EUROPEAN JOURNAL OF PAEDIATRIC DENTISTRY VOL. 15/1-2014
72
M. D’Attilio, D. Rodolfino, A. Filippakos,
M. Saccucci*, F. Festa, D. Tripodi
Department of Oral Science, Nano and Biotechnologies,
G. D'Annunzio, University of Chieti- Pescara, Chieti, Italy
*Department of Oral and Maxillofacial Science
Sapienza University of Rome
e-mail: tripodi@unich.it
ABSTRACT
Aim To evaluate the use of Second Class Resolver (SCR©),
a new fixed orthopaedic appliance, for the treatment of
skeletal Class II malocclusion in growing subjects.
Subjects and Method Design Retrospective analysis.
Forty subjects were treated with Second Class Resolver
(SCR©). The mean age was 8 years at the beginning of
treatment and 10 years at the end of treatment. Digital
cephalometric superimpositions on lateral radiographs
taken at start and end of treatment were assessed. The
cephalometric values were statistically analysed.
Results Cephalometric analysis of changes during
treatment shows reduction of ANB angle (mean 2°);
reduction of Witts Index (mean 3 mm); reduction of
Maxillo-Mandibular angle (MM) (mean 1°); reduction of
SNA (angle mean 3°); reduction of gonial angle (mean
1.8°); increase of the mandibular branch length (mean
5 mm); increase of mandibular body (mean 2.9°).
Conclusion The Second Class Resolver© can
be beneficially used for the treatment of Class II
malocclusion.
Second Class Resolver:
a retrospective
analysis
Introduction
The developmental skeletal Class II malocclusion is one
of the most challenging problems confronting orthodontic
practitioners. In a growing patient, an optimal aesthetic
result would ideally be obtained by using an orthopaedic
Keywords Fixed rigid orthodontic appliances;
Functional orthodontics; Orthopaedic appliances; Second
Class Resolver (SCR
©
).
appliance to accelerate the development of the mandible
by acceleration of growth at the condyles and bone
apposition in the condylar fossae. This orthopaedic
phase is generally followed by a separate stage of fxed
appliance therapy to align teeth and establish optimal
occlusion [Bass, 2006]. A large number of removable
and fxed orthopaedic appliances are available for the
treatment of skeletal Class II malocclusion in adolescents
and young adults. Removable orthodontic appliances,
heavily dependent on patient compliance, are mostly
indicated in mixed and early adult dentition at the time
of the pubertal growth spurt [Sander, 1998; Vardimon et
al., 1990]. On the other hand, fxed appliances, rigid and
semi-elastic, are permanently effective. The semi-elastic
bimaxillary fxed appliances are capable of achieving mainly
a dentoalveolar correction. In contrast, rigid appliances
have proven useful in achieving a more extensive skeletal
effect, mainly due to the adaptive osseous remodelling
processes in the temporomandibular joint related to the
therapeutic repositioning of the mandible [Cash, 1991;
Crismani, 1998; Crismani, 1999; Weiland and Bantleon,
1995].
In literature, the cephalometric fndings after treatment
of Class II malocclusion with orthopaedic appliances
(Herbst, activator, Frankel II, high-pull headgear) indicate:
increase in mandibular length and in lower facial height,
retroinclination of upper incisors and proinclination of
lower incisors, correction of facial convexity, increase
in lower anteroposterior and lower vertical soft
tissue dimensions [Cozza et al., 2004; Marşan, 2007;
McNamara et al., 1990; Nedeljković et al., 2010].
Analysis of a case series is used to investigate the
effcacy of the Second Class Resolver (SCR
©
) for non-
compliance sagittal mandible repositioning in growing
subjects, devised to minimise the side effects of the Class
II malocclusion treatment with orthopaedic appliances.
Materials and methods
Forty subjects (enrolled at the dental clinic of the
University of Chieti), mean age 8 years at the beginning
of treatment and 10 years at the end of treatment, with
a Class II malocclusion were included in this series. The
Second Class Resolver (SCR
©
) (Fig. 1) (Dental Word,
Molfetta BA, Italy) was applied for the treatment of
Class II malocclusion. The mean time of treatment was
6 months. Standardised lateral cephalograms were used
to evaluate all morphological and structural changes.
Cephalometric variations were carried out through
Enlow and Steiner analyses, with relative initial and fnal
superimpositions.
Results
Cephalometric values were statistically analysed before