Functional Appliances Effectiveness and Stability of Treating Class II Skeletal Malocclusion: A Systematic Review
Author(s): Nancy Ajwa*
Abstract
Background: Skeletal malocclusion is a serious condition, which has many complications that affect oral health as causing dental trauma and mastication difficulties. There are many strategies for correction of class II malocclusion in growing age, including the use of functional appliance as a growing modification. The functional appliance aims to modify the position of mandible sagittal and vertically and to induce lengthening of the mandible by increasing the growth at condylar cartilage. Therefore, these appliances have the maximum effect when applies early, among the growing phase.
Aim: The current review aimed to systematically assess the literature on the effectiveness of fixed and removable functional appliances and determines its stability results among growing patients with skeletal class II malocclusion.
Material and methods: A systematic review was conducted where clinical trials were analyzed and published up to 2020, respecting years of seniority. The current systematic review of literature is carried out in view of the most essential points of the report for systematic reviews. The search question was developed following the PICO standards.
Results: The search identified a total of 5639 papers for screening after the removal of duplicate articles. Among the retrieved studies, 5376 papers did not meet the study inclusion criteria. Consequently, 263 full text articles were retrieved and reviewed. Finally, 10 papers that fulfilled all the inclusion criteria were selected and reviewed systematically. Quality assessment of the final articles was appraised for the risk of bias by one independent reviewer using a well formulated quality assessment tool.
Conclusion: Accordingly, it can be concluded that Fixed Appliances (FA) have a higher restriction on maxillary development, while Removable Appliances (RA) have a more significant effect on mandibular development. RA is more preferred for patients due to higher comfort levels; patients' speech is a reasonable and immediate improvement in patient appearance.