ORTHODONTICS
Effects of Farmand and Fränkel-2 functional appliances on
mandibular deficiency in late mixed dentition
Hamid Reza Pakshir 1a , Abdolreza Jamilian 2a* , Ali Mokhtar 2b , Alireza Darnahal 2c , Zinat Kamali 3d , Ludovica Nucci 4e ,
Letizia Perillo 4f
Orthodontic Department, Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
Orthodontic Department, Craniomaxillofacial Research Center, Tehran Dental Branch, Islamic Azad University, Tehran, Iran
3
National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology,Shahid Beheshti University of Medical
Sciences, Tehran, Iran
4
Multidisciplinary Department of Medical-Surgical and Dental Specialties, Università degli studi della Campania “Luigi Vanvitelli”, Naples, Italy
1
2
DMD, PhD, Professor
DMD, Orthodontist
c
DDS
d
MSc
e
Undergraduate student, Course of Dentistry
f
DMD, PhD, Professor, Head and Chair
a
b
Received: April 03, 2017
Revised: May 05, 2017
Accepted: August 14, 2017
Published: August 16, 2017
Academic Editor: Irina Nicoleta Zetu, DDS, PhD, Professor, „Gr. T. Popa“ University of Medicine and Farmacy Jassy, Jassy, Romania
Cite this article:
Pakshir HR, Jamilian A, Mokhtar A, Darnahal A, Kamali Z, Nucci L, Perillo L. Effects of Farmand and Fränkel-2 functional appliances on mandibular
deficiency in late mixed dentition. Stoma Edu J. 2017;4(3):176-181.
Abstract
DOI: 10.25241/stomaeduj.2017.4(3).art.3
Introduction: The present study aimed to evaluate the cephalometric changes in Class II Division I
mandibular deficient patients treated with the Fränkel 2 and Farmand appliances as a new functional
appliance.
Methodology: Fifty-five subjects treated for Class II Division I malocclusion and mandibular deficiency
were selected for the study. Twenty-seven of the subjects (17 girls, 10 boys) with the mean age of 11.1
(SD 1.4) years were treated with the Farmand appliance and twenty-eight of them (15 girls, 13 boys) with
the mean age of 11 (SD 1.5) years were treated with the FR-2 appliance. T-test, paired t-test, Wilcoxon
and Mann-Whitney test were used to evaluate the data.
Results: A skeletal Class I relationship and a marked reduction in overjet were achieved in both treatment
groups. ANB decreased significantly by 3.2 (SD 1.7) degrees in the Farmand appliance group and it
decreased significantly by 3.5 (SD 1.6) degrees in the Fränkel group.
Conclusion: Both Farmand and Fränkel appliances were successful in the correction of mandibular
deficiency in Class II Division 1 patients.
Keywords: malocclusion, Angle Class II Division I, orthodontic appliances, functional appliances.
1. Introduction
A Class II malocclusion may result from a mandibular
deficiency, maxillary excess or a combination of
both, but the most common finding is mandibular
skeletal retrusion. 1,2 Approximately 15% of
American children have Class II malocclusion;
however, It seems that Class II problems are most
prevalent in Caucasians of Northern European
descent (for instance, 25% of children in Denmark
are reported to be Class II. 3 Different removable
functional appliances such as Activator, Bionator,
Fränkel-2, Herbst, R-appliance, and Twin Block have
been used to treat Class II division 1 malocclusions
and mandibular deficiency. 4-13 Fränkel-2 (FR-2)
is one of the appliances commonly used in the
treatment of Class II division 1 malocclusion. This
appliance was developed nearly 50 years ago
by Rolf Fränkel as an orthopedic exercise device
designed to reprogram the neuromuscular system
of the orofacial complex. 14,15 Recently, Perillo et al.
performed a meta-analysis of articles studying the
changes produced by the FR-2 appliance during
the treatment of growing patients with Class II
malocclusions and reported that the FR-2 appliance
had a statistically significant impact on the size of
the mandible in the treated patients. 16
Another functional appliance used for the
correction of mandibular deficiency is the “Farmand
Appliance”. 17,18 This appliance has been shown
to cause significant changes in the position and
anterior displacement of the hyoid bone, resulting
in the improved airway and respiratory status of the
patients.
An electronic search in literature shows that no one
*Corresponding author:
Dr Abdolreza Jamilian, No 2713, Vali Asr St., Tehran 1966843133, Iran
Tel: 0098-21-22011892; Fax: 0098-21-22022215; e-mail: [email protected]
176
Stoma Edu J. 2017;4(3): 176-181
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