Complications encountered during Forsus Fatigue Resistant Device therapy

ABSTRACT Introduction: Fixed functional appliances are non-compliant solutions to Class II malocclusion treatment. The clinician, however, should be careful of unexpected complications during the therapy. Methods: 58 female adolescents who presented with Class II malocclusion due to deficient mandible were treated with Forsus Fatigue Resistant Device (FFRD) therapy until an overcorrection to an edge to edge incisor relationship was achieved. Results: Incisor relationship and overjet were corrected successfully in all the subjects. Twenty-two patients had a complications-free treatment, while several complications were encountered with the remaining 36 subjects. In particular, mandibular canine rotation and development of posterior crossbites were the most common complications, with percentages of 51.7% and 25.9% respectively. Other complications included the breakage and shearing of the extraoral tubes of the first molar bands, and excessive intrusion of the upper first molars. Conclusions: FFRD is an efficient appliance for treatment of Class II malocclusion; however, different complications were encountered during the appliance therapy. A focus on taking precautions and applying preventive measures can help to avoid such problems, reducing the number of emergency appointments and enhancing the treatment experience with the appliance.

RESUMO Introdução: Os aparelhos funcionais fixos são uma solução para o tratamento da má oclusão de Classe II em pacientes não colaboradores. Porém, o ortodontista deve estar ciente das complicações inesperadas decorrentes do seu uso. Métodos: Cinquenta e oito pacientes adolescentes do sexo feminino com má oclusão de Classe II por deficiência mandibular foram tratadas com o aparelho Forsus FRD até se alcançar uma sobrecorreção, com relação de topo a topo dos incisivos. Resultados: A relação entre os incisivos e a sobressaliência foram corrigidas com sucesso em todas as pacientes. Vinte e duas pacientes não apresentaram complicações durante o tratamento, enquanto as demais trinta e seis pacientes apresentaram diferentes complicações. As complicações mais comuns foram a rotação do canino inferior e o desenvolvimento de mordida cruzada posterior, com prevalência de 51,7% e 25,9%, respectivamente. As demais complicações incluíram quebra e cisalhamento dos tubos extrabucais das bandas dos primeiros molares, e intrusão excessiva dos primeiros molares superiores. Conclusões: O FRD é um aparelho eficiente para o tratamento da má oclusão de Classe II. No entanto, diferentes complicações foram encontradas durante o uso desse aparelho. O foco na tomada de precauções e em medidas preventivas pode ajudar a evitar tais complicações, reduzindo o número de consultas de emergência e melhorando a experiência do paciente no tratamento com esse aparelho.

The effect of unilateral Forsus appliance in the treatment of ClassⅡmalocclusion subdivision / 口腔疾病防治

Objective @# To assess the result of treatment in ClassⅡmalocclusion subdivision with unilateral Forsus appliance. @*Methods @#23 patients with ClassⅡmalocclusion subdivision were selected, who were treated with Straight wire fixed appliance in combination with unilateral Forsus appliances while another 27 patients were untreated as control group. Lateral cephalographs were taken before and after the comprehensive treatment, and the indicators of dental, skeletal, and soft tissue profile were measured.@*Results @#The Forsus appliance can correct ClassⅡmalocclusion subdivision through distalizing the upper teeth and moving the lower teeth mesially. Midline can be corrected at the same time. There was a statistically significant difference in the amount of tooth movement (P < 0.05). @*Conclusion @#Forsus appliance is an effective device for treating ClassⅡmalocclusion subdivision, which can induce significant dental and soft tissue changes.

Eficiencia del forsus en el tratamiento de maloclusión clase II / Efficiency of forsus in the treatment of maloclusion class II

La maloclusión clase II es uno d los problemas más frecuentes de ortodoncia, ésta afecta a un tercio de los pacientes que buscan tratamiento ortodoncico. De acuerdo con McNamara, la causa más común de esta es la retrusión mandibular, más que el prognatismo maxilar. Entre los distintos aparatos ortopédicos funcionales removibles y dispositivos fijos, que no requieren la colaboración del paciente. El Forsus es uno de los aparatos fijos que se ha utilizado para mantener la mandíbula en un constante posición anterior y ha demostrado ser uno de los mejores métodos de tratamiento en maloclusiones Clase II. En el siguiente artículo se presenta el caso clínico de un paciente con maloclusión de Clase II esquelética y dentaria tratado con el aparato de Forsus para la corrección de la Clase II-1; lográndose mejorar notoriamente la relación esquelética y dentaria. El Forsus demostró ser una buena opción terapéutica en el tratamiento de las maloclusiones de Clase II. (AU)

