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1

Toshniwal, Nandalal Girijalal, Pooja Changdev Katkade, Shubhangi Amit Mani, and Nilesh Mote. "Fixed Functional Appliances." Journal of Evolution of Medical and Dental Sciences 10, no. 31 (August 2, 2021): 2499–504. http://dx.doi.org/10.14260/jemds/2021/511.

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Considering the large number of fixed functional appliances, choosing the best device for your patient is not an easy task. To describe the development of fixed functional appliances as well as our 20-year experience working with them. Fixed functional appliances are grouped into flexible, rigid and hybrid. They are different appliances, whose action is described here. Four clinical cases will be reported with a view in illustrating the different appliances. Rigid fixed functional appliances provide better skeletal results than flexible and hybrid ones. Flexible and hybrid appliances have similar effects to those produced by class II elastics. They ultimately correct class II with dentoalveolar changes. From a biomechanical standpoint, fixed functional appliances are more recommended to treat class II in dolichofacial patients, in comparison to class II elastics. The electromyographic (EMG) activity of masticatory muscles was monitored longitudinally with chronically implanted EMG electrodes to determine whether functional appliances produce a change in postural EMG activity of the muscles. Pre-appliance and post-appliance EMG levels in four experiments that had been fitted with functional appliances were compared against the background of EMG levels in controls without appliances. The insertion of two types of functional appliance to induce mandibular protrusion was associated with a decrease in postural EMG activity of the superior and inferior heads of the lateral pterygoid, superficial masseter, and anterior digastric muscles; the decrease in the first three muscles was statistically significant. This decreased postural EMG activity persisted for approximately 6 weeks, with a gradual return towards pre-appliance levels during a subsequent 6-week period of observation. Progressive mandibular advancement of 1.5 to 2 mm every 10 to 15 days did not prevent the decrease in postural EMG activity. KEY WORDS Orthodontics, Class II Malocclusion, Fixed Functional Appliance.
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Akriti Tiwari, Ravindra Kumar Jain, and Remmiya Mary Varghese. "A Survey To Evaluate Patients’ Acceptance To Various Fixed Functional Appliance." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (December 25, 2020): 876–80. http://dx.doi.org/10.26452/ijrps.v11ispl4.4100.

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Fixed functional appliances correct class II malocclusion by bringing the mandible forward into a new position. Patients using Fixed Functional Appliances complain of difficulty in oral hygiene, soft-tissue irritation, appliance breakage, and difficulty in mastication. Hence, the aim of this study was to conduct a survey evaluating patients’ acceptance of various fixed functional appliances in a university set up. This questionnaire-based study was a university-based setting which consisted of 10 closed-ended and open-ended questions out of which 2 were open-ended questions and 8 were close-ended. It covered discomfort, difficulty in speech, brushing, mastication, oral hygiene and fracture of the appliance. Descriptive statistics were performed. Chi-square test was used to determine the discomfort experienced due to the duration of wear. The significance level for the p-value was set at 0.05. Chi-square test reported that statistically, the insignificant association observed between duration of wear and level of discomfort (p>0.31). All functional appliances have their own disadvantages and discomfort, which is dependent on the intricate fabrication as well as their implementation. Within the limits of the study, it was observed that discomfort was more in the initial few days but reduced over a period of time as the patients got adapted to the appliance.
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Vijayalakshmi, PS, and AS Veereshi. "Management of Severe Class II Malocclusion with Fixed Functional Appliance: Forsus." Journal of Contemporary Dental Practice 12, no. 3 (2011): 216–20. http://dx.doi.org/10.5005/jp-journals-10024-1037.

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ABSTRACT Background Management of class II malocclusion in adolescent patients by growth modulation is one of the most debated topics in orthodontics. Noncompliance has been a major concern for orthodontists. Case report This case report describes the management of severe class II malocclusion in adolescent patient using functional appliance system—Forsus to correct class II problems, which is clipped on to bands. This appliance has several advantages, as the patient cannot remove it. It acts on the teeth and jaws for 24 hours each day, patient cooperation is not a problem, and as a result the treatment time is short. There is lot of controversy about the use of functional appliances. Conclusion This case report illustrates that even today, functional appliances have a significant role in the management of class II malocclusion by using growth modulation. The growth modulation minimizes the necessity of extraction of permanent teeth and probably orthognathic surgery. Clinical significance Functional appliances have a significant role in the management of class II malocclusion. The growth modulation minimizes the necessity of extraction of permanent teeth and probably orthognathic surgery. How to cite this article Vijayalakshmi PS, Veereshi AS. Management of Severe Class II Malocclusion with Fixed Functional Appliance: Forsus. J Contemp Dent Pract 2011; 12(3):216-220.
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Sonawane, Manish Suresh, Girish Ramchandra Karandikar, Shaili Sanjay Shah, Vinayak Shridharrao Kulkarni, and Hitesh Jagadish Burad. "Treatment of Skeletal Class II Malocclusion Using a Fixed Functional Appliance." Journal of Contemporary Dentistry 3, no. 3 (2013): 153–58. http://dx.doi.org/10.5005/jp-journals-10031-1057.

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ABSTRACT Treatment of class II malocclusion has always been an enigma to the orthodontic fraternity. Noncompliant correction of class II malocclusion using fixed functional appliances at the deceleration stage of growth has gained tremendous popularity in the recent times. Aim of the illustrated article is to demonstrate the efficacy of a fixed functional appliance in correction of class II malocclusion. We are reporting a 12-year-old female patient with a skeletal class II malocclusion treated using the Forsus appliance. Forsus FRD was the best option considering age, patient comfort, ease of installation, predictable results and patient compliance. The appliance was worn for 5 months after the initial alignment with fixed mechanotherapy (MBT 0.022"). The mandible was brought forward to a class I skeletal and dental relationship by the end of this phase of treatment. How to cite this article Shah SS, Karandikar GR, Sonawane MS, Kulkarni VS, Burad HJ. Treatment of Skeletal Class II Malocclusion Using a Fixed Functional Appliance. J Contemp Dent 2013;3(3):153-158.
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Wiedel, Anna-Paulina, and Lars Bondemark. "A randomized controlled trial of self-perceived pain, discomfort, and impairment of jaw function in children undergoing orthodontic treatment with fixed or removable appliances." Angle Orthodontist 86, no. 2 (July 17, 2015): 324–30. http://dx.doi.org/10.2319/040215-219.1.

