Class 2 and growth modulation. So near yet so far. Nikhilesh Vaid. Part 2. Episode 24. September 2nd 2020

Play episode
Hosted by
Farooq Ahmed

Part 2: Nikhilesh explores the use of class 2 elastics, myobraces, growth and success.


Conclusions from part 1 and 2


  • No advantage of early treatment
  • No difference in self esteem with early treatment
  • 20% failure of removable class 2 appliances
  • Patients prefer fixed functional appliances



Question 9 Dento-alveolar correction worth it?

  • If the results are stable = yes
  • Drop outs for removable appliances 19%


Question 10 Use of class 2 elastics?

  • Duration to achieve overjet correction
    • 8/12 Vs Forsus 4.5/12 Arora 2018
    • Side effects of class 2 elastics
      • Extrusion and palatal tipping of Ui
      • Clockwise rotation of occlusal plane (forsus anticlockwise rotation)


Question 11 Myobraces – off the shelf appliances?


  • Activator appliances is more effective than Myobrace by 1mm Idris 2018
  • Cost-benefit analysis however favours myobraces: Cirgic 2018


Question 12 Future growth


  • No consensus about future growth prediction
  • Relapse is unpredictable
    • Nikhilesh recommends 1 year appliance use due to:
      • Minimising subnormal growth affects
      • Time for bone to mature
      • Minimise relapse


Question 13 Criteria for success:

  • Cervical Spine Maturation 3 (CM3)
  • CL2 molars
  • CO-GO-ME 1250 – reduced vertical component Franchi & Bacetti







Arora, V., Sharma, R. and Chowdhary, S., 2018. Comparative evaluation of treatment effects between two fixed functional appliances for correction of Class II malocclusion: A single-center, randomized controlled trial. The Angle Orthodontist88(3), pp.259-266.


Idris, G., Hajeer, M.Y. and Al-Jundi, A., 2012. Acceptance and discomfort in growing patients during treatment with two functional appliances: a randomised controlled trial. European journal of paediatric dentistry13(3), pp.219-224.


Franchi, L. and Baccetti, T., 2006. Prediction of individual mandibular changes induced by functional jaw orthopedics followed by fixed appliances in Class II patients. The Angle Orthodontist76(6), pp.950-954.


Join the discussion

More from this show