Dentoskeletal effects of the forsus™ fatigue resistance device in the treatment of class II malocclusion: A systematic review and meta-analysis

Amal I Linjawi, Mona A Abbassy, Amal I Linjawi, Mona A Abbassy

Abstract

Objective: The aim of this systematic review and meta-analysis is to quantitatively compare previous studies that evaluated skeletal and dentoalveolar effects of the Forsus™ Fatigue Resistance Device (FRD) in the treatment of Class II malocclusion with a matched untreated control group.

Materials and methods: Four electronic searches PubMed, Web of Science, Cochrane Library, and Science Direct that were limited to articles on human studies comparing the effect of Forsus appliance with a matched control group in the treatment of Class II malocclusion from the year (2000-2017). An additional manual search was carried out by examining the references of the included articles, SEARCH terms included; Forsus and Class II malocclusion. The quality of the included studies was assessed using the modified methodological score for clinical trials. The data were analyzed using Michael Borenstein's Comprehensive Meta-Analysis Software (V3.3.070, Biostat, Inc., US).

Results: Seven studies were included comprising 273 participants (Forsus group = 142; control group = 131). The results indicated a statistical significant skeletal effect of the Forsus appliance on increasing the occlusal plane only (P < 0.001). The results also indicated a statistical significant (P < 0.001) dentoalveolar effects of the Forsus appliance on the following outcomes; protruding, proclining, and intruding lower incisors; retroclining upper incisors, distalizing and intruding upper molars, as well as reducing overjet and overbite.

Conclusions: The Forsus™ showed positive effects on the maxillary incisors and first molars as well as overjet and overbite. However, multiple negative effects were reported on the occlusal plane and lower incisors that need to be considered when using such appliance in treating Class II malocclusion.

Keywords: Class II malocclusion; Forsus; dental changes; dentoalveolar changes; skeletal changes.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of the systematic search and selection strategy