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ABSTRACT Objective: To compare patients’ perceptions of fixed and removable appliance therapy for correction of anterior crossbite in the mixed dentition, with special reference to perceived pain, discomfort, and impairment of jaw function. Material and Methods: Sixty-two patients with anterior crossbite and functional shift were recruited consecutively and randomized for treatment with fixed appliances (brackets and archwires) or removable appliances (acrylic plates and protruding springs). A questionnaire, previously found to be valid and reliable, was used for evaluation at the following time points: before appliance insertion, on the evening of the day of insertion, every day/evening for 7 days after insertion, and at the first and second scheduled appointments (after 4 and 8 weeks, respectively). Results: Pain and discomfort intensity were higher for the first 3 days for the fixed appliance. Pain and discomfort scores overall peaked on day 2. Adverse effects on school and leisure activities were reported more frequently in the removable than in the fixed appliance group. The fixed appliance group reported more difficulty eating different kinds of hard and soft food, while the removable appliance group experienced more speech difficulties. No significant intergroup difference was found for self-estimated disturbance of appearance between the appliances. Conclusions: The general levels of pain and discomfort were low to moderate in both groups. There were some statistically significant differences between the groups, but these were only minor and with minor clinical relevance. As both appliances were generally well accepted by the patients, either fixed or removable appliance therapy can be recommended.
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Dogra, Namrata, Archana Jaglan, Sidhu M. S., Seema Grover, and Suman Suman. "Skeletal Class II Malocclusion Treated with AdvanSync 2 - A Case Report." Journal of Evolution of Medical and Dental Sciences 10, no. 34 (August 23, 2021): 2951–53. http://dx.doi.org/10.14260/jemds/2021/603.

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Treatment of complex malocclusion poses a challenge for the orthodontist because of its multifactorial aetiology. Class II malocclusion is the most frequently encountered and treated malocclusion in orthodontic practice and affects approximately 14.6 % of the North Indian population.1 A common reason for Class II malocclusion is mandibular skeletal retrusion which is the most common characteristic, as reported by McNamara.2 This can be caused by genetic or hereditary factors. When evaluating treatment options for Class II patients, the extent of the skeletal discrepancy and the skeletal maturity of the patient needs to be considered. Treatment may range from dental compensation including camouflage with extractions to surgical procedures targeted at moving the jaw at fault. In growing patients, growth modification with functional appliances offers an intermediate treatment option. Functional appliances are basically of two types; Removable and Fixed. Removable functional appliances such as Activator, Bionator, Frankel Function regulator and Twin Block appliance change Class II relationship by the transmission of soft tissue tension to the dentition. Treatment success with these appliances relies heavily on patient compliance. Therefore, in non-compliant patients, fixed Class II correctors in conjunction with fixed orthodontic appliances are the best choice.3 Fixed functional appliances generate continuous stimuli for mandibular growth without break and permit better adaptation to functions like mastication, swallowing, speech and respiration.1 The Herbst fixed functional appliance has been used routinely for Class II patients and has undergone many design variations over time.4 The AdvanSync2 Class II corrector is a recently introduced fixed functional appliance. It has a much smaller size than the conventional Herbst appliances, is easier to place, activate and remove and most importantly, can be used in conjunction with full-arch fixed appliances throughout.3 Here we describe a case report of a patient treated with the AdvanSync2 Class II corrector and the findings observed in the sagittal and vertical dimensions
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Sebastian, Biju. "Mini-Implants: New Possibilities in Interdisciplinary Treatment Approaches." Case Reports in Dentistry 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/140760.

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The introduction of mini-implants has broadened the range of tooth movements possible by fixed appliance therapy alone. The limits of fixed orthodontic treatment have become more a matter of facial appearance than anchorage. Many complex cases which would previously have required surgery or functional appliances can now be treated with fixed appliance therapy using mini-implants. A mutilated dentition case where mini-implants were used to provide anchorage for intrusion of molars and retraction of anterior teeth is reported here to illustrate this point.
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Ruf, Sabine, and Hans Pancherz. "Fixed functional appliance treatment and avascular necrosis." American Journal of Orthodontics and Dentofacial Orthopedics 126, no. 3 (September 2004): A20—A21. http://dx.doi.org/10.1016/j.ajodo.2004.06.018.

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Brito, Deborah Brindeiro de Araújo, José Fernando Castanha Henriques, Camilla Foncatti Fiedler, and Guilherme Janson. "Effects of Class II division 1 malocclusion treatment with three types of fixed functional appliances." Dental Press Journal of Orthodontics 24, no. 5 (October 2019): 30–39. http://dx.doi.org/10.1590/2177-6709.24.5.030-039.oar.

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ABSTRACT Objective: This study aimed at comparing the dentoskeletal changes in patients with Class II division 1 malocclusion, treated with three types of fixed functional appliances. Methods: A sample comprising 95 patients with the same malocclusion, retrospectively selected, and divided into four groups, was used: G1 consisted of 25 patients (mean age 12.77 ± 1.24 years) treated with Jasper Jumper appliance; G2, with 25 patients (mean age 12.58 ± 1.65 years) treated with the Herbst appliance; G3, with 23 patients (mean age 12.37 ± 1.72 years) treated with the Mandibular Protraction Appliance (MPA); and a Control Group (CG) comprised of 22 untreated subjects (mean age 12.66 ± 1.12 years). Intergroup comparison was performed with ANOVA, followed by Tukey test. Results: The Jasper Jumper and the Herbst group showed significantly greater maxillary anterior displacement restriction. The Jasper Jumper demonstrated significantly greater increase in the mandibular plane angle, as compared to the control group. The MPA group demonstrated significantly greater palatal inclination of the maxillary incisors. Vertical development of the maxillary molars was significantly greater in the Herbst group. Conclusions: Despite some intergroup differences in the amount of dentoskeletal changes, the appliances were effective in correcting the main features of Class II malocclusions.
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Kettle, Jennifer E., Amy C. Hyde, Tom Frawley, Clare Granger, Sarah J. Longstaff, and Philip E. Benson. "Managing orthodontic appliances in everyday life: A qualitative study of young people’s experiences with removable functional appliances, fixed appliances and retainers." Journal of Orthodontics 47, no. 1 (February 3, 2020): 47–54. http://dx.doi.org/10.1177/1465312519899671.

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Objective: To compare young people’s experiences of wearing a range of orthodontic appliances. Design: A cross-sectional, qualitative study with purposive sampling. Setting: UK dental teaching hospital. Participants: Twenty-six orthodontic patients aged 11–17 years. Methods: Patients participated in in-depth semi-structured interviews. All interviews were transcribed verbatim and analysed thematically. Results: Young people reported physical, practical and emotional impacts from their appliances. Despite these reported impacts, participants described ‘getting used’ to and, therefore, not being bothered by their appliance. Framework analysis of the data identified a multi-dimensional social process of managing everyday life with an appliance. This involves addressing the ‘dys-appearance’ of the body through physically adapting to an appliance. This process also includes psychological approaches, drawing on social networks, developing strategies and situating experiences in a longer-term context. Engaging in this process allowed young people to address the physical, practical and emotional impacts of their appliances. Conclusion: This qualitative research has identified how young people manage everyday life with an appliance. Understanding this process will help orthodontists to support their patients.
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Dawjee, S. M., M. I. Khan, and P. Hlongwa. "The repositioning Nance appliance: a fixed functional appliance and case report." Journal of Maxillofacial and Oral Surgery 8, no. 1 (March 2009): 68–73. http://dx.doi.org/10.1007/s12663-009-0017-8.

