STOMATOLOGY EDU JOURNAL 2017, Volume 4, Issue 3 SEJ_3-2017_Online - Page 30

Effects of Farmand and Fränkel-2 functional appliances on mandibular deficiency in late mixed dentition After treatment, SNB and ANB showed significant changes. The Increase of SNB and decrease of ANB are indicative of favorable changes in the mandibular growth. The increase of GoGn, Co-Gn, and Co-Pog also indicates favorable mandibular growth. The Farmand appliance is a passive tooth-born appliance composed of one extended labial bow on each jaw, two rests (stop) on each dental arch, a tongue bow and an acrylic plate. The labial bows with a distance of 1 mm from the labial surfaces of the upper and lower anterior teeth, act as an eruptive guidance for the incisors as well as eliminating the perioral muscles’ forces, especially in case of severe mentalis muscle contraction. The tongue bow, with its loop in a distal direction, helps the patient to redirect his/her tongue to a distal position, thus removing the tongue pressure from the anterior part of the upper jaw. In addition, the patient is instructed to open and close his/her mandible while stabilizing the appliance on the maxillary arch by the tongue tip. This kind of exercise will improved the patient’s adaptation in the new advanced mandibular position. The rests (stop), which are placed in the mesial surfaces of the first molars, restrict the first molars mesial movement and assist in achieving Class I molar relationship by forward movement of mandible. In two recent studies, Yassaei and Soroush 17 and Yassaei et al. 21 studied the effects of the Farmand functional appliance on the hyoid bone position in Class II division 1 malocclusion patients. They found that the hyoid bone shifted significantly forward in the horizontal dimension. The results of our study are consistent with the findings of the study conducted by Perillo et al. 6 in which the Fränkel-2 treatment produced a significant decrease in the ANB angle that improved the skeletal intermaxillary and occlusal relationship in Class II growing patients with mandibular retrusion. According to Fränkel, 15,22 the FR-2 acts by changing the biomechanical environment of the developing dentition. In agreement with many previous studies, 6,10,14,23-27 FR-2 proclines lower incisors slightly, probably because the lower labial pads of FR-2 change the lip po \H[YXHHٝ\YH\\HۈH\[\ܜˈ[\YKSTH[[ܙX\YYۚYX[KX\[Z[\H[[و\[[ۘ[\X[\ˈ M H\X[[[ۘ[\X[K[Z[\H[ۘ]܈[[ۘ[\X[H\\[B\HL\X[H[]\]Y[\[H[\[\\H\]X]Z\YX HX]Y[[\YH\܈[][ܜX[ۈ[\\X]Y[[[]Y[\۝[YY]^Yܝ۝X˂Kۘ\[ۂ\X[[[ۘ[\X[\[[\X[H\HX\ٝ[[HܜX[ۈقX[X[\YXY[H[\RH]\[ۈ H]Y[˜[[H\Y\[[\]]H[[ۘ[\X[K]]܈۝X][ۜۘ\ H R\Yۈ H R\\\[ۈ BR\\\ HSKQX]\X[ HSKQ]BX[ۈ[ ܈\[8$SN[[\\[ ܂[\]][ۈ HQ ]\]\HX\ H •ܚ][X[\ܚ\ H Rܚ]X[]Y] H RۙXو[\\ۙHX\Y Y\[\ŒKBB˂B BKBB˂B BN XӘ[X\HH[\H ܙ \[Y]X[[\\›و[X]YY[]YX[XX[[\[[][ۜ\ˈ[Y[ܝۈܝۘ]\˂NN NKLKXYYB\[ YX[H\H][ \RHX[\[ۂ]\[ۈ NH]\YX][ۈY]H\[Y]X˜[[\\ˈ]\YYX][ LL NNLLNMXYYBٙ]ԋX[\[ۈ[[٘XX[YܛZ]H[۝[\ܘ\HY]K[ٙ]ԋY[\\KY]ܜˈ۝[\ܘ\Hܝ۝Xˈ Z\[ˎ[]Y\[؞N L˂]Z\[RK[Z[X[K][ X]Y[YXوX\X[H[[ L[\RH]\[ۈ HX[\[ۜˈ]\YYX][ LM JNMLXYYBМY[ܚYۘH][ X\HX]Y[܈\RH]\[ۈ HX[\[ۈ]H[X˜\X[NH][KX[\[Z^Y ۝YX[ [Hܝ[٘XX[ܝ NLJ JNMBMKN L L MڋZˌ ˌL ѝ[^[BXYYB\[ \[RK[][H][ ][X][ۂوۙ]\HYX[]Y[X]Y][ L\X[K]\YYX][ LNL NKLXYYB[Z[X[K]Z[Z\HˈX]Y[YXوHX\X[H[[[\RB]\[ۈ HX[\[ۋ]\ܝ LN NM BN N L LLZڜL ѝ[^[HXYYB[\ H\\X[NH\YYH[BKBL BLKBLBL˂BM BMKB[\RHX]Y[ ܛܝ N͔\ LL XYYB[H ]ۚH[[][ ۙ]\H[][[[[YX[X]Y[[Z[܈[[ۘ[\X[\[\RHX[\[ۋ[Hܝ L N L N L NK LLLM L Kѝ[^[HXYYB\[ ۈH\K\X[[Hو[][[\Y\[[ۈY[]܈ LHX]Y[ق]Y[]]\]H\RHX[\[ۜˈ[Hܝ[٘XX[ܝ NNMLJ NL̋LLKѝ[^[HXYYB]ZY^XHK[Z[X[K][ X]Y[YXوX\X[H[[\[܈[[Y]H]H[\RK]\[ۈHX[\[ۋ\ܘ[K LNNJ N M ќYHP\XWHѝ[^[HXYYB[Z[X[K]Z[X[HX\X[NBY\[\Yۈ[[[ۘ[\\H[\RH]\[ۂHX[\[ۋ[ܝZ[]ZYK Ň NLKBM XYYB[Z[X[K]ZYU Hݙ[\X܈X]Y[وX[X[\YXY[H]\X[ܛ]\[ܝZ[]ZYK Ľ NBˈXYYBY[X[XӘ[X\HHX]H ][ ۙB\HX]Y[YXوHL\X[Hو[ [Hܝ[٘XX[ܝ NLJ JNMMMKMM͎\\[ۈ M MMKN L L MڋZˌ ˌLK Kѝ[^[HXYYB[H[ܙ]X[ۘ\[\Z[BXHYH M N M͋LN B˜XYYZ