Class II maloclusión is one of the most common problems in orthodontics, as it affects one third of the patients that are seeking for orthodontic treatment. According to McNamara, the cause most common is mandibular retrognatism had been used removable orthopedic appliances or fixes that don't need patient colaboration. The Forsus is one of the fixes appliances that had been used to keep the mandible in constant anterior position, it has been proved being one of the best treatment for class II malocclusion. In this case report, we show a patient with skeletal and dental class II treated with Forsus appliance for correction of class II-1, improving the dental and skeletal relationship. Forsus demonstrated be a good option in the treatment of class II malocclusion. (AU)

Management of Class II Malocclusion with Modification in Forsus Fatigue Resistance Device: A Case Report.

Management of class II malocclusion in adolescents by growth modulation is one of the most difficult and commonly encountered scenario in clinical orthodontics. Noncompliance has been a major concern for orthodontists. This case report describes the management of class II malocclusion in young adult with Forsus fatigue resistance device (3M Unitek, 2724 S., Peck Road, Monrovia, CA 91096; www.3Munitek.com), a fixed functional appliance, that is now most widely used for correction of Class II malocclusion. A common problem with this appliance is frequent debonding of mandibular canine brackets. The present article also describes a simple, chairside fabrication of acrylic button that will ensure prevention of debonding of brackets. This case report illustrates that functional appliances even today have a significant role in growth modulation that further minimizes the necessity of extraction of permanent teeth and orthognathic surgery.

Comparison of efficacy between modified forsus appliance and activator appliance in the treatment of class Ⅱ patients with madibular retrusion / 中华医学美学美容杂志

Objective To evaluate and analyze the effects between with modified Forsus appliance and activator in the treatment of class Ⅱ madibular retrusion.Methods 70 children with class Ⅱ malocclusion and mandibular retrusion were selected and divided into two groups:35 patients treated with this modified Forsus appliance (group A) and other 35 treated with activator (group B).Cephalometric radiographs were taken and analyzed at the pre-treatment time (T0) and the post-treatment time (T1) with the Pancherz analysis.Results The course of treatment was obviously different:the course of group A was (21.4±2.0) months,and group B was (27.3±2.5) months; the treatment course of group A was shorter than that of group B.After treatment,profiles of the two groups were obviously improved.The trends were similar in overjet and the molar relationship,SNB and ANB,with significant differences.But there was no significant difference between the results of the two groups.The change of occlusal plane was notably in group B.Conclusions Both the modified Forsus appliance and activator appliance combined with straight wire appliance can effectively stimulate the mandibular growth,balance the jaw relationship,and correct the class Ⅱ mandibular retrusion.But the modified Forsus appliance can effectively treat the class Ⅱ patients with the shorter course.And the same time,it can take effect continually without depending on the coordination of the patients.

Elastomeric Ligatures With Forsus Appliance - A Case Report.

One of the many fixed functional appliances is Forsus appliance. If incremental force is required with this appliance 2mm split crimps are placed onto the mandibular push button to increase pressure on the spring. This article describes a case report of a patient treated with fixed functional appliance therapy where a Forsus fatigue resistant device (FRD) is used with elastic ligatures.

Treatment of division II malocclusion in young adult with Forsus™ fatigue-resistant device.

The traditional technique for correcting class II malocclusion - involving the use of class II elastics and headgear - has been problematic due to its dependence on patient compliance. Functional orthopedic treatment seeks to correct malocclusions and harmonize the shape of the dental arch and orofacial functions. Removable functional appliances are normally very large in size, have unstable fixation, cause discomfort, exert pressure on the mucosa, reduce space for the tongue, cause difficulties in deglutition and speech, and very often affect esthetic appearance. With a fixed appliance like the Forsus™ fatigue-resistant device (FRD), as the appliance is fixed, there is less dependence on patient compliance and the remaining growth after the pubertal growth spurt can be harbored effectively. The Forsus™ FRD is not as rigid as the previous fixed functional appliances and hence is comfortable for the patients. In this case report we describe a patient at the end of the growth stage who had mandibular retrognathia and was successfully treated with the Forsus™ FRD.

Treatment of skeletal class II malocclusion using the “Forsus” appliance: A case report.