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Prasad, M. Bhanu, and S. Sreevalli. "Unilateral Molar Distalization: A Nonextraction Therapy." Case Reports in Dentistry 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/846319.

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In the recent years, nonextraction treatment approaches and noncompliance therapies have become more popular in the correction of space discrepancies. One of the conventional approaches for space gaining in the arches without patient compliance is done by using certain extra oral appliances or intraoral appliance. The greatest advantage of certain appliances like fixed functional and molar distalization appliances is that they minimize the dependence on patient cooperation. Molar distalization appliances like pendulum appliance which distalizes the molar rapidly without the need of head gear can be used in patients as a unilateral space gaining procedure due to buccal segment crowding.
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Aminian, Amin, Shahriar Sarvareh Azimzadeh, and Elina Rahmanian. "Cl II Malocclusion Treatment, Using the Modified Twin Block Appliance Coordinated with Fixed Orthodontics in a Postmenarche Patient." Case Reports in Dentistry 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/2525374.

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Functional appliances have been used for treatment of Class II patients for a long time. The main objective of therapy with functional appliances is to induce supplementary lengthening of the mandible by stimulating increased growth at the condylar cartilage. The Twin Block appliance is one of the most commonly used functional appliances. The aim of this paper is to present a case report of mandibular deficiency treatment with Twin Block appliance in a female patient whose sexual maturation (one and a half years after menarche) and cervical vertebral maturation stage indicated the end of the growth peak. The treatment started with bonding 0.022 in MBT prescription brackets on the upper arch in order to align upper teeth and create a symmetric overjet. When reaching alignment, a modified Twin Block was given to the patient for 8 months. Final coordination was achieved with fixed appliances in both arches. At the end of the treatment, profile of the patient improved, crowding was relieved, and Cl I relationship with normal overjet and overbite was achieved.
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Kohli, Sarvraj, Virinder Kohli, and Gagan Deep Kochhar. "Management of Class II Division 1 Subdivision malocclusion using unilateral bicuspid extractions and fixed functional appliance: A Two Year Follow-Up." South European Journal of Orthodontics and Dentofacial Research 8, no. 1 (August 29, 2021): 12–19. http://dx.doi.org/10.5937/sejodr8-27254.

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Introduction: Management of Class II Subdivision cases pose a clinical dilemma and require a careful diagnosis to ascertain the source of asymmetry. Various treatment modalities involving: different protocols of tooth extractions; molar distalization; fixed functional appliances or orthognathic surgery have been proposed for the same. Objective: This article reports a unique approach for management of a severe skeletal Class II with Angle’s Class II Division 1 subdivision malocclusion using unilateral bicuspid extractions in mandibular and maxillary arches and a fixed functional appliance. Results: A 13 year 1 month old male in CVMI transition stage was successfully treated. Extraction of #44 was done to alleviate crowding in the mandibular anterior region and #15 was extracted to protract #16 to achieve a Class II molar relationship. A pre-functional Class II molar and canine relationship with co-incident midlines was achieved. The functional phase consisted of a fixed functional appliance (Forsus FRD) for mandibular advancement to correct the severe skeletal Class II. Class I molar and canine relationships were achieved with reduction of facial convexity and overjet. Result remained stable 24 months after treatment. The improvement can be quantified by the reduction in scores of orthodontic indices measured pre and post treatment. Conclusions: Management of Class II subdivision malocclusion requires careful planning. This paper presents a unique approach utilizing unilateral extractions and fixed functional appliance to address severe skeletal Class II discrepancy and the subdivision dilemma.
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Read, M. J. F. "The Integration of Functional and Fixed Appliance Treatment." Journal of Orthodontics 28, no. 1 (March 2001): 13–18. http://dx.doi.org/10.1093/ortho/28.1.13.

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Singh, S. P., Raj Kumar Verma, Sombir Singh, Nameksh Bhupali, and Sanjeev Verma. "Fixed-functional appliance treatment and growth hormone therapy." American Journal of Orthodontics and Dentofacial Orthopedics 153, no. 3 (March 2018): 325. http://dx.doi.org/10.1016/j.ajodo.2017.11.019.

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Murarka, Shriya Prakash, Sunita Shrivastav, Ranjit Kamble, Hamza Dargahwala, Prutha Khakhar, Zynul John, Purva Dhannawat, and Shruti Rathi. "Comparative Evaluation of Discomfort, Expectations and Functional Experiences during Treatment of Class II Malocclusion with Forsus Fixed Functional Appliance and Sharma’s Class II Corrector - A Questionnaire Based Survey." Journal of Evolution of Medical and Dental Sciences 10, no. 8 (February 22, 2021): 474–78. http://dx.doi.org/10.14260/jemds/2021/104.

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BACKGROUND The Forsus fatigue resistant device (FFRD) appliance is known to correct Class II malocclusion. The disadvantage of it are labial flaring of lower incisors, distalisation and extrusion of maxillary molars, difficulty in procuring the appliances in remote areas and cost. No research has documented the comparison of patient’s experience with FFRD and Sharma’s Class II corrector appliance. Therefore, a questionnaire survey was conducted. METHODS 40 patients having Class II Division 1 malocclusion were included and were divided into two groups- FFRD appliance (group 1, 20 patients) and Sharma’s Class II corrector (group 2, 20 patients). A questionnaire was framed that consisted of 15 questions. Descriptive and analytical statistics was done using SPSS software. The difference in proportions was calculated by chi-square test. The level of significance was set at P < 0.05. RESULTS 30 % of cases in group 2 indicated that the Sharma’s Class II corrector looks good (Q1) as compared to 15 % in group 1. (P = 0.630) 5 % indicated it was not aesthetic in group 2 as compared to 10 % in group 1. 30 % of cases in group 1 indicated that there were problems associated with speech as compared to 0 % in group 2. (P < 0.05). Values were statistically significant. CONCLUSIONS Sharma’s Class II corrector has similar patient acceptance as compared to FFRD appliance with the additional benefit of cost effectiveness. Hence, this can be considered as a better option in treating Class II malocclusion with fixed therapy. KEY WORDS FFRD, Fixed Function Appliance, Economic Orthodontics, Growth Modification, Sharma’s Class II Corrector
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Aleksic, Ema, Maja Lalic, Jasmina Milic, Mihajlo Gajic, and Zdenka Stojanovic. "Dentofacial changes after treatment with prefabricated functional appliance T4CII." Serbian Dental Journal 60, no. 2 (2013): 93–98. http://dx.doi.org/10.2298/sgs1302093a.

