Examination of dentofacial changes in patients treated with Bionator and Forsus

Abstract

Objective: The aim of this study was to examine the effects of Bionator (B) and Forsus (F) appliances in Class II div 1 cases on the dentofacial system. Materials and Methods: Forty patients with mandibular retrognathia in the pubertal period were divided into two groups. The Bionator appliance (15 female, 5 male) was applied to Group 1, and the Forsus appliance was applied to Group 2 (9 female, 11 male). Cephalometric films were taken before and after the use of functional appliances in both groups. Cephalometric records of 20 patients who were not treated and had mandibular retrognathia were used to establish the control group. To compare the cephalometric data of the groups, a Paired t-test, ANOVA, and Tukey HSD post-hoc test was used. Results: After the Bionator and Forsus, a decrease was found in the SNA angle, but the decrease in the Forsus group was found to be significant. A significant increase in SNB angle and a significant decrease in ANB angle were found in both groups (p<0.05). At the end of Bionator use, there was a significant increase in vertical face height (p<0.05), while the vertical dimension was preserved in the Forsus group. A decrease in the upper incisor inclination and an increase in the lower incisor inclination were observed in both groups, and the difference between the groups was significant (p<0.05). A significant retrusion was observed in the sagittal position of the upper lip (Ls-RD) in the Forsus group. Conclusion: Class II malocclusion was corrected with both appliances. Vertical face height increased in the Bionator group. Compared to the Bionator group, more lower incisor proclination and more upper incisor retroclination were observed in the Forsus group. Keywords: Bionator, Forsus, Class II malocclusion, Mandibular retrognathia, Cephalometrics

Keywords

• Class II malocclusion
• Bionator
• Forsus
• Mandibular retrognathia
• Cephalometrics

Bionator ve Forsus uygulanan hastalarda dentofasiyal değişimlerin incelenmesi

Abstract

Amaç: Bu çalışmanın amacı Sınıf II div 1 vakalarda uygulanan Bionator (B) ve Forsus (F) apareylerinin dentofasiyal sisteme olan etkilerini karşılaştırmaktır. Gereç ve Yöntem: Mandibular retrognatiye sahip ve pubertal gelişim dönemindeki 40 hasta iki gruba ayrıldı. Grup 1'e Bionator apareyi (15 kadın, 5 erkek), Grup 2'ye Forsus apareyi (9 kadın, 11 erkek) uygulandı. Her iki grupta da fonksiyonel aparey kullanımından önce ve sonra sefalometrik filmler alındı. Tedavi uygulanmayan mandibular retrognatiye sahip 20 hastanın sefalometrik kayıtları kontrol grubunun oluşturulmasında kullanıldı. Sefalometrik verilerin karşılaştırılmasında ANOVA ve Tukey HSD post-hoc testi kullanıldı. Bulgular: Bionator ve Forsus kullanımı sonucunda SNA açısında azalma bulundu. Forsus grubundaki azalma anlamlı düzeyde bulundu. Her iki grupta da SNB açısında anlamlı bir artış ve ANB açısında anlamlı bir azalma bulunmuştur (p<0.05). Bionator kullanımı sonunda vertikal yüz yüksekliğinde (N-Me, ANS-Me) anlamlı bir artış bulunurken (p<0.05), Forsus grubunda vertikal boyutun korunduğu görüldü (p>0.05). Gruplar arası fark anlamlıdır. Her 2 grupta da üst kesici eğiminde azalma (U1/SN) ve alt kesici eğiminde (L1/MD) artış gözlendi (p<0.05). Forsus grubunda üst dudağın sagittal yöndeki konumunda (Ls-RD) anlamlı bir retrüzyon gözlendi (p<0.05). Sonuçlar: Her iki aparey ile sagital yönde Sınıf II problemin şiddeti azalmıştır. Bionator grubunda vertikal yüz yüksekliği Forsus grubuna göre artış göstermiştir. Forsus apareyi Bionator apareyine göre alt kesicilerde daha çok proklinasyon, üst kesicilerde daha çok retroklinasyona neden olmuştur. Anahtar kelimeler: Bionator, Forsus, Sınıf II maloklüzyon, Mandibular retrognati, Sefalometri

Keywords

• Bionator
• Forsus
• Sınıf II maloklüzyon
• Mandibular retrognati
• Sefalometri

References

1. 1. Ackerman JL, Proffit WR. The characteristic of malocclusion: A modem approach to classification and diagnosis. Am J Orthod 1969;56;443-454
2. 2. Moore RN, Igel KA, Boice PA. Vertical and horizontal components of functional appliance therapy. Am J Orthod Dentofac Orthop 1989; 96:433-443.
3. 3. Bilgiç F, Başaran G, Hamamci O. Comparison of Forsus FRD EZ and Andresen activator in the treatment of class II, division 1 malocclusions. Clin Oral Invest 2015;19, 445–451
4. 4. Pancherz H. A cephalometric analysis of skeletal and dental changes contributing to class II correction in activator treatment. Am J Orthod 1984;85:125–134
5. 5. Nalbantgil D, Arun T, Sayinsu K, Isık F. Skeletal, dental and soft-tissue changes induced by the Jasper Jumper appliance in late adolescence. Angle Orthod 2005;75:426–436
6. 6. Cozza P, Baccetti T, Franchi L, De Toffol L, McNamara JA Jr. Mandibular changes produced by functional appliances in Class II malocclusion: a systematic review. Am J Orthod Dentofacial Orthop. 2006;129:599.e1–e12.
7. 7. 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.
8. 8. Baccetti T, Franchi L, McNamara JA Jr. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod. 2002;72:316-23.

9. 9. Pancherz H. The mechanism of Class II correction in Herbst appliance treatment. A cephalometric investigation. Am J Orthod 1982;82:104-113.
10. 10. Forsberg CM, Odenrick L. Skeletal and soft tissue response to activator treatment. Eur J Orthod 1981;3:67–74
11. 11. Turkkahraman H, Sayin MÖ. Effects of activator and activator headgear treatment: comparison with untreated class II subjects. Eur J Orthod 2006;28:27–34
12. 12. Karacay S, Akin E, Olmez H, Gurton AU, Sagdic D. Forsus Nitinol flat spring and Jasper Jumper corrections of class II division 1 malocclusions. Angle Orthod 2006;76:666–672
13. 13. George AS, Ganapati Durgekar S. Skeletal and dentoalveolar contributions during Class II correction with Forsus™ FRD appliances : Quantitative evaluation. J Orofac Orthop. 2022;83:87-98.
14. 14. Nogueira CQ, Galvão Chiqueto KF, Freire Fernandes TM, Castanha Henriques JF, Janson G. Effects of the Forsus fatigue-resistant device and mandibular anterior repositioning appliance in Class II malocclusion treatment. Am J Orthod Dentofacial Orthop. 2022 Dec;162:814-823.
15. 15. Elkordy SA, Abdeldayem R, Fayed MMS, Negm I, El Ghoul D, Abouelezz AM. Evaluation of the splint-supported Forsus Fatigue Resistant Device in skeletal Class II growing subjects. Angle Orthod. 2021;91:9-21.
16. 16. Basciftci FA, Uysal T, Büyükerman A, Sarı Z. The effects of activator treatment on the craniofacial structures of class II division 1 patients. Eur J Orthod 2003;25:87–93