Fixed functional appliances are valuable tools introduced to assist in the correction of skeletal class II malocclusions at the deceleration stage of growth for achieving stable results. The most commonly used such appliances are the Herbst appliance and the Jasper jumper. The recent advance in the field of fixed functional appliance is the Forsus appliance. We are reporting a 16 year old patient with a skeletal class II malocclusion treated using the Forsus appliance. The appliance was worn for 4 months after the initial alignment with fixed mechanotherapy (MBT O22). The mandible was brought forward to a class I skeletal and dental relationship by the end of this treatment.

A Case Report of Growing Skeletal Class II Treated Forsus Fatigue Resistance Appliance.

Growing skeletal class II malocclusions with mandibular deficiency have been treated for more than a century with different types of functional appliances. Removable or fixed functional appliances are available to advance the mandible. Fixed functional appliances have the advantage of not requiring patient compliance. They can also be used concurrently with brackets. This case report documents the successful treatment of mild skeletal class II in late stages of puberty by using Forsus fatigue resistance appliance. The Forsus appliance is a three-piece, semi-rigid telescoping system incorporating a super-elastic nickel -titanium coil spring that can effectively brings the mandible forward in a relatively shorter treatment time. It is compatible with complete fixed orthodontic appliances and can be incorporated into preexisting appliances.

Effect of combined forsus appliance on dental arch and hard tissue of classⅡ~1 malocclusion / 实用口腔医学杂志

Objective:To investigate the treatment effect of combined forsus appliance on young people's Angel Ⅱ~1 malocclusion. Methods:13 Angel Ⅱ~1 cases during pre-peak or peak period was chosen, treated with combined forsus appliance for an average period of 5.5 months, evaluated treatment effect through cephalometric and cast measurement. Results: All canines and molars have reached class Ⅰ or over-class Ⅰrelations, 13 patients' mandibular retrognathia face have gained significant improvement. Conclusion: The combined forsus appliance can be used in early functional treatment, improve class Ⅱ face type and decrease the difficulty of the second period and enhanced treatment effect.

Eficiência no tratamento da má-oclusão de classe II com o aparelho forsus / Efficiency in class II treatment with forsus appliance

A falta de colaboração dos pacientes no uso de aparelhos removíveis para o tratamento da má oclusão de classe II tem sido amplamente divulgada na Ortodontia. Isso tem levado os ortodontistas a procurarem métodos de tratamento que independam da cooperação do paciente. Entre os inúmeros aparelhos que surgiram nos últimos anos para o tratamento da classe II um dos que mais tem conquistado adeptos é o aparelho Forsus. Esse artigo tem por finalidade fazer uma descrição desse aparelho, mostrando a sua eficiência na correção de um caso clínico. Os aspectos biomecânicos do emprego de tal dispositivo também são discutidos.

The lack of patient cooperation in the use of removable appliances for the treatment of class II malocclusion have been widely reported in Orthodontics. This has led to seek orthodontic treatment methods that do not depend on patient cooperation. Among the many devices that have emerged in recent years for the treatment of Class II one who has won more users is the Forsus appliance. This article aims to provide a description of this device, showing its effectiveness in the correction of a clinical case. The biomechanical aspects of using this device are also discussed.

The mechanical simulation analysis of instantaneous distal moving trend of the maxillary first molar in forsus / 重庆医科大学学报

Objective:To simulate the instantaneous distal moving trend of the maxillary first molar based on the three-dimensional finite element mode(l3-FEM)of Forsus distalizing the maxillary first molar with some visco-elastic-plastic characters and explore the favorable loading mode of molar distal movement in Forsus in order to provide biomechanical basis for clinical practice.Methods:A male patient with ClassⅡmalocclusion was selected.The 3-FEM of Forsus distalizing the maxillary first molar was built through spiral CT scanning,Mimics8.0,and Abaqus6.5 software.This study simulated instantaneous distal moving process of the maxillary first molar under three dif-ferent loading modes(loading force was 300 g,point of force was on the center of the crown's buccal surface,loading time was 1s),which included a distalizing force,a distalizing force+counterrotation moment,a distalizing force+countertipping moment+counterrotation moment.Results:When Forsus distalized the maxillary first molar,different loading modes lead to different PDL stress distributions.When the model was added by a distalizing force,the maxillary first molar would be relatively seriously inclined;when added by a distalizing force +counterrotation moment(Mt/F=9),the maxillary first molar would be relatively seriously rotated and when added by a distalizing force+ countertipping momen(tMt/F=9)+counterrotation momen(tMr/F=5),the distal surface of the PDL would bear the lightest stress,and the first molar would achieve approximate translation movement.Conclusion:When mandible is guided forward by Forsus,the maxillary first molar would achieve better molar translation effect if added certain countertipping and counterrotation moment