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Fixed or removable function appliances for Class II malocclusions.

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  • 1Department of General Practice, VCU School of Dentistry, Richmond, Virginia, USA.

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Both fixed and removable functional appliances effectively reduce overjet in children with Class II malocclusions. However, current evidence is insufficient to determine differences in skeletal effects or patient experiences between fixed functional appliances and removable functional appliances (RFAs).

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Area of Science:

  • Orthodontics
  • Pediatric Dentistry
  • Craniofacial Biology

Background:

  • Class II malocclusion is a common dental anomaly in growing children.
  • Functional appliances are used to correct skeletal discrepancies in Class II malocclusions.
  • Fixed and removable functional appliances (RFAs) are two main categories of treatment.

Purpose of the Study:

  • To compare the effectiveness of fixed functional appliances versus removable functional appliances (RFAs) in treating Class II malocclusions in children.
  • To evaluate skeletal and dental changes, treatment duration, patient experiences, and harms associated with both types of appliances.

Main Methods:

  • Systematic review and meta-analysis (planned) of Randomized Controlled Trials (RCTs) and Controlled Clinical Trials (CCTs).
  • Searched multiple databases (Embase, Cochrane, Medline, Web of Science, etc.) with no language or date restrictions.
  • Included studies compared fixed functional appliances with RFAs in children under 16 with Class II malocclusions.

Main Results:

  • Four trials (2 RCTs, 2 CCTs) were included; three had high risk of bias, precluding meta-analysis.
  • Both fixed and removable appliances showed improvements in overjet and skeletal discrepancies.
  • Some fixed appliances demonstrated shorter treatment times, but results varied; fixed appliances had better compliance but more emergency visits.

Conclusions:

  • Limited evidence suggests both fixed and removable functional appliances are effective for overjet reduction in growing children.
  • Insufficient evidence exists to differentiate between fixed and removable functional appliances regarding biological effects or patient-reported outcomes.
  • Further high-quality research is needed to guide clinical decision-making.