Improvement in Soft Tissue Profile & Upper Airway Dimensions Following Forsus FRD – A Prospective Clinical Study


Affiliations

  • AFMC, Dental Unit, Pune, Department of Orthodontics and Dentofacial Orthopaedics, Maharashtra, 411010, India
  • ADC (R&R), Delhi, Department of Orthodontics and Dentofacial Orthopaedics, Delhi, 110010, India

Abstract

Aim: To assess improvement of soft tissue profile and upper airway dimensions in skeletal Class II adolescent patients treated with Forsus Fatigue Resistant Device (FRD). Material and Methods: This prospective observational study was planned with a sample size of 15 subjects (5 male & 10 female) diagnosed with mandibular hypoplasia as a cause of Class II malocclusion, requiring fixed functional therapy, with the inclusion criteria of age of 16-25 yrs with the ANB value range of 4°+2° with a non-extraction treatment plan. Pre-functional records were recorded once the leveling and alignment phase was complete and Forsus FRD attachments were placed. Treatment continued till the desired objectives were achieved. Post functional records were made at the end of functional therapy, after removal of Forsus FRD. Along with soft tissue analysis on lateral cephalogram, Acoustic Pharyngometry (AP) was recorded for each patient (Eccovision®†(sleep group solutions Florida, US) for airway changes before and after Forsus FRD. Results: Post functional treatment indicated statistically significant changes in nasolabial angle, upper lip position, upper lip strain, H angle and mento-labial sulcus. On evaluation of upper airway dimensions of the subjects by pharyngometry , there were statistically significant changes in mean upper airway volume and area. Conclusion: Study concluded that Forsus FRD is an effective method for correction of skeletal Class II malocclusion among adolescent patients, enhancing marked improvement in soft tissue profile of the patients, along with significant increase in volume and area of hypopharyngeal and oropharyngeal spaces, thus improving the upper airway patency.

Keywords

Acoustic Pharyngometry, Forsus FRD, Soft Tissue Profile, Upper Airway

Subject Discipline

Dentistry, Orthodontics & Dentofacial Orthopaedics

Full Text:

References

Krogman MR. The role of genetic factors in the human face, jaws and teeth. A review.The Eugen Rev 1967; 59: 161–91.

McNamara JA Jr. Components of Class II malocclusion in children 8–10 years of age. Angle Orthod 1981; 51: 177–202.

Gunay EA, Arun Talbantgtil D. Evaluation of the immediate dentofacial changes in late adolscent patients treated with the Forsus FRD. Eur J Orthod 2011; 5: 423–31. https:// doi.org/10.1055/s-0039-1698915

GraberT, Vanarsdall Jr, Vig K. Orthodontics current principles & techniques. 6th ed. St Louis Missouri: Elsevier, 2005: 396–00.

Ritto AK, Ferreira AP. Fixed functional appliances–A classification. Funct Orthod. 2000; 17: 2–32.

Panigrahi P,Vineeth V. Biomechanical effects of fixed functional appliance on craniofacial structures. Angle Orthod 2009; 79: 668–75. https://doi.org/10.2319/052708-281.1

Taki AA, Ghaffarpasand A. Effects of functional appliance therapy on the depth of the pharyngeal airways: Activator vs Forsus. J Dent Health Oral Disord Therapy 2015; 3: 1–7. https://doi.org/10.15406/jdhodt.2015.03.00082

Alhammadi MS, Halboubi E, Fayad MS, Labib A, Saidi CE. Global distribution of malocclusion traits: A systemic review. Dent Press J Orthod 2018; 23: 1–10. https://doi.org/10.1590/2177-6709.23.6.40.e1-10.onl

Siddegowda R, Satish RM. The prevalence of malocclusion and its gender distribution among school children: An epidemiological survey. SRM J Res Dent Sci 2014; 5: 224–9. https://doi.org/10.4103/0976-433X.145118

Vogt W.The forsus fatigue resistant device. J Clin Orthod 2006;13: 368–76.

Heinig N, Goz G. Clinical application and effects of the Forsus spring. J Orthofac Orthop 2001; 6: 436–41. https://doi.org/10.1007/s00056-001-0053-6

Jones G, Buschang P, Kim B, Oliver D. Class II non-extraction patients treated with the Forsus fatigue resistant device versus intermaxillary elastics. Angle Orthod 2008; 79: 322– 38. https://doi.org/10.2319/030607-115.1

Shahid F, Alam MK, Irshad M, Alswilem R, Ganji K. Forsus fatigue resistant device a fixed functional appliances: An update. Int Med J 2017; 24: 132–5.

Franchi L, Alvetro L, Giuntini V, Masucci C, Defraia E, Baccetti T. Effectiveness of comprehensive fixed appliance treatment used with the Forsus fatigue resistant device in Class II patients. Angle Orthod 2011; 81: 678–83. https://doi.org/10.2319/102710-629.1

Chaudhary DC, Kumar P, Sharma M, Nehra K. Comparative evaluation of soft tissue changes one year post-functional in Twin Block and Forsus FRD treated patients. MJAFI 2015; 8: 644–8.

Mir CF, Major MP, Major PW. Soft tissue changes with fixed functional appliances in Class II division 1. A systematic review. Angle Orthod 2006; 76: 712–20.

Gohilot A, Pradhan T, Keluskar KM. Comparison of dentoskeletal and soft tissue changes seen in Class II division I malocclusion using Forsus fatigue resistant device, Churro Jumper and Herbst Appliance – A randomized clinical trial. Orthod Cyber J 2013; 1:1–14.

Fujita S, Michigan T. Obstructive sleep apnea syndrome: pathophysiology, upper airway evaluation and surgical treatment. ENT J 1993; 72: 67–76. https://doi.org/10.1177/014556139307200115

Urzo AD, Lawson VG, Vassal KP. Airway area by acoustic response measurements and computerized tomography. Am Rev Respir Dis 1987; 125: 392–8.

Rossi RC, Rossi NJ, Rossi NC, Fijuya RR, Pignatari SN. Functional appliance in treatment of sleep apnea in children: A systemic review. Otolaryngol 2015; 5: 1–7. https://doi.org/10.4172/2161119X.1000212

Quintao C, Helena V, Brunharo P, Menezes C, Almeeida M. Soft tissue facial profile changes following functional appliance therapy. Eur J Orthod 2006; 28: 35–41. https://doi.org/10.1093/ejo/cji067

Kamal I. Normal standard curve for acoustic pharyngometry. Otolaryng head and neck surgery 2001: 323–30. https://doi.org/10.1067/mhn.2001.113136

Vompi C, Germano F, Martino O, Lombardi S, Talocci V. Effects of functional appliances on pharyngeal airways in patients with Class II malocclusions: A literature review. Web Med Cent 2019; 1: 1–5.

Xiang M, Hu B, Liu Y, Sun J. Changes in airway dimensions following functional appliances in growing patients with skeletal class II malocclusion: A systematic review and meta-analysis. Int J Paed Otorhino 2017; 97: 170–80. https://doi.org/10.1016/j.ijporl.2017.04.009

Temani P, Jain P, Rathee P, Temani R. Volumetric changes in pharyngeal airway in Class II division 1 patients treated with Forsus fixed functional appliance: A three-dimensional cone beam computed tomography study. Contemp Clin Dent 2016; 7: 31–5. https://doi.org/10.4103/0976-237X.177100


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