Functional appliance treatment assessed using the PAR index

Area of Science:

• Orthodontics
• Pediatric Dentistry

Background:

• Class II, division 1 malocclusions are common in children.
• Functional appliances are used to treat these malocclusions.
• The Peer Assessment Rating (PAR) Index is used to assess treatment outcomes.

Purpose of the Study:

• To determine if lower incisor proclination affects the assessment of treatment outcomes in children with Class II, division 1 malocclusions treated with functional appliances.
• To evaluate the effectiveness of functional appliance treatment before and after adjusting for lower incisor proclination.

Main Methods:

• Fifty-one children (10-13 years) with Class II, division 1 malocclusions were randomly assigned to an untreated group, Fränkel function regulators, or Harvold activators.
• Study casts were assessed at baseline and 6, 12, and 18 months.
• Lateral cephalometric radiographs measured incisor inclination at baseline and 18 months.

Main Results:

• PAR scores decreased by over 30% in 33% of the Fränkel group and 75% in the Harvold group.
• After adjusting for lower incisor proclination, 66% of cases showed "worse/no different" outcomes in both treated groups.
• 33% of treated cases showed "improved" outcomes after adjustment.

Conclusions:

• Functional appliance treatment for Class II, division 1 malocclusions may yield less favorable results when lower incisor proclination's effect on overjet is accounted for.
• The use of functional appliances should be limited to carefully selected cases.
• Further research is needed to refine treatment protocols for malocclusions involving incisor proclination.