Treatment Effects of Mini-implants and Functional Appliances in ClassII Malocclusions

Objectives:Moderate to severe Class II malocclusions can not only cause esthetic and functional problems but can also lead to psychological problems of varying intensity depending on the amount of anterior-posterior discrepancy and its interaction with the related soft tissue structures. Although there are several methods of treating such malocclusions (extractions,distalization,functional appliances etc), the final goal is always to provide acceptable esthetics and stability.The purpose of this clinical-cephalometric prospective study was to examine the dentoskeletal and soft tissue treatment effects of maxillary anterior teeth retraction with mini-implant (MI) anchorage in young adults having Class II Division I malocclusion undergoing extraction of only the maxillary first premolars in comparison with patients undergoing treatment with a non-extraction approach i.e using a fixed functional appliance(Forsus). Methods:35 patients (mean age 16.5±3.2 years,overjet ≥ 6mm) were randomly assigned to group 1(G1):correction of overjet with MIs as anchor units, or group 2 (G2): where fixed functional appliances were used. Dentoskeletal and soft tissue changes were analyzed on lateral cephalograms taken before(T1) and after(T2) the correction of overjet. Statistical analyses were performed using the Student's paired and unpaired't tests' Results: A statistically significant increase was noted in the facial vertical dimensions in G2, but the variables in G1 showed no significant differences(P>0.05). Extrusion and mesialization of the lower molar was noted in G2, whereas G1 showed distalization (anchorage gain) and intrusion of the upper molar. Facial convexity angle, nasolabial angle, and lip potrusion did not show any significant differences. Conclusions:The force system in G1 provided effective control over the posterior dentoalveolar segment while in G2 clockwise rotation of the mandible was noted. There was a dramatic improvement in the facial esthetics in both the groups however the different treatment methods used in the two groups did not yield any significant soft tissue differences.