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Introduction. Functional maxillary orthodontics has a large number of different mobile devices with different effects on craniomandibular system and great capabilities in solving many orthodontic problems. The aim of this article was to show the effects of 9-month treatment of malocclusion class II, division 1 in a 14-year-old female patient using pre-fabricated functional appliance Trainer T4CII. Case Outline. Skeletal distal relation, deep bite, increased overjet, narrowness and irregular position of upper and lower frontal teeth are indicated for orthodontic treatment with fixed appliance. After refusal of fixed appliance therapy, a female patient was proposed treatment with mobile orthodontic appliance. A pre-fabricated functional appliance Trainer T4CII was delivered to the patient. She was motivated and she was wearing appliance at night and 2-3 hours during the day. After 9 months of treatment there was a significant improvement in the position of upper and lower frontal teeth and reshaping of upper and lower dental arch, yet overbite and overjet were corrected. Conclusion. Surprisingly good and fast improvement of all problems within class II, division 1 in a 14-year-old patient was achieved with prefabricated functional appliance Trainer T4CII.
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Ansari, Akram, Abhay Kumar Jain, Ankit Singh, Priya Sharma, and Muneeb Adil. "Management of Skeletal Class II Malocclusion in Non-Complaint Patient using Powerscope - A Case Report." Orthodontic Journal of Nepal 9, no. 2 (December 31, 2019): 77–81. http://dx.doi.org/10.3126/ojn.v9i2.28421.

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Class II malocclusion in pubertal phase presents a major and a common challenge to orthodontists. Proper diagnosis and treatment planning in early stage help in preventing and intercepting the severity of malocclusion. In pubertal phase skeletal Class II malocclusion due to mandibular retrusion are best treated with functional appliance. In recent time PowerScope fixed functional appliance is gaining immense popularity as noncompliant Class II corrector. In the present case report an adolescent male patient having Class II division 1 malocclusion with functional jaw retrusion was treated using MBT 0.022” prescription and PowerScope appliance. 7-8 months of PowerScope wear obtained stable and successful results with improvement in facial profile, skeletal jaw relationship and mild increase in IMPA. It can thus be concluded that PowerScope gives good results in Class II correction with a combination of patient comfort and ease of use that was unmatched among other appliances
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Achmad, Muhammad H. "Overjet problems at the growing child, case report using the twin block appliance." Journal of Dentomaxillofacial Science 2, no. 1 (April 1, 2017): 63. http://dx.doi.org/10.15562/jdmfs.v2i1.454.

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Objective : Overjet is a horizontal relationship between maxillary and mandibular incisors. Normal range from overjet is 2-4 mm. Increased overjet is marked by maxillary incisor’s protrusion. A 6 mm overjet will have impact on psychological and social relationship of children due to the aesthetics of the face profile. Increased overjet has relationship with Class II Angle malocclusion, Class II skeletal sagittal relationship, and mandibular retrognathia. Clinical problem caused by increased overjet in children are maxillary permanent incisors trauma in growing age, damaged periodontal tissue, lip incompetency, social impact such as lack of confidence in children, and also increased overjet has a close relationship with Temporomandibular Disorder (TMD) sign and symptoms.Methods : Increased overjet case can be managed by maxillary retraction of labial segment and increasing mandibular labial segment. Case management are based on skeletal and soft tissue pattern and patient’s age. Reducing overjet can be based on using several appliances, such as functional removable appliance to modify dental and skeletal relationship, fixed orthodontic appliances with tipping and bodily movement or using jaw reposition by orthognathic surgery.Results : One of the effective appliance to reduce overjet, especially Class II malocclusion treatment is Twin Block Functional Appliances developed by Clark. Twin Block appliances is used for developing age children in certain time period to support mandibular growth. This appliance is easy to use, so the patient cooperativity can be maintained. Maximum treatment depends on children’s cooperativity. By using Twin Block functional appliance, we can observe that early treatment can be effective to reduce overjet, to change skeletal pattern, and to increase children psychology such as self-confidence by making aesthetic changes to their faces significantly.[B1] Conclusion : This appliances is made with 70o angle to occlusal plane. Maxillary arch lateral expansion can be achieved with expansion screw. Patient will be instructed to use the appliance for 24 hours a day.[B2]
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Panigrahi, Priyankar, and Varadarajan Vineeth. "Biomechanical Effects of Fixed Functional Appliance on Craniofacial Structures." Angle Orthodontist 79, no. 4 (July 1, 2009): 668–75. http://dx.doi.org/10.2319/052708-281.1.

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Abstract Objective: To evaluate displacement and stress distribution on craniofacial structures associated with fixed functional therapy. Materials and Methods: A finite element model of the human skull was constructed from sequential computed tomography images at 2-mm intervals using a dry adult human skull. In this study, linear, four-nodal, tetramesh and triangular shell elements were used with six degrees of freedom at each of their unstrained nodes: three translations (x, y, and z) and three rotations (around the x-, y-, and z-axes). Results: The entire mandible moved anteroinferiorly. Maximum displacement was observed in the parasymphyseal and midsymphyseal regions. The pterygoid plate was displaced in a posterosuperior direction. The anteroinferior displacement of the mandibular dentition was most pronounced in the incisor region, while the maxillary dentition was displaced posterosuperiorly. The entire dentition experienced tensile stress except for the maxillary posterior teeth. Tensile stress was also demonstrated at point A, the pterygoid plates, and the mandible, and minimal compressive stress was demonstrated at anterior nasal spine. Maximum tensile stress and von Mises stresses occurred in the condylar neck and head. Conclusion: Fixed functional therapy causes a posterosuperior displacement of the maxillary dentition and pterygoid plate and thus can contribute to the correction of Class II malocclusion. The displacement was more pronounced in the dentoalveolar region as compared to the skeletal displacement. All dentoalveolar structures experienced tensile stress, except for anterior nasal spine and the maxillary posterior teeth.
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Jung, Min-Ho. "Fixed-functional appliance treatment combined with growth hormone therapy." American Journal of Orthodontics and Dentofacial Orthopedics 152, no. 3 (September 2017): 402–12. http://dx.doi.org/10.1016/j.ajodo.2016.08.030.

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Rizk, Susan, Valmy Pangrazio Kulbersh, and Riyad Al-Qawasmi. "Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance." Angle Orthodontist 86, no. 6 (December 9, 2015): 955–61. http://dx.doi.org/10.2319/042915-295.1.

