain less about sores and discomfort, and is esthetically pleasant since it's not visible in the mouth. Short arms of this appliance help to decrease irritation and discomfort of the patient, and helps to advance the mandible in a constant forward direction to encourage growth, and reduce malocclusion.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        A.F.I.D, Rawalpindi. Thirty patients ( 15 between cervical vertebral maturation (CVM) stage
        of 2-3 to be treated with removable functional applianc and remaining 15 between CVM stage
        of 4-5 to be treated with fixed functional appliance) with skeletal class II malocclusion,
        presented at the department of Armed forces institute of dentistry (AFID).