Treatment timing for functional jaw orthopaedics followed by fixed appliances: a controlled long-term study
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Objective: To evaluate the role of treatment timing on long-term dentoskeletal effects of Class II treatment with removable functional appliances followed by full-fixed appliance therapy. Materials and methods: A group of 46 patients (23 females and 23 males) with Class II malocclusion treated consecutively with either Bionator or Activator, followed by fixed appliances was compared with a matched control group of 31 subjects (16 females and 15 males) with untreated Class II malocclusion. The treated sample was evaluated at T1, start of treatment (mean age: 9.9 ± 1.3 years); T2, end of functional treatment and prior to fixed appliances (mean age: 11.9 ± 1.3 years); and T3, long-term observation (mean age: 18.3 ± 2.1 years). The treated and the control samples were divided into pre-pubertal and pubertal groups according to skeletal maturity observed at the start of treatment. Statistical comparisons were performed with independent sample t-tests. Results: When treatment was initiated before puberty, Class II correction was mostly confined to the dentoalveolar changes, with significant improvements of both overjet and molar relationships. On the other hand, treatment with the outset at puberty produced significant long-term improvement of sagittal skeletal relationships, which were mainly sustained by mandibular changes. Conclusions: Treatment with removable functional appliances (Bionator or Activator) followed by full-fixed appliances produced significant skeletal long-term changes when it begins at puberty. Prepubertal Class II treatment results primarily in dentoalveolar changes.
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In patients treated before the pubertal period, the significant effects of functional appliances seem to be confined to the dentoalveolar level, with minimal clinical implications.
“In patients treated before the pubertal period, the significant effects seems to be confined to the dentoalveolar level, with minimal clinical implications.”
From Effectiveness of functional orthodontic appliances in obstructive sleep apnea treatment in children: literature review (2022) · cites this paper as [15]
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- Authors
- Pavoni, C., Lombardo, E. C., Lione, R., Faltin, K., McNamara, J. A., Cozza, P., & Franchi, L.
- Affiliations
- University of Rome Tor Vergata (IT)
- Universidade Paulista (BR)
- University of Michigan (US)
- University of Florence (IT)
- Corresponding author
- Franchi, Lorenzo
- Venue
- European Journal of Orthodontics
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-11-01
- Volume
- 40
- Issue
- 4
- Pages
- 430-436
- ISSN
- 0141-5387 (ISSN-L)
- 1460-2210
- OpenAlex
- W2765948530
- Cited by
- 41
- References
- 31
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 7 · 2022: 2 · 2021: 6 · 2020: 4 · 2019: 5
- FWCI
- 3.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- European Journal of Orthodontics (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion, other-oa)
- Florence Research (University of Florence) (submittedVersion)
- Topics
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › dental development and anomalies
- Keywords
- treatment timing, Class II malocclusion, functional orthodontic appliances, Bionator, activators, fixed orthodontic appliances, puberty onset, mandibular changes, overjet, molar relationship, dentoalveolar changes
- MeSH terms
- Orthodontic Appliances, Fixed, Activator Appliances, Adolescent, Adult, Cephalometry, Child, Female, Humans, Longitudinal Studies, Male, Malocclusion, Angle Class II, Mandible, Orthodontics, Corrective, Sexual Maturation, Time Factors, Treatment Outcome, Orthodontic Appliances, Functional, Young Adult, Overbite
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