A Comparison of The Treatment Effects of the 3D Bimetric Distalizing Arch (3D-BMDA) and Forsus Fatigue Resistant Device (FRD) In Patients with Class II Malocclusion (A Cephalometric Study)
Alshebly, Mohamad N.
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Introduction: The objective of this study was to compare the skeletal and dental effects of the Forsus Fatigue Resistant Device (FRD) and the three-dimensional bimetric maxillary distalizing arch (3D-BMDA), which are two types of appliances used in Class II patients. Materials and method: This study was a retrospective clinical investigation that included 30 Forsus patients (15 females, 15 males) with a mean start age of 12.9 ± 1.3 years and 30 3D-BMDA patients (15 females, 15 males) with a mean start age of 12.7 ± 1.4 years compared with 30 untreated Class II patients with a mean start age of 13.1 ± 1.2years. The 3D-BMDA and Forsus were matched according to age, gender, and cervical maturation stage at all observation time. Pre-treatment (T1), at the completion of comprehensive therapy (T2), cephalograms were hand traced using the Modified Pancherz's cephalometric analysis, linear and angular measurements for mandibular dimensions, cranial base angulation, and vertical relationships were added to the original analysis. Statistical comparisons for the three groups were carried out with the ANOVA test (p < 0.05). Results: The skeletal contributions to the correction of the Class II malocclusion were greater in the Forsus group than it was in the 3D-BMDA group. The Forsus group showed a greater mandibular base advancement as compared to the 3D-BMDA. In the 3D-BMDA group the correction of the Class II malocclusion was mainly dentoalveolar in nature with a statistically significant retroclination of the upper anterior teeth. In both groups the dentoalveolar molar correction was mainly due to a maxillary first molar distalization rather than to a mesial movement of the mandibular molars. Conclusion: The Forsus and the 3D-BMDA are both effective appliances for Class II correction. In comparison to 3D-BMDA, the Forsus show that most of the molar correction and overjet correction in Forsus came from skeletal effect. While most of the molar correction in the 3D-BMDA group came from dentoalveolar effect, the largest contribution came from the maxillary molar distalization, and the most of 3D-BMDA overjet correction came from the proclination and mesial movement of the lower incisors.