Treatment effects produced by the Twin-block appliance vs the Forsus Fatigue Resistant Device in growing Class II patients

Objective: To compare the dentoskeletal changes produced by the Twin-block appliance (TB) followed by fixed appliances vs the Forsus Fatigue Resistant Device (FRD) in combination with fixed appliances in growing patients having Class II division 1 malocclusion. Materials and Methods: Twenty-eight Class II patients (19 females and 9 males; mean age, 12.4 years) treated consecutively with the TB followed by fixed appliances were compared with a group of 36 patients (16 females and 20 males; mean age, 12.3 years) treated consecutively with the FRD in combination with fixed appliances and with a sample of 27 subjects having untreated Class II malocclusion (13 females and 14 males; mean age, 12.2 years). Mean observation interval was 2.3 years in all groups. Cephalometric changes were compared among the three groups by means of ANOVA and Tukey's post hoc tests. Results: The FRD produced a significant restraint of the maxilla compared with the TB and control ;samples (SNA, -1.1 degrees and -1.8 degrees, respectively). The TB sample exhibited significantly greater mandibular advancement and greater increments in total mandibular length than either the FRD or control groups (SNB, 1.9 degrees and 1.5 degrees, respectively; and Co-Gn, 2.0 mm and 3.4 mm, respectively). The FRD produced a significantly greater amount of proclination of the mandibular incisors than what occurred with the TB or the control samples (2.9 degrees and 5.6 degrees, respectively). Conclusion: The TB appliance produced greater skeletal effects in terms of mandibular advancement and growth stimulation while the Forsus caused significant proclination of the mandibular incisors.