References

    1. Moyers RE, Riolo ML, Guire KE, Wainright RL, Bookstein FL. Differential diagnosis of class II malocclusions. Part 1. Facial types associated with class II malocclusions. Am J Orthod. 1980;78:477–94.
    1. McNamara JA., Jr Components of class II malocclusion in children 8-10 years of age. Angle Orthod. 1981;51:177–202.
    1. Proffit WR, Fields HW, Sarver DM. Contemporary Orthodontics. St Louis, Mo: Mosby Inc; 2012.
    1. Aras A, Ada E, Saracoǧlu H, Gezer NS, Aras I. Comparison of treatments with the Forsus fatigue resistant device in relation to skeletal maturity: A cephalometric and magnetic resonance imaging study. Am J Orthod Dentofacial Orthop. 2011;14:616–25.
    1. McSherry PF, Bradley H. Class II correction-reducing patient compliance: A review of the available techniques. J Orthod. 2000;27:219–25.
    1. Bertl MH, Mandl C, Crismani AG. Do functional orthodontic appliances stimulate mandibular growth in class II division 1 patients? Int J Stomatol Occlusion Medicinent. 2011;4:45–53.
    1. Cozza P, Baccetti T, Franchi L, De Toffol L, McNamara JA., Jr Mandibular changes produced by functional appliances in Class II malocclusion: A systematic review. Am J Orthod Dentofacial Orthop. 2006;129:599.e1–12.
    1. Karacay S, Akin E, Olmez H, Gurton AU, Sagdic D. Forsus Nitinol Flat Spring and Jasper Jumper corrections of Class II division 1 malocclusions. Angle Orthod. 2006;76:666–72.
    1. Cacciatore G, Ghislanzoni LT, Alvetro L, Giuntini V, Franchi L. Treatment and posttreatment effects induced by the Forsus appliance: A controlled clinical study. Angle Orthod. 2014;84:1010–7.
    1. Zymperdikas VF, Koretsi V, Papageorgiou SN, Papadopoulos MA. Treatment effects of fixed functional appliances in patients with Class II malocclusion: A systematic review and meta-analysis. Eur J Orthod. 2016;38:113–26.
    1. Celikoglu M, Buyuk SK, Ekizer A, Unal T. Treatment effects of skeletally anchored Forsus FRD EZ and Herbst appliances: A retrospective clinical study. Angle Orthod. 2016;86:306–14.
    1. Bilgic F, Hamamci O, Basaran G. Comparison of the effects of fixed and removable functional appliances on the skeletal and dentoalveolar structures. Aust Orthod J. 2011;27:110–16.
    1. Cacciatore G, Alvetro L, Defraia E, Ghislanzoni LT, Franchi L. Active-treatment effects of the Forsus fatigue resistant device during comprehensive Class II correction in growing patients. Korean J Orthod. 2014;44:136–42.
    1. Heinrichs DA, Shammaa I, Martin C, Razmus T, Gunel E, Ngan P. Treatment effects of a fixed intermaxillary device to correct class II malocclusions in growing patients. Prog Orthod. 2014;15:45.
    1. Shen G, Hägg U, Darendeliler M. Skeletal effects of bite jumping therapy on the mandible-removable vs.fixed functional appliances. Orthod Craniofac Res. 2005;8:2–10.
    1. Tarvade SM, Chaudhari CV, Daokar SG, Biday SS, Ramkrishna S, Handa AS. Dentoskeletal comparison of changes seen in Class II cases treated by Twin Block and Forsus. J Int Oral Health. 2014;6:27–31.
    1. Turkkahraman H, Eliacik SK, Findik Y. Effects of miniplate anchored and conventional Forsus Fatigue Resistant Devices in the treatment of Class II malocclusion. Angle Orthod. 2016;86:1026–32.
    1. Aslan BI, Kucukkaraca E, Turkoz C, Dincer M. Treatment effects of the Forsus Fatigue Resistant Device used with miniscrew anchorage. Angle Orthod. 2014;84:76–87.
    1. Bilgic F, Basaran G, Hamamci O. Comparison of Forsus FRD EZ and Andresen activator in the treatment of class II, division 1 malocclusions. Clin Oral Investig. 2014;19:445–51.
    1. Gunay EA, Arun T, Nalbantgil D. Evaluation of the Immediate Dentofacial Changes in Late Adolescent Patients Treated with the Forsus (TM) FRD. Eur J Dent. 2011;5:423–32.
    1. Aidar LA, Abrahão M, Yamashita HK, Dominguez GC. Herbst appliance therapy and temporomandibular joint disc position: A prospective longitudinal magnetic resonance imaging study. Am J Orthod Dentofacial Orthop. 2006;129:486–96.
    1. Aidar LA, Dominguez GC, Yamashita HK, Abrahão M. Changes in temporomandibular joint disc position and form following Herbst and fixed orthodontic treatment. Angle Orthod. 2010;80:843–52.
    1. Hanoun A, Al-Jewair TS, Tabbaa S, Allaymouni MA, Preston CB. A comparison of the treatment effects of the Forsus Fatigue Resistance Device and the Twin Block appliance in patients with class II malocclusions. Clin Cosmet Investig Dent. 2014;6:57–63.
    1. Heinig N, Göz G. Clinical application and effects of the Forsus spring. A study of a new Herbst hybrid. J Orofac Orthop. 2001;62(6):436–50.
    1. Servello DF, Fallis DW, Alvetro L. Analysis of Class II patients, successfully treated with the straight-wire and Forsus appliances, based on cervical vertebral maturation status. Angle Orthod. 2015;85:80–6.
    1. Franchi L, Alvetro L, Giuntini V, Masucci C, Defraia E, Baccetti T. Effectiveness of comprehensive fixed appliance treatment used with the Forsus Fatigue Resistant Device in Class II patients. Angle Orthod. 2011;81:678–83.
    1. Felty TL. The effectiveness of the Forsus (TM) fatigue resistant device: A systematic review: Temple University. 2012
    1. Lagravere MO, Major PW, Flores-Mir C. Long-term skeletal changes with rapid maxillary expansion: A systematic review. Angle Orthod. 2005;75:1046–52.
    1. Sharshar HH, El-Bialy TH. Cephalometric evaluation of airways after maxillary anterior advancement by distraction osteogenesis in cleft lip and palate patients: A systematic review. Cleft Palate Craniofac J. 2012;49:255–61.
    1. Swiglo BA, Murad MH, Schünemann HJ, Kunz R, Vigersky RA, Guyatt GH, et al. A case for clarity, consistency, and helpfulness: State-of-the-art clinical practice guidelines in endocrinology using the grading of recommendations, assessment, development, and evaluation system. J Clin Endocrinol Metab. 2008;93:666–73.
    1. Oztoprak MO, Nalbantgil D, Uyanlar A, Arun T. A cephalometric comparative study of class II correction with Sabbagh Universal Spring (SUS(2)) and Forsus FRD appliances. Eur J Dentistry. 2012;6:302–10.
    1. Jones G, Buschang PH, Kim KB, Oliver DR. Class II non-extraction patients treated with the Forsus Fatigue Resistant Device versus intermaxillary elastics. Angle Orthod. 2008;78:332–8.
    1. Gao W, Li X, Bai Y. An assessment of late fixed functional treatment and the stability of Forsus appliance effects. Aust Orthod J. 2014;30:2–10.
    1. Elkordy SA, Abouelezz AM, Fayed MM, Attia KH, Ishaq RA, Mostafa YA. Three-dimensional effects of the mini-implant-anchored Forsus Fatigue Resistant Device: A randomized controlled trial. Angle Orthod. 2016;86:292–305.
    1. Giuntini V, Vangelisti A, Masucci C, Defraia E, McNamara JA, Franchi L. Treatment effects produced by the Twin-block appliance vs the Forsus Fatigue Resistant Device in growing Class II patients. Angle Orthod. 2015;85:784–9.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する