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
- Nikhilesh recommends 1 year appliance use due to:
Question 13 Criteria for success:
- Cervical Spine Maturation 3 (CM3)
- CL2 molars
- CO-GO-ME 1250 – reduced vertical component Franchi & Bacetti
References
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 Orthodontist, 88(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 dentistry, 13(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 Orthodontist, 76(6), pp.950-954.
