Timing of functional appliance treatment of class 2 correction
Meta analysis Perinetti 2015:
- Mandibular length increase:
- Pre puberal: 9mm
- Pubertal: 2.9mm
Ideal time for removable appliances CS3
- Approximately 3mm of mandibular growth
- Shorter duration of total therapy 2.5years Vs 4 years (pre pubertal) Tulloch 2004
- Less time in fixed appliances compared to fixed functional appliances
- Good stability, as ends at post pubertal stage
Compliance of removable functional appliance
- Part time Vs full time Parekh 2019 – No difference in skeletal or dento-alveolar changes
Individual responsiveness to functional appliance therapy
- Ideal timing of functional appliance still results in variation to functional appliances, 1-13mm at CS 13mm Baccetti 2001
- Good responders Vs bad responders Franchi 2006
- Mandibular angle = Co-Go-Me
- Poor responders =+128o
- Good responders =123 o -128 o
- Excellent responders =-123 o
- Predictive variable: Gender, age, cephalomertric variables = Only Co-Go-Me predictive variable
- Mandibular angle = Co-Go-Me
What are the long term effects of functional appliance therapy Pavoni 2017
- Prepubertal treatment – showed acceleration of growth, but no long term (Age 9.4-17)
- Pubertal treatment – showed increased overall growth long term 5mm (Age 10-18)
