Patient dependent factors for the efficient treatment of class ii malocclusion Lorenzo Franchi Episode 30 IOC 2020

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Farooq Ahmed

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 =+128
      • Good responders =123 o -128 o
      • Excellent responders =-123 o
    • Predictive variable: Gender, age, cephalomertric variables = Only Co-Go-Me predictive variable


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)
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