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ABSTRACT Objective: To evaluate the effects of functional appliance treatment on the oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position of growing Class II patients. Materials and Methods: Twenty Class II white patients (mean age, 11.7 ± 1.75 years) treated with the MARA followed by fixed appliances were matched to an untreated control sample by cervical vertebrae maturation stage at pretreatment (T1) and posttreatment (T2) time points. Cone beam computed tomography scans were taken at T1 and T2. Dolphin3D imaging software was used to determine oropharyngeal airway volume, dimensions, and anteroposterior hyoid bone position. Results: Multivariate ANOVA was used to evaluate changes between T1 and T2. Oropharyngeal airway volume, airway dimensions, and A-P position of the hyoid bone increased significantly with functional appliance treatment. SNA and ANB decreased significantly in the experimental group (P ≤ .05). Changes in SNB and Sn-GoGn failed to reach statistical significance. Conclusions: Functional appliance therapy increases oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position in growing patients.
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Matic, Sava, and Predrag Nikolic. "Perception of pain, social and functional discomfort during orthodontic treatment." Srpski arhiv za celokupno lekarstvo 145, no. 1-2 (2017): 65–69. http://dx.doi.org/10.2298/sarh151222013m.

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Introduction/Objective. Pain and social discomfort are common experiences after the insertion of a fixed orthodontic appliance. The aim of the study was to determine the intensity of pain during the first seven days after the placement of a fixed orthodontic appliance, the impact of orthodontic treatment on psychosocial component of the patient and daily life activities in the first month of therapy. Methods. The study included 60 randomly selected patients from the Department of Orthodontics, Faculty of Dental Medicine, Belgrade, Serbia, aged 15 to 20 years. After the insertion of a fixed orthodontic appliance, the patients were given a questionnaire form comprising questions related to the intensity of pain in the first seven days, function of speech and chewing, oral hygiene, injury of the oral mucosa, and social contacts. For the processing of results obtained from the questionnaire ?2 test was used. Results. The largest percentage of respondents (21.7%) rated pain with grade 1, while less than 10% of respondents gave grades 4, 6, 7, 9, and 10. Most of the participants (95%) answered that they had no difficulties with daily life activities caused by the fixed orthodontic appliance. Most respondents (91.7%) did not have any social discomfort, while a small percentage (8.3%) said they had these problems. Conclusion. General intensity of pain that respondents felt during the first seven days after the placement of a fixed orthodontic appliance was low to moderate. For most of the respondents there was no change in social behavior related to the psychosocial component. Except for changes in dietary habits and sores on the oral mucosa of the cheek in the first month of therapy, examines had no major problems with daily life activities.
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Kalra, Anirudh, Vinit Swami, and Veera Bhosale. "Treatment effects of “PowerScope” fixed functional appliance – a clinical study." Folia Medica 63, no. 2 (April 30, 2021): 253–63. http://dx.doi.org/10.3897/folmed.63.e52892.

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Aim: To study the skeletal, dental effects and evaluate the soft tissue changes with PowerScope-fixed functional appliance in class II malocclusion. Materials and methods: This clinical study was carried out where a total of 10 growing (CVMS 3 and 4) Class II Division 1 malocclusion patients, indicated for treatment with fixed functional appliance were allocated based on specific inclusion criteria. PowerScope (American Orthodontics) was used as the fixed functional appliance. Skeletal, dental and soft tissue effects of the appliance with various angular and linear parameters on a digital lateral cephalogram were evaluated for all 10 participants. Records were collected before the insertion of PowerScope appliance (T0) and after 5 months, during the appliance removal (T1). All participants were treated with 0.018&#698;&times;0.025&#698; MBT (3M Unitek) prescription. Statistical analysis was performed using a paired t-test to compare individual mean changes for each treatment category.&nbsp; Results: Statistically significant changes were seen in skeletal parameters such as forward positioning of the mandible with an increase in SNB angle and N perpendicular-Pogonion distance, the class II jaw base relationship improved with reduction in ANB angle and Wits appraisal. Significant changes were observed in dental parameters such as forward positioning of mandibular incisors, maxillary molar distalization and intrusion with reduction in overbite and overjet respectively. In the soft tissue, a significant improvement in facial profile was seen due to an increase in labiomental angle. Conclusions: The results of this study have shown that statistically significant changes in skeletal, dental and soft tissue parameters
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Gaikwad, Shashank Sharad, Manish Suresh Sonawane, Girish Ramchandra Karandikar, Priyanka Anil Pawar, and Shaili Sanjay Shah. "Two-Phase Treatment of a Growing Patient with a Skeletal Class II." Journal of Contemporary Dentistry 3, no. 1 (2013): 40–43. http://dx.doi.org/10.5005/jp-journals-10031-1033.

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ABSTRACT Functional appliances have been used for many years in the treatment of class II malocclusions. They redirect the growth of mandible bringing about a skeletal change in a growing patient. In case of any remaining dental discrepancy, a fixed appliance is obligatory. This patient was an 11-year-old growing female with a convex profile, receding chin, lower lip trap, class II skeletal and dental relationship, a large overjet and overbite and a high maxillary labial frenum attachment. Treatment started with the Twin-block appliance with an expansion screw to achieve transverse correction, promote growth of the mandible and improve her profile. This was followed by fixed appliance mechanotherapy to align and level the dentition, close spaces and retract the maxillary anteriors. Frenectomy was carried out after space closure. How to cite this article Sonawane MS, Karandikar GR, Gaikwad SS, Pawar PA, Shah SS. Two-Phase Treatment of a Growing Patient with a Skeletal Class II. J Contemp Dent 2013;3(1):40-43.
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Nedeljkovic, Nenad, Ivana Scepan, Branislav Glisic, and Evgenija Markovic. "Dentaoalveolar changes in young adult patients with Class II/1 malocclusion treated with the Herbst appliance and an activator." Vojnosanitetski pregled 67, no. 2 (2010): 170–75. http://dx.doi.org/10.2298/vsp1002170n.

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Background/Aim. Functional appliances can be used effectively in the treatment of skeletal Class II/1 malocclusions. The best treatment results are obtained during active period of facial growth when skeletal, as well as dentoalveolar, changes occur. In comparison with removable functional appliances, such as activator, that are effective only during adolescent period of growth, the Herbst fixed appliance is also successful at the end of the growth period. It also offers a shorter treatment time and a patient compliance is not necessary. The aim of this study was to analyze and compare dentoalveolar changes in the group of young adult patients with Class II/1 malocclusion treated with the Herbst appliance and an activator. Methods. The sample for this study consisted of 50 patients of both sexes, 14-21 years of age with Class II/1 malocclusion. For estimating the effect of functional appliances used, the following cephalometrics parameters were determined: inclination of the upper and lower incisors, interincisal angle, antero-posterior molars relationships, overjet and overbite. The results obtained were statistically tested. Results. The cephalometric findings after the treatment indicated retroinclination of upper incisors (average value of 9?) and proclination of lower incisors (average value of 7?), mostly expressed in the patients treated by Herbst appliance (p < 0.001). Increased overjet and distocclusion were completely corrected in the group of patients treated with the Herbst appliance, while the correction of malocclusion in the activator group was only partially accomplished. No changes in the overbite were noticed at the end of the treatment in both groups. Conclusion. The results of this study revealed that the Herbst appliance is more effective in the treatment of Class II/1 malocclusion in young adults in comparison with the activator.
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Shivaprakash, G. "FUNCTIONAL TREATMENT OBJECTIVE-ROLE IN TWO PHASE TREATMENT." CODS Journal of Dentistry 5, no. 2 (2013): 9–12. http://dx.doi.org/10.5005/cods-5-2-9.

