AIM: To evaluate the effectiveness and timing of Class II treatment with functional appliances by means of a systematic review of the literature of the last 40 years. MATERIALS AND METHOD: A systematic review of the literature was performed on the articles written in English from January 1967 to January 2007. The survey was conducted on the Medline database and used the MeSH terms ‘malocclusion, Angle Class II’ and ‘functional, appliances’. The retrieved studies had to analyze cephalometrically the effects of functional therapy on mandibular dimensions (including total mandibular length as measured by using the anatomical point Condylion) with respect to untreated Class II controls. Modifi cation in total mandibular length in Class II patients treated with functional appliances when compared with untreated Class II controls (supplementary mandibular growth) was calculated, and it was considered effective when it was greater than 3.0 mm, i.e. the amount of defi ciency in mandibular growth in subjects with untreated Class II malocclusion when compared with subjects with normal occlusion. RESULTS: Twenty-two articles qualifi ed for the fi nal review analysis [four randomized controlled clinical trials (RCTs), two prospective controlled clinical trials (CCTs), and 16 retrospective CCTs]. Ten out of 32 samples in the 22 studies described effectiveness in producing supplementary growth along total mandibular length. Seven of the 22 studies included in the review reported information about actual skeletal maturity of analyzed subjects by means of a biological indicator (hand and wrist analysis, cervical vertebral maturation method). Of these seven studies, six samples received treatment before the pubertal peak in skeletal growth, while in three treatment included the pubertal peak. The amount of actual supplementary mandibular growth induced by treatment (as measured by Co-Gn or Co-Pg) was effective in all the ‘peak’ samples. None of the samples treated in the pre-peak period exhibited an effective amount of supplementary mandibular growth. CONCLUSIONS: One-third of the samples in the 22 studies showed an effective supplementary elongation in total mandibular length as a result of treatment with functional appliances. None of the four RCTs described the effectiveness of functional therapy. The effectiveness of functional appliances on mandibular growth is signifi cantly greater if treatment is performed at the adolescent growth spurt or slightly thereafter.

Forty years of clinical research on functional jaw orthopaedics: a systematic review / T. Baccetti; L. Franchi; L. De Toffol; P. Cozza. - In: EUROPEAN JOURNAL OF ORTHODONTICS. - ISSN 1460-2210. - STAMPA. - 30:(2008), pp. e44-e44.

Forty years of clinical research on functional jaw orthopaedics: a systematic review.

BACCETTI, TIZIANO;FRANCHI, LORENZO;
2008

Abstract

AIM: To evaluate the effectiveness and timing of Class II treatment with functional appliances by means of a systematic review of the literature of the last 40 years. MATERIALS AND METHOD: A systematic review of the literature was performed on the articles written in English from January 1967 to January 2007. The survey was conducted on the Medline database and used the MeSH terms ‘malocclusion, Angle Class II’ and ‘functional, appliances’. The retrieved studies had to analyze cephalometrically the effects of functional therapy on mandibular dimensions (including total mandibular length as measured by using the anatomical point Condylion) with respect to untreated Class II controls. Modifi cation in total mandibular length in Class II patients treated with functional appliances when compared with untreated Class II controls (supplementary mandibular growth) was calculated, and it was considered effective when it was greater than 3.0 mm, i.e. the amount of defi ciency in mandibular growth in subjects with untreated Class II malocclusion when compared with subjects with normal occlusion. RESULTS: Twenty-two articles qualifi ed for the fi nal review analysis [four randomized controlled clinical trials (RCTs), two prospective controlled clinical trials (CCTs), and 16 retrospective CCTs]. Ten out of 32 samples in the 22 studies described effectiveness in producing supplementary growth along total mandibular length. Seven of the 22 studies included in the review reported information about actual skeletal maturity of analyzed subjects by means of a biological indicator (hand and wrist analysis, cervical vertebral maturation method). Of these seven studies, six samples received treatment before the pubertal peak in skeletal growth, while in three treatment included the pubertal peak. The amount of actual supplementary mandibular growth induced by treatment (as measured by Co-Gn or Co-Pg) was effective in all the ‘peak’ samples. None of the samples treated in the pre-peak period exhibited an effective amount of supplementary mandibular growth. CONCLUSIONS: One-third of the samples in the 22 studies showed an effective supplementary elongation in total mandibular length as a result of treatment with functional appliances. None of the four RCTs described the effectiveness of functional therapy. The effectiveness of functional appliances on mandibular growth is signifi cantly greater if treatment is performed at the adolescent growth spurt or slightly thereafter.
2008
T. Baccetti; L. Franchi; L. De Toffol; P. Cozza
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/777348
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