Comparison of stepwise vs single-step advancement with the functional mandibular advancer in class ıı division 1 treatment

Comparison of stepwise vs single-step advancement with the Functional Mandibular Advancer in Class II division 1 treatment

Sınıf II divizyon 1 tedavilerinde fonksiyonel mandibular ilerleticiler ile aşamalı ve tek seferde ilerletme yöntemlerinin karşılaştırılması

Isil Aras; Aylin Pasaoglu; Sultan Olmez; Idil Unal; Ali Vehbi Tuncer; Aynur Aras

Angle Orthod. 2017;87:82–87

Objective: To compare two groups of subjects at the peak of the pubertal growth period treated with the Functional Mandibular Advancer (FMA; Forestadent, Pforzheim, Germany) appliance using either single-step or stepwise mandibular advancement. Materials and Methods: This study was conducted on 34 Class II division 1 malocclusion subjects at or just before the peak phase of pubertal growth as assessed by hand-wrist radiographs. Subjects were assigned to two groups of mandibular advancement, using matched randomization. Both groups were treated with the FMA. While the mandible was advanced to a super Class I molar relation in the single-step advancement group (SSG), patients in the stepwise mandibular advancement group (SWG) had a 4-mm initial bite advancement and subsequent 2-mm advancements at bimonthly intervals. The material consisted of lateral cephalograms taken before treatment and after 10 months of FMA treatment. Data were analyzed by means paired t-tests and an independent t-test. Results: There were statistically significant changes in SNB, Pg horizontal, ANB, Co-Gn, and CoGo measurements in both groups (P , .001); these changes were greater in the SWG with the exception of Co-Go (P , .05). While significant differences were found in U1-SN, IMPA, L6 horizontal, overjet, and overbite appraisals in each group (P , .001), these changes were comparable (P . .05). Conclusion: Because of the higher rates of sagittal mandibular skeletal changes, FMA using stepwise advancement of the mandible might be the appliance of choice for treating Class II division 1 malocclusions. (Angle Orthod. 2017;87:82–87)
KEY WORDS: Functional orthodontic appliance; Angle Class II