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ABSTRACT A distal occlusion exerts restraining occlusal forces on the mandibular dentition, and the maxillary dental arch is narrow from distal positioning of the lower dentition. These factors may not allow the mandible to grow to its full genetic potential In severe class II. In the hands of an experienced clinician, full time functional appliances are most efficient in correcting severe class II malocclusion than conventional fixed appliance techniques without mandibular propulsion. This is especially true when the treatment is timed to coincide with the pubertal growth spurt. A case successfully treated with two phase treatment to meet the functional treatment objective is presented.
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Arici, Selim, Huseyin Akan, Kamran Yakubov, and Nursel Arici. "Effects of fixed functional appliance treatment on the temporomandibular joint." American Journal of Orthodontics and Dentofacial Orthopedics 133, no. 6 (June 2008): 809–14. http://dx.doi.org/10.1016/j.ajodo.2006.07.035.

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Woods, Michael G. "The use of a simple functional appliance as an adjunct to fixed appliance orthodontic treatment." Australian Dental Journal 41, no. 4 (August 1996): 221–34. http://dx.doi.org/10.1111/j.1834-7819.1996.tb04864.x.

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Ozdemir, Fulya, Feyza Ulkur, and Didem Nalbantgil. "Effects of fixed functional therapy on tongue and hyoid positions and posterior airway." Angle Orthodontist 84, no. 2 (August 29, 2013): 260–64. http://dx.doi.org/10.2319/042513-319.1.

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ABSTRACT Objective: To evaluate how therapy with a fixed functional appliance affects airway dimensions, dentoalveolar changes, and tongue and hyoid positions. Materials and Methods: A retrospective study was carried out on 46 pre- and posttreatment lateral cephalometric radiographs of 23 post-peak Class II patients (12 girls, 11 boys) treated with a Forsus Fatigue Resistant Device (FRD) appliance. The radiographies were taken at the start and at the end of Forsus FRD appliance therapy when a Class I or overcorrected Class I canine and molar relationship was achieved. The process took an average of 5 months 13 days ± 1 month 4 days. Skeletal and dental parameters were measured using Dolphin software, and the sagittal airway area was measured by AutoCAD software. Results: Analyses of the pre- and posttreatment means revealed that there was no statistically significant skeletal correction of the sagittal malocclusion; increase of lower incisor inclination, decrease of upper incisor inclination, decrease of interincisal angle, and rotation of occlusal plane all contributed to the reduction of overjet. The tongue area and intermaxillary space area increased in response to these dentoalveolar changes; however, there was no statistically significant change in the hyoid position or the oropharyngeal area between the two time points. Conclusions: The dentoalveolar changes produced by Forsus FRD appliance did not cause any significant posterior airway changes in young adult patients.
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Cheung, Rhonda Nga Yi, Urban Hägg, Ricky Wing Kit Wong, Chongshan Liao, and Yanqi Yang. "Change of Mandibular Position during Two-Phase Orthodontic Treatment of Skeletal Class II in the Chinese Population." Scientific World Journal 2015 (2015): 1–16. http://dx.doi.org/10.1155/2015/804831.

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The aim of this study was to evaluate the change in mandibular position during a two-phase orthodontic treatment of skeletal Class II malocclusion. Thirty consecutively treated Chinese male adolescents who had undergone two-phase treatment with Herbst appliance and fixed appliance and fulfilled the specific selection criteria were sampled. Cephalograms taken at T0 (before treatment), T1 (at the end of functional appliance treatment), and T2 (at the end of fixed appliance treatment) were analyzed. The change in sagittal positioning of the mandible was6.8±3.44 mm in phase I (T0-T1),0.4±2.79 mm in phase II (T1-T2), and7.2±4.61 mm in total. The mandible came forward in 100% of the patients at T1. In phase II, it came forward in one-third (positive group) remained unchanged in one-third (stable group) and went backward in one-third (negative group) of the patients. At T2, it came forward twice as much in the positive group compared to the negative group. Mandibular length was significantly increased in 100% of the patients in both phases. In conclusion, during the treatment with functional appliance, the mandibular prognathism increases in all patients, whereas during the treatment with fixed appliance there is no significant change in mandibular prognathism.
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Chowdhary, Sonal. "Management of severe Class II malocclusion with sequential modified twin block and fixed orthodontic appliances." APOS Trends in Orthodontics 6 (March 4, 2016): 113–18. http://dx.doi.org/10.4103/2321-1407.177966.

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Functional appliance is an effective way of treating skeletal Class II malocclusion in children and adolescents. A 12 months stepwise mandibular advancement protocol with Herbst appliance has been proved to enhance condylar growth and improve mandibular prognathism. The present case report documents a 12-year-old boy presenting with Angle’s Class II, division 1 malocclusion associated with excessive overjet (11 mm), 100% deep bite, and retrognathic mandible. He was treated by a phase I growth modification therapy using twin block appliance with lip pads in a stepwise mandibular advancement protocol followed by a phase II preadjusted Edgewise appliance therapy.
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Nedeljkovic, Nenad, Vesna Zivojinovic, and Mirjana Ivanovic. "Clinical effects of fixed functional Herbst appliance in the treatment of class II/1 malocclusion." Srpski arhiv za celokupno lekarstvo 137, no. 11-12 (2009): 675–80. http://dx.doi.org/10.2298/sarh0912675n.

