Class II Division 1 Malocclusion Clinical Trial
Official title:
Comparative Evaluation of Treatment Effects of PowerScope and Forsus Fixed Functional Appliance in Correction of Class II Malocclusion: A Single Centre Randomised Controlled Trial
The objective of this 2-arm parallel double blinded randomized controlled trial is was to evaluate and compare the treatment effects of PowerScope and Forsus in the treatment of Class II division 1 malocclusion. Patient comfort and operator convenience was also assessed and compared .
INTRODUCTION : Among different dental and skeletal combinations that can create a Class II
malocclusion, mandibular retrusion is one of the most common characteristics.In such cases,
to stimulate mandibular growth by forward positioning of the mandible, various removable and
fixed functional appliances are commonly used to alter the position of mandible during the
pubertal growth period.
Stimulation of mandibular growth, distal movement of upper dentition, mesial movement of
lower dentition contributes to correction of Class II malocclusion with the use of fixed
functional appliances. Of the various fixed functional appliances available to the
orthodontist today for the correction of Class II malocclusion are Forsus fatigue resistant
device which is the most popular fixed functional appliance6 and the PowerScope which is a
recent addition to the armamentarium.
PowerScope is delivered as a one-size-fits-all appliance pre-assembled with attachment nuts
for quick and easy chairside application. The appliance is a wire-to-wire installation with
attachments placed mesial to the first molar in the maxillary arch and distal to the canine
of the mandibular arch. Although there are a few case reports in the literature showing the
treatment effects and clinical application of PowerScope, there is not a single study
mentioning the effects of PowerScope appliance, which has a different status from other fixed
functional appliances due to its special attachment. The purpose of this clinical study was
to evaluate the skeletal and dental changes produced by the PowerScope and compare these
effects with one of the most commonly used fixed functional appliance the Forsus Fatigue
Resistant Device (FRD).
MATERIALS AND METHODS: The present study is a prospective, non-pharmacological, double blind,
randomised clinical study conducted in the department of Orthodontics and Dentofacial
orthopedics, PGIDS Rohtak.
The study sample consisted of 28 patients, were selected from subjects reporting to the
department for fixed orthodontic treatment.
The primary researcher explained the nature of the study to the patients and their parents
and their consent was taken. The final sample of 28 patients fulfilling the criteria were
randomly divided in two groups: Group 1( PowerScope group) and Group 2 (Forsus group) All
subjects in both the treatment groups were treated with MBT 0.022- inch slot preadjusted
edgewise appliance (Ortho Organizers, San Marcos, Calif). Both arches were levelled and
aligned upto 0.019" ×0.025" stainless steel wires and then the fixed functional appliance as
per the group mentioned in the patients envelop was installed.
Lateral cephalometric radiographs were taken before starting fixed functional appliance
therepy( T1) immediately (1-3 days) before placement of the fixed functional appliance (T2)
and after removal of the fixed functional appliance(T3). All cephalometric radiographs were
taken on the same cephalostat.
For evaluation of skeletal and dentoalveolar changes that contributed to the Class II
correction, pitchfork analysis was used.
To check patient comfort, all the patients were given a questionnaire. The questionnaire was
designed in English and then verbally translated into the patients and parents native
language at the installation appointment though all the patients and their parents could read
and understand it in English. After the installation all the patients were given the
questionnaire and requested to bring it at the next scheduled appointment after filling the
required details .
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