Biomechanical and clinical considerations in correcting skeletal class II malocclusion with Forsus™.

AIM The present case report describes the importance of understanding of biomechanical and clinical considerations in application of Forsus appliance in correction of class II skeletal malocclusion. BACKGROUND Angle's class II malocclusion is one of the most prevailing that may be either skeletal or dental presenting with different clinical manifestations. There are number of appliances to treat such a malocclusion in a growing child. Fixed functional appliances are indicated for class II corrections in patients who report late with minimal residual growth left. CASE DESCRIPTION A case of class II skeletal and dental malocclusion treated with preadjusted edgewise appliance supplemented with Forsus Fatigue Resistant Device (FRD) (3M Unitek Corp, California, USA) is reported. CONCLUSION Forsus device is an effective alternative in treating moderate skeletal class II malocclusion. The Forsus FRD (3M Unitek Corp, California, USA) can be used instead of class II elastics in mild cases and in place of Herbst appliance in severe cases. Alteration of force vector by modifying the archwire as shown in this case report while applying Forsus and incorporation of 10 degree labial root torque in lower archwire will minimize the effects on dentition. Engaging modules or tubing on to the pushrod and leaving 1 to 2 mm clearance between distal end of the upper tube and L-pin as shown in this case report will significantly improve the patient compliance. CLINICAL SIGNIFICANCE Much emphasis should be given to biomechanical considerations which were discussed in this article while treating patients with Forsus to prevent the unwanted effects. Clinical considerations and certain modifications advised in this case report should be utilized while treating class II skeletal malocclusions with Forsus appliance to eliminate the patient cooperation factor and make treatment time estimates much more accurate.