Current concepts on functional appliances and mandibular growth stimulation

Area of Science:

• Orthodontics
• Craniofacial development
• Growth stimulation

Background:

• The efficacy of functional appliances in orthodontics, specifically for stimulating mandibular growth, remains a subject of debate.
• Many existing studies on functional appliances suffer from methodological limitations, impacting the reliability of their findings.

Purpose of the Study:

• To critically evaluate the evidence regarding the effectiveness of functional appliances in stimulating mandibular growth.
• To emphasize the importance of high-quality research, such as prospective randomized clinical trials, in assessing orthodontic interventions.

Main Methods:

• Review of existing literature on functional appliances and their effects on mandibular growth.
• Prioritization of findings from prospective randomized clinical trials for assessment.
• Analysis of reported growth changes and long-term stability following treatment.

Main Results:

• Evidence does not support the conclusion that functional appliances effectively stimulate or increase mandibular growth in the long term.
• While some favorable growth changes may occur during phase 1 therapy, these effects are typically not substantial.
• Long-term stability of any observed growth changes following functional appliance therapy appears to be poor.

Conclusions:

• Based on current evidence, functional appliances cannot be definitively considered effective for substantial and stable long-term mandibular growth stimulation.
• Further high-quality research is needed to clarify the precise role and long-term impact of functional appliances in orthodontic treatment.
• The methodological quality of studies significantly influences the interpretation of functional appliance efficacy.