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BMC Oral Health
Published in: BMC Oral Health 1/2017

Open Access 01-12-2017 | Research article

Effect of removable functional appliances on mandibular length in patients with class II with retrognathism: systematic review and meta-analysis

Authors: Adriana Santamaría-Villegas, Rubén Manrique-Hernandez, Emery Alvarez-Varela, Claudia Restrepo-Serna

Published in: BMC Oral Health | Issue 1/2017

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Abstract

Background

Orthopedic functional devices, are used to improve mandibular length in skeletal class II patients. However, the orthopedic functional device with the best effect to increasing the mandibular length, has not been identified before. Thus, the aim of the present investigation was to evaluate Randomized Controlled Trials (RCT), to determine the best functional appliance improving mandibular length in subjects with retrognathism.

Methods

A systematic review and meta-analysis was performed, including studies published and indexed in databases between 1966 and 2016. RCTs evaluating functional appliances’ effects on mandibular length (Condilion-Gnation (Co-Gn) and Condilion-Pogonion (Co-Po)), were included. Reports’ structure was evaluated according to 2010 CONSORT guide. The outcome measure was distance between Co-Gn and/or Co-Po after treatment. Data were analyzed with Cochran Q Test and random effects model.

Results

Five studies were included in the meta-analysis. The overall difference in mandibular length was 1.53 mm (Confidence Interval (CI) 95% 1.15–1.92) in comparison to non-treated group. The Sander Bite Jumping reported the greatest increase in mandibular length (3.40 mm; CI 95% 1.69–5.11), followed by Twin Block, Bionator, Harvold Activator and Frankel devices.

Conclusions

All removable functional appliances, aiming to increase mandibular length, are useful. Sander Bite Jumping was observed to be the most effective device to improve the mandibular length.
Literature
1.
Woźniak K, Piątkowska D, Szyszka-Sommerfeld L, Buczkowska-Radlińska J. Impact of functional appliances on muscle activity: a surface electromyography study in children. Med Sci Monit Int Med J Exp Clin Res. 2015;21:246–53.CrossRef
2.
Cevidanes LHS, Franco AA, Gerig G, et al. Assessment of mandibular growth and response to orthopedic treatment with 3-dimensional magnetic resonance images. Am J Orthod Dentofacial Orthop. 2005;128:16–26.CrossRefPubMed
3.
Cevidanes LHS, Franco AA, Gerig G, et al. Comparison of relative mandibular growth vectors with high-resolution 3-dimensional imaging. Am J Orthod Dentofacial Orthop. 2005;128:27–34.CrossRefPubMed
4.
Araujo AM, Buschang PH, Melo ACM. Adaptive condylar growth and mandibular remodelling changes with bionator therapy–an implant study. Eur J Orthod. 2004;26:515–22.CrossRefPubMed
5.
Malmgren O, Omblus J, Hägg 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. 1987;91:143–51.CrossRefPubMed
6.
Hägg 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. 1988;10:169–76.CrossRefPubMed
7.
Martina R, Cioffi I, Galeotti A, et al. Efficacy of the Sander bite-jumping appliance in growing patients with mandibular retrusion: a randomized controlled trial. Orthod Craniofac Res. 2013;16:116–26.CrossRefPubMed
8.
Cozza P, Baccetti T, Franchi L, De Toffol L, McNamara JA. Mandibular changes produced by functional appliances in Class II malocclusion: a systematic review. Am J Orthod Dentofacial Orthop. 2006. doi:10.​1016/​j.​ajodo.​2005.​11.​010.
9.
Marsico E, Gatto E, Burrascano M, Matarese G, Cordasco G. Effectiveness of orthodontic treatment with functional appliances on mandibular growth in the short term. Am J Orthod Dentofacial Orthop. 2011;139:24–36.CrossRefPubMed
10.
Zymperdikas VF, Koretsi V, Papageorgiou SN, Papadopoulos MA. Treatment effects of fixed functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis. Eur J Orthod. 2016;38(2):113–26. doi:10.​1093/​ejo/​cjv034.CrossRefPubMed
11.
D’Antò V, Bucci R, Franchi L, Rongo R, Michelotti A, Martina R. Class II functional orthopaedic treatment: a systematic review of systematic reviews. J Oral Rehabil. 2015;42:624–42.CrossRefPubMed
12.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009. doi:10.​1136/​bmj.​b2535.
13.
14.
Wright RW, Brand RA, Dunn W, Spindler KP. How to write a systematic review. Clin Orthop. 2007;455:23–9.CrossRefPubMed
15.
Siwek J, Gourlay ML, Slawson DC, Shaughnessy AF. How to write an evidence-based clinical review article. Am Fam Physician. 2002;65:251–8.PubMed
16.
Henderson LK, Craig JC, Willis NS, Tovey D, Webster AC. How to write a Cochrane systematic review. Nephrol Carlton Vic. 2010;15:617–24.CrossRef
17.
18.
Petitti DB. Meta-analysis, decision analysis, and cost-effectiveness analysis: methods for quantitative synthesis in medicine. 2nd ed. New York: Oxford University Press; 2000.
19.
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. 2003;124:234–43.CrossRefPubMed
20.
Dalci O, Altug AT, Memikoglu UT. Treatment effects of a twin-force bite corrector versus an activator in comparison with an untreated Class II sample: a preliminary report. Aust Orthod J. 2014;30:45–53.PubMed
21.
Baysal A, Uysal T. Soft tissue effects of Twin Block and Herbst appliances in patients with Class II division 1 mandibular retrognathy. Eur J Orthod. 2013;35:71–81.CrossRefPubMed
22.
Nelson C, Harkness M, Herbison P. Mandibular changes during functional appliance treatment. Am J Orthod Dentofacial Orthop. 1993;104:153–61.CrossRefPubMed
23.
Tulloch JF, Phillips C, Koch G. The effect of early intervention on skeletal pattern in Class II malocclusion: a randomized clinical trial. Am J Orthod Dentofac Orthop. 1997;111:391–400.CrossRef
24.
Illing HM, Morris DO, Lee RT. A prospective evaluation of Bass, Bionator and Twin Block appliances. Part I–The hard tissues. Eur J Orthod. 1998;20:501–16.CrossRefPubMed
25.
Saikoski LZ, Cançado RH, Valarelli FP, de Freitas KM. Dentoskeletal effects of Class II malocclusion treatment with the Twin Block appliance in a Brazilian sample: a prospective study. Dental Press J Orthod. 2014;19:36–45.CrossRefPubMedPubMedCentral
26.
Schulz KF, Chalmers I, Haynes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA. 1995;273:408–12.CrossRefPubMed
27.
Booij JW, Goeke J, Bronkhorst EM, Katsaros C, Ruf S. Class II treatment by extraction of maxillary first molars or Herbst appliance: dentoskeletal and soft tissue effects in comparison. J Orofac Orthop. 2013;74:52–63.CrossRefPubMed
28.
Haas DW, Martinez DF, Eckert GJ, Diers NR. Measurements of mandibular length: a comparison of articulare vs condylion. Angle Orthod. 2001;71:210–5.PubMed
29.
Pancherz H. The mechanism of Class II correction in Herbst appliance treatment. A cephalometric investigation. Am J Orthod. 1982;82:104–13.CrossRefPubMed
Metadata
Title
Effect of removable functional appliances on mandibular length in patients with class II with retrognathism: systematic review and meta-analysis
Authors
Adriana Santamaría-Villegas
Rubén Manrique-Hernandez
Emery Alvarez-Varela
Claudia Restrepo-Serna
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2017
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-017-0339-8

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