title: Comparison of stepwise vs single-step advancement with the Functional Mandibular Advancer in Class II division 1 treatment.
abstract: OBJECTIVE
  To compare two groups of subjects at the peak of the pubertal growth period treated with the Functional Mandibular Advancer (FMA; Forestadent, Pforzheim, Germany) appliance using either single-step or stepwise mandibular advancement.
  
  
  METHODS
  This study was conducted on 34 Class II division 1 malocclusion subjects at or just before the peak phase of pubertal growth as assessed by hand-wrist radiographs. Subjects were assigned to two groups of mandibular advancement, using matched randomization. Both groups were treated with the FMA. While the mandible was advanced to a super Class I molar relation in the single-step advancement group (SSG), patients in the stepwise mandibular advancement group (SWG) had a 4-mm initial bite advancement and subsequent 2-mm advancements at bimonthly intervals. The material consisted of lateral cephalograms taken before treatment and after 10 months of FMA treatment. Data were analyzed by means paired t-tests and an independent t-test.
  
  
  RESULTS
  There were statistically significant changes in SNB, Pg horizontal, ANB, Co-Gn, and Co-Go measurements in both groups (P < .001); these changes were greater in the SWG with the exception of Co-Go (P < .05). While significant differences were found in U1-SN, IMPA, L6 horizontal, overjet, and overbite appraisals in each group (P < .001), these changes were comparable (P > .05).
  
  
  CONCLUSIONS
  Because of the higher rates of sagittal mandibular skeletal changes, FMA using stepwise advancement of the mandible might be the appliance of choice for treating Class II division 1 malocclusions.
authors.forename: Isil
authors.initials: I
authors.lastname: Aras
authors.forename: Aylin
authors.initials: A
authors.lastname: Pasaoglu
authors.forename: Sultan
authors.initials: S
authors.lastname: Olmez
authors.forename: Idil
authors.initials: I
authors.lastname: Unal
authors.forename: Ali Vehbi
authors.initials: AV
authors.lastname: Tuncer
authors.forename: Aynur
authors.initials: A
authors.lastname: Aras
mesh_terms: D000293:Adolescent; D002508:Cephalometry; D002648:Child; D003766:Dental Occlusion; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D008334:Mandible / Q000000981:diagnostic imaging / Q000254:growth & development; D019186:Mandibular Advancement / Q000295:instrumentation* / Q000379:methods*; D008445:Maxillofacial Development; D017289:Orthodontic Appliances, Functional; D057887:Overbite / Q000628:therapy
keywords: Angle Class II; Functional orthodontic appliance