الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Class II Division 1 malocclusion with mandiblular retrusion presents a common challenge that orthodontists face, concerning its treatment and retention. During the last decades, a great variety of noncompliance appliances and techniques have been proposed in order to correct Class II malocclusion by advancing the mandible to a more forward position.
The main problem of orthopedic treatment with fixed functional appliances is the difficulty in controlling the proclination of the lower incisors and the advancement of all the mandibular teeth. These can compromise the mandibular advancement and the final esthetic result. That is why this study was designed to use miniplates as a Temporary Skeletal Anchorage Devices (TSAD) to allow lower bone support to advance the mandible.
The aim of this clinical study was to evaluate the efficiency of the fixed functional appliance supported with skeletal anchorage system for treatment of developing class II malocclusion.
The study was carried out on 19 Class II Div 1 patients who were divided into two treatment groups. Group 1: Twin Force Bite Corrector group (double lock version) (TFBC) with a mean age of 13 years and 10 months. Group 2: Twin Force Bite Corrector with skeletal anchorage with initial mean age of 14 years and 2 months. All the subjects suffered from a skeletal Class II Div 1 malocclusion with a convex skeletal profile due to retrognathic mandible. After placement of upper and lower fixed appliances and completion of the leveling and alignment stage, lateral cephalometric radiographs (T1) were then obtained. In the 1st group TFBC was inserted directly on the maxillary and mandibular heavy arches. In the 2nd group, a pair of miniplates were fixed on the anterior lateral surface of the mandible and secured by 3 screws. The TFBC was then attached and secured on the pierced part of the miniplates. After correction of the Class II discrepancy and an anterior edge to edge occlusion was reached, the TFBC was removed, and intramaxillary elastics were placed to settle the occlusion. After 3 month of removal of TFBC the lateral cephalometric radiographs (T2) were obtained.
The total treatment time for group 1 was average of 16 months and for group 2 was average of 14 months.
The results have shown that the TFBC with skeletal anchorage was successful and of superior performance in treating Class II Division 1 malocclusion with mandiblular retrusion, as it can prevent the proclination of mandibular anterior teeth that usually occur with classic TFBC and other fixed functional appliances.
Based on the results of the present study the following conclusions could be drawn:
1. The twin force bite corrector are effective in the treatment of skeletal Class II division 1 malocclusion with mandibular retrusion in the early permanent dentition.
2. The twin force bite corrector with skeletal anchorage are effective and of superior performance in treating Class II Division 1 malocclusion with mandiblular retrusion, as it can prevent the proclination of mandibular anterior teeth that usually occur with classic TFBC and other fixed functional appliances
3. The major skeletal changes produced were confined to the mandible in the form of a more anterior position, increase in the mandibular length and increase in the lower anterior facial height.
4. There were significant differences between the treatment effects of the two appliances.