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Introduction. Sagittal mandible deficiency is the most common cause of skeletal Class II malocclusion. Treatment objective is to stimulate sagittal mandible growth. Fixed functional Herbst appliance use is beneficial for shortening the time required for treatment and does not depend on patient compliance. Case outline. A 13-year-old girl was referred to the Clinic of Orthodontics, School of Dentistry in Belgrade following previous unsuccessful treatment of her skeletal Class II malocclusion using an activator. The patient's poor cooperation had led to failure of the treatment. Patient was subjected to the Herbst treatment for 6 months followed by fixed appliance for another 8 months. Lateral cephalograms before and after the treatment was performed. The remodelation of condylar and fossal articulation was assessed by superimposition of pre- and post-treatment temporomandibular joint tomograms. The promotion of oral hygiene and fluoride use was performed because orthodontic treatment carries a high caries risk and risk for periodontal disease. Skeletal and dental changes were observed after treatment (correction [Max+Mand]: molar relation 7 mm, overjet 8 mm, skeletal relation 5 mm, molars 2 mm, incisors 3 mm). Combination of Herbst and fixed appliances was effective in the treatment of dental and skeletal irregularities for a short period of time. Conclusion . In the retention period, 14 months after treatment, occlusal stability exists. Follow-up care in oral prevention is based on regular recalls at the dental office and supervision at home by the parents.
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Taira, Koji, Shoichiro Iino, Takeshi Kubota, Tomohiro Fukunaga, and Shouichi Miyawaki. "Effects of Mandibular Advancement plus Prohibition of Lower Incisor Movement on Mandibular Growth in Rats." Angle Orthodontist 79, no. 6 (November 1, 2009): 1095–101. http://dx.doi.org/10.2319/112608-603r.1.

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Abstract Introduction: To test the hypothesis that mandibular advancement with the use of a fixed functional appliance combined with prohibition of labial movement of the lower incisors will have no effect on mandibular growth in growing rats. Materials and Methods: Fifteen 4-week-old male rats were divided into fixed, unfixed, and control groups (n = 5, each). Bite-jumping appliances were used in the fixed and unfixed groups. Sites of bone perforation and the lower incisors were connected with ligature wires in the fixed group. The ramus height, mandibular length, and inclination of lower incisors were examined for 4 weeks, and those values were compared among five intervals and three groups by through one-way analysis of variance models and the Bonferroni multiple comparison test for post hoc comparison. Results: Increases in ramus height and mandibular length during the experimental period were 1.5 mm and 2.5 mm in the fixed group, 1 mm and 1.5 mm in the unfixed group, and 1.2 mm and 1.9 mm in the control group, respectively. Growth of ramus height and growth of mandibular length in the fixed group were greater than in the unfixed and control groups during the experimental period. The inclination of lower incisors in the unfixed group was increased 8.0 degrees throughout the experimental period, which differed from results obtained in the other groups. Conclusions: Mandibular growth was accelerated effectively before and during the pubertal period in rats by mandibular advancement with a fixed functional appliance combined with prohibition of labial movement of the lower incisor.
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Shetty, Prajwal, Mukul Shetty, Maitreyi Chalapati, Chaitra Kori, Crystal Runa Soans, and Murali P. S. "Comparative Evaluation of Hard-Tissue and Soft-Tissue Changes following Fixed Functional Appliance Treatment in a Skeletal Class II Malocclusion Using Forsus and PowerScope." Journal of Health and Allied Sciences NU 11, no. 02 (February 10, 2021): 087–92. http://dx.doi.org/10.1055/s-0041-1722821.

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Abstract Introduction The purpose of this study was to evaluate and compare the skeletal, dentoalveolar and soft-tissue effects of 2 fixed functional appliance; Forsus Fatigue Resistance Device (FFRD) and PowerScope appliance in treating patients with skeletal class II division 1 malocclusion. Materials and Methods This comparative prospective two-group study included 20 patients with a mean age of 11.2 ± 1.6 years with skeletal class II malocclusion with retrognathic mandible. One group was treated with FFRD, and second group was treated with PowerScope appliance. Lateral cephalograms were evaluated at T1 (pre-functional appliance treatment)) and at T2 (postappliance treatment). Cephalometric values were calculated and assessed to evaluate skeletal, dentoalveolar and soft-tissue changes. Results Sagittal correction of class II malocclusion appeared to be mainly achieved by dentoalveolar changes in the PowerScope group. The FFRD was able to induce both skeletal and dentoalveolar changes. A favorable influence on facial convexity was achieved by both groups. A significant increase in upper pharynx and lower pharynx dimension was seen in the PowerScope group. A statistically significant decrease in upper lip protrusion, increase in lower lip protrusion, increased nasolabial angle, and decrease in inferior labial sulcus were noted in both the groups. Lower incisors proclined more in the PowerScope group. Conclusion Both appliances were effective in correcting class II malocclusion. Forsus had more skeletal effects on the mandible, whereas PowerScope had less skeletal effects on the mandible and more dentoalveolar effects, contributing to class II correction. Both groups showed a significant improvement in soft-tissue profile. PowerScope group showed a significant increase in airway dimensions.
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Chandorikar, Harshal, Wasundhara A. Bhad, Umal Hiralal Doshi, and Santosh Chavan. "Versatile Twin-block design for noncompliance class II correction." APOS Trends in Orthodontics 6 (September 16, 2016): 271–72. http://dx.doi.org/10.4103/2321-1407.190749.

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Compliance for removable Twin-block appliance wear is one of the most common problems for successful functional correction. This article describes a simple but versatile semi-fixed Twin-block design that ensures full-time wear of the appliance with provision of possible modifications in different clinical situations.
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Surana, Ashok, Surajit Chakrabarty, and Siddhartha Dhar. "Correction of Skeletal Class II Malocclusion using Functional-Fixed Appliance Therapy." Journal of Indian Orthodontic Society 46 (October 15, 2012): 348–51. http://dx.doi.org/10.5005/jp-journals-10021-1118.

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Chanchala, HP, PJ Nagaratna, S. Rashmi, and Brinda S. Godhi. "Fixed Functional Distal Shoe Appliance for Bilateral Loss of Deciduous Molars." Journal of Orofacial Research 4 (2014): 130–32. http://dx.doi.org/10.5005/jp-journals-10026-1143.

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Surana, Ashok, Surajit Chakrabarty, and Siddhartha Dhar. "Correction of Skeletal Class II Malocclusion using Functional-Fixed Appliance Therapy." Journal of Indian Orthodontic Society 46, no. 4_suppl2 (December 2012): 348–51. http://dx.doi.org/10.1177/0974909820120610s.

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Read, Michael J. F., Scott Deacon, and Kevin O'Brien. "A prospective cohort study of a clip-on fixed functional appliance." American Journal of Orthodontics and Dentofacial Orthopedics 125, no. 4 (April 2004): 444–49. http://dx.doi.org/10.1016/j.ajodo.2003.05.011.

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42

Kinzinger, Gero Stefan Michael, Jan Hourfar, Cornelia Kober, and Jörg Alexander Lisson. "Mandibular fossa morphology during therapy with a fixed functional orthodontic appliance." Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 79, no. 2 (February 20, 2018): 116–32. http://dx.doi.org/10.1007/s00056-018-0124-6.

