Removable Orthodontic Therapy - Clinics Or/and Science

Class II malocclusion is one of the most common orthodontic problems in our population, and the most consistent diagnostic finding is mandibular skeletal retrusion. There are many treatment approaches for the correction of this malocclusion with varying degrees of scientific support. In the last twenty years, functional appliances were widely used for correction of sagittal intermaxillary relationship in children, but mostly in Angle Class II treatment. One of the most controversial topics in orthodontics relates to the effectiveness of functional appliances on mandibular growth. Much of the debate about Class II treatment centres on the possibility of permanently increasing mandibular length, because an underdeveloped mandible is a common cause of Class II malocclusion. Functional appliances based their wide application on the hypothesis that they stimulate growth modification, which is only possible in patients with adequate growth amount, or potential, to correct maxilomandibular relationship, which is the reason why they should be used before or during adolescent growth spurt. Functional appliances encompass a range of removable and fixed devices that are designed to alter the position of the mandible, both sagittally and vertically, to induce supplementary lengthening of the mandible by stimulating increased growth at the condylar cartilage. The results of the new, relevant studies state there is no evidence that functional appliances significantly increase horizontal growth when evaluated in the long term, and that most of the correction of the malocclusion is due to dentoalveolar changes with a small but statistically significant amount of skeletal effect. Despite of this there are some indications for their application with successful results