Comparison of Frankel Regulator and Cervera Appliance in Functional Treatment of Class II Malocclusions: A Systematic Review

Background: The Class II Malocclusion is the most frequent dento-skeletal anomaly that involves one third of all orthodontic patients. So many appliances have been described in the literature for treating this malocclusion, in particular when it’s indicated to obtain a mandibular advancement. The aim of this study is to compare the dental and skeletal effects of Frankel II Regulator and Cervera Appliance. Materials and Methods: A detailed research of literature published on PubMed (Medline), Lilacs and Scopus, till October 2016, has been performed selecting sixteen articles. The treatment approaches have been evaluated for effectiveness, efficiency and distance follow up. Results: The literature confirms that both Frankel Regulator and Cervera Appliance are two fundamental devices in the functional treatment of Class II Malocclusions. They are based both on Moss’ functional matrices principle, so the modification of the neuro-muscular engram induces the stabilization of skeletal and dento-alveolar proportions as the correction of class II malocclusion. Although the Frankel Regulator can be considered the precursor of the actual Cervera appliance, the second device has demonstrated more effectiveness and efficiency in functional treatment as the possibility to correct facial asymmetries. Despite their considerable validity, it’s important to remember that all these devices are strictly dependent on patients’ compliance because they are removable appliances. Conclusions: The functional regulator induces counterclockwise rotation rather than vertical or sagittal changes in the maxilla, in the way that it affects the angulation of the cranial base.