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43

Mani, Shubhangi Amit, Nilesh Mote, Kunal Dilip Pawar, Prashantkumar Mishra, Richa Anil Mishra, and Rajlaxmi Rajaram Rai. "Treatment of class II and class III maloccolusion by using churro jumper: an efficient, inexpensive and uncomplicated fixed flexible functional technique." Journal of Research in Dentistry 4, no. 1 (July 24, 2016): 9. http://dx.doi.org/10.19177/jrd.v4e120169-12.

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Functional orthopedic treatment seeks to improve skeletal and dental relationship of the jaws. The challenging task is to correctly position jaws antero-posteriorly and vertically with correct overbite, overjet and Centric relation. The Churro Jumper is an efficient, inexpensive and uncomplicated fixed flexible functional appliance. It is used to evaluate the efficacy of the Churro Jumper appliance in treatment of skeletal Class II malocclusion with retrognathic mandible. Churro Jumper contributes in correction of Class II molar relationship by dento-alveolar effects on both jaws. There was up-righting of maxillary incisors and proclination of mandibular incisors. Churro Jumper is clinically efficient as well as effective appliance to correct skeletal class II malocclusion. The only problem with this appliance is its frequent breakage and oral hygiene maintenance causing inconvenience to both patient as well as operator.
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Kinzinger, Gero Stefan Michael, Jörg Alexander Lisson, Linda Frye, Ulrich Gross, and Jan Hourfar. "A retrospective cephalometric investigation of two fixed functional orthodontic appliances in class II treatment: Functional Mandibular Advancer vs. Herbst appliance." Clinical Oral Investigations 22, no. 1 (April 1, 2017): 293–304. http://dx.doi.org/10.1007/s00784-017-2111-5.

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45

Garg, Ashish. "Indian Board of Orthodontics Case Report: Management of Skeletal Class II Division 1 Malocclusion With Single-Phase Fixed Orthodontic Treatment Along With Forsus FRD Fixed Functional Appliance." Journal of Indian Orthodontic Society 55, no. 2 (April 2021): 202–8. http://dx.doi.org/10.1177/03015742211004436.

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This case report was submitted to the board under category II for the Indian Board of Orthodontics examination in November 2017. This case report illustrated the treatment of class II division 1 malocclusion by pre-adjusted appliance along with Forsus Fatigue Resistance Device (FRD) fixed functional appliance (single-phase treatment) in a 13.6 year-old female patient whose growth was about to cease. The summary of the treatment, various records, treatment progress, and critical appraisal are reprinted here with minimal editing and reformatting, and hence, the presentation resembles the actual documents submitted to the board.
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Nayak, U. S. Krishna, Ashutosh Shetty, Crystal Runa Soans, and Vivek Bhaskar. "TWO PHASE FOR A BETTER FACE!! TWIN BLOCK AND HEADGEAR FOLLOWED BY FIXED THERAPY FOR CLASS II CORRECTION." Journal of Health and Allied Sciences NU 05, no. 02 (June 2015): 074–79. http://dx.doi.org/10.1055/s-0040-1703896.

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AbstractCorrection of a skeletal sagittal Class II in a growing child can be done either in one single phase of treatment, or in two phases, i.e a first phase of functional appliance to reduce the severity of the skeletal discrepancy, followed by fixed appliance therapy to refine the occlusion. This 2 phase treatment has quite a few advantages such as early correction of the facial profile is seen by the child and parent, which motivates them, as well as, reduces the social handicap produced as a result of the malocclusion. Hence, this case report describes the treatment of a Class II child, with a Twin block appliance followed by fixed orthodontic treatment.
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Muslim Yusuf, Yufridika, Erna Sulistyawati,. "PENGARUH PIRANTI FUNGSIONAL LEPASAN TERHADAP PERUBAHAN PANJANG MANDIBULA." ODONTO : Dental Journal 5, no. 2 (December 28, 2018): 126. http://dx.doi.org/10.30659/odj.5.2.126-130.

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Background: Class II malocclusion prevalence is about 70%. Class II malocclusion could be caused by retrognatic mandible and normal maxilla, prognatic maxilla and normal mandible or combination of retrognatic mandible and prognatic maxilla. Class II malocclusion can be treated with fixed or removable functional appliance on advancing mandibular length. Aim: To examine the effect of functional appliance in mandibular length. Method: Age of sample is ranging from 7-13 years old treated using removable functional appliance with proper and complete medical record. In this research, a purposive sampling method was used. The mandibular length changes of samples were evaluated and analyzed with statistical computerized system. Result: The research reveals that total mandibular length was changed by 7.09 mm while mandibular corpus length was changed by 3.27 mm. Based on paired t-test, these results are found to be statistically significant (p< 0.05). Conclusion: The removable functional appliance on samples with Class II malocclusion contributes a significant effect both for total mandibular and corpus mandibular length.
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Babenko, Andrii, Iryna Kostiuk, Yuriy Oktysyuk, Valentyn Avakov, and Nataliia Shovkova. "Cellular immunity indexes after therapeutic use of immunoactive and anti-inflammatory agents in patients with orthodontically induced gingival hyperplasia." Pharmacia 68, no. 2 (April 21, 2021): 375–79. http://dx.doi.org/10.3897/pharmacia.68.e64701.

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Orthodontic treatment with fixed appliances that is mediated by the power forces of the apparatus might lead to changes in the blood circulation, predispose to a number of complications such as tooth movement and contributes to the morphological bone tissue remodeling. We have investigated 126 patients aged 16–35 years after appliance bracket therapy that has caused orthodontically induced gingival hyperplasia. Immunological investigation which comprised the study of the cellular immune system in patients with orthodontically induced gingival hyperplasia suggested that there were significant disorders of the cellular immune system that correspond to the T-suppressor type of the secondary immunodeficiency state. Endogenous interferon composed of a low molecular weight organic compounds and an interferon-inducing agent (isonicotinic acid derivative) was used in the treatment of the patients with orthodontically induced gingival hyperplasia. Interferon provides restoration of functional activity in T-lymphocytes, enhances the functional capacity of the macrophages, provides normalization of the cell immunity, contributes to the elimination of secondary immunodeficiency and restoration of immunological homeostasis in individuals with orthodontically induced gingival hyperplasia caused by fixed appliances.
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Milosevic, A. "Functional occlusion after fixed appliance orthodontic treatment: a UK three-centre study." European Journal of Orthodontics 20, no. 5 (October 1, 1998): 561–68. http://dx.doi.org/10.1093/ejo/20.5.561.

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Devi, Anjana, Bhadrinath Srinivasan, and Sridevi Padmanabhan. "Ideal parameter to assess efficacy of fixed functional appliance: angular or linear?" European Journal of Orthodontics 38, no. 3 (April 6, 2016): 337. http://dx.doi.org/10.1093/ejo/cjw025.

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