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Niger J Clin Pract. 2018 Dec;21(12):1557-1563. doi: 10.4103/njcp.njcp_110_18.

Treatment of class II malocclussion: A comparative study of the effects of twin-block and fatigue resistant device.

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Department of Orthodontics, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey.



This is a retrospective cephalometric study aimed to compare the treatment effects of Twin-Block (TB) appliance with The Forsus Fatigue Resistant Device (FRD) appliance in class II division I patients in a composite of peak and post peak growth of period time.

Materials and Methods:

The experimental sample consisted of the lateral cephalograms of 40 patients who were treated with either TB appliance (n = 15), FRD (n = 15) or the untreated control ones. In treatment groups lateral cephalograms taken before therapy as initial records (T1) and at the completion of functional therapy (T2) were used. The control group comprised 10 children with untreated skeletal Class II malocclusions. The normality of distribution of continuous variables was tested by Shaphiro wilk test. Oneway ANOVA and LSD test in parametric; Kruskall Wallis and all pairwaise multible comparison tests in non-parametric samples were used for comparing differences among 3 groups.


Cephalometric analysis revealed that both TB and FRD appliances stimulated mandibular growth (P < 0.05) and no restriction was seen in maxilla in both groups (P > 0.05). The unwanted mandibular proclination was seen more in FRD group (P ≤ 0.001). Soft tissue didn't imitate the hard tissue (P > 0.05).


FRD group produced skeletal effects as much as TB group in peak and post peak period of growth with still more mandibular incisor proclination.


Cephalometrics; forsus fatigue resistant device; functional appliances; functional theraphy; twin block

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