title: Treatment effects of the mandibular anterior repositioning appliance in patients with Class II skeletal malocclusions.
abstract: OBJECTIVE
  To examine the changes produced by the mandibular anterior repositioning appliance (MARA) appliance and compare the treatment effects to an untreated Class II control group.
  
  
  METHODS
  Thirty consecutively treated patients were matched with an untreated control group. Lateral cephalograms were taken at T1, 5 months pre-MARA (CVMS 2.7); T2, immediately after MARA removal and prior to placement of full fixed edgewise appliances (CVMS 4.2); and T3, at least 2 years after MARA removal and completion of edgewise treatment (CVMS 5.4). The mean age of the MARA patients was 11.9 years for boys and 10.8 years for girls. Repeated-measures analysis of variance (ANOVA) was used to assess if the samples were morphologically comparable at the outset and to test if there were significant differences between the groups for the various increments of change. Given a significant ANOVA, the source of the difference was explored via Tukey-Kramer tests.
  
  
  RESULTS
  Restriction of maxillary growth and no significant mandibular growth were observed with the MARA appliance. The Class II correction was obtained mainly by slight maxillary molar distalization and intrusion, in addition to mesial migration of the lower molars and flaring of the lower incisors. No vertical effect was observed with this appliance.
  
  
  CONCLUSIONS
  The MARA appliance was effective in the treatment of Class II malocclusions. Restriction of maxillary growth and dentoalveolar changes in the maxillary and mandibular arches were responsible for the correction of the Class II malocclusion. Significant mandibular growth did not contribute to this correction.
authors.affiliation: University of Detroit Mercy, MI, USA.
authors.forename: Marcelo N Kegler
authors.initials: MN
authors.lastname: Pangrazio
authors.forename: Valmy
authors.initials: V
authors.lastname: Pangrazio-Kulbersh
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Berger
authors.forename: Burcu
authors.initials: B
authors.lastname: Bayirli
authors.forename: Amin
authors.initials: A
authors.lastname: Movahhedian
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D016022:Case-Control Studies; D002508:Cephalometry; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000000981:diagnostic imaging / Q000628:therapy*; D008334:Mandible / Q000000981:diagnostic imaging / Q000254:growth & development*; D008445:Maxillofacial Development; D008963:Molar / Q000000981:diagnostic imaging / Q000254:growth & development*; D017289:Orthodontic Appliances, Functional; D011859:Radiography; D012189:Retrospective Studies; D014087:Tooth Movement Techniques / Q000295:instrumentation*