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Evaluation of Dentoskeletal Changes Accompanying the Treatment of Class II Malocclusion by Advansync Appliance versus Intermaxillary Coil Spring Mechanics

Objectives: The present study was designed to determine and compare the skeletal, dentoalveolar and soft tissue effects produced by the Advansync functional appliance and intermaxillary NiTi coil springs in the treatment of growing patients with Class II division 1 malocclusion. Subjects and methods: A sample of 19 growing patients, as evaluated by hand wrist radiographs, with age range 12-15 years was divided into two groups. Group I patients were treated with the Advansync appliance (n=10) and Group II patients were treated using intermaxillary NiTi coil springs (n=9). The study was conducted using lateral cephalograms taken before appliance insertion and immediately after appliance removal. Treatment changes were evaluated for each group and compared between both groups. Data were analyzed using Paired sample t-test for each group and Independent t-test for comparing groups together. Results: The use of Advansync and fixed appliances (Group I) resulted in significant decrease in SNA and ANB angles (p≤0.001). Dental changes included retroclination of maxillary teeth, proclination and intrusion of mandibular teeth as well as mesialization of mandibular molars (p≤0.001). On the other hand, SNA and ANB showed non-significant changes for patients treated with intermaxillary NiTi coil springs (Group II) (p≥0.05). While dental changes included retroclination of maxillary teeth, proclination and intrusion of mandibular teeth as well as mesialization of mandibular molars (p≤0.001) which were greater in Group II than Group I. The effects of both treatment modalities showed significant increases in total mandibular length and anterior facial height (p≤0.01 and p≤0.05) with no significant difference between both groups. Lower lip to PtV was theonly soft tissue measurement with significant changes (p≤0.05) for each group and was non-significant when the two groups were compared together. Conclusion: Both treatment modalities were effective in treating Class II division 1 malocclusion. The Advansync appliance produced its effect through maxillary growth restriction and dentoalveolar changes. While the effects of intermaxillary NiTi coil springs were only dentoalveolar, but more than the Advansync appliance.