A national survey of orthodontists in Malaysia and their use of functional appliances for Class II malocclusions

Bahar, Aufa Dahlia; Kamarudin, Yasmin; Chadwick, Stephen

doi:10.21307/aoj-2021.023

Abstract

Objectives

The aim of this study was to evaluate the use of functional appliances by the currently practising orthodontists in Malaysia. The objectives were to identify the different types of functional appliances used by Malaysian orthodontists and to investigate the variation in treatment protocols when attempting growth modification.

Methods

An online questionnaire consisting of 24 open-ended and multiple-choice questions was emailed to members of the Malaysian Association of Orthodontists (MAO) (n = 183). The survey was based on a previous study conducted by members of the British Orthodontic Society and was modified to suit the Malaysian population. The data were analysed using SPSS to generate frequency tables and descriptive statistics.

Results

Seventy-two responses were received from current Malaysian orthodontists. Of the respondents, 71% practised in a government setting and 29% were in private practice. The Clark Twin Block was the most frequently used functional appliance by 90% of Malaysian orthodontists. Many of the respondents (57%) prescribed full-time wear of removable functional appliances for 6–9 months (except during mealtimes) (51%). Following active removable functional appliance therapy, 91% prescribed a period of retention which involved a reduction in the duration of wear. The retention phase extended for 2 to 3 months (41%) or for 4 to 6 months (39%) for the majority of the respondents.

Conclusions

The Clark Twin Block is the most frequently-used functional appliance for the management of a Class II malocclusion by orthodontists currently practising in Malaysia.

References

Mills JRE. The effect of functional appliances on the skeletal pattern. Br J Orthod 1991;18:267–75.
Search in Google Scholar Back to article
Batista KBSL, Thiruvenkatachari B, Harrison JE, O’Brien KD. Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents (Review). Cochrane Database Syst Rev 2018;00:CD003452, doi: 10.1002/14651858.CD003452.pub4.
Open DOI Search in Google Scholar Back to article
Ruf S, Pancherz H. Temporomandibular joint adaptation in Herbst treatment: a prospective magnetic resonance imaging and cephalometric roentgenographic study. Eur J Orthod 1998;20:375–88.
Search in Google Scholar Back to article
Mills JRE. The effect of orthodontic treatment on the skeletal pattern. Br J Orthod 1978;5:133–43.
Search in Google Scholar Back to article
Bishara SE, Ziaja RR. Functional appliances: a review. Am J Orthod Dentofacial Orthop 1989;95:250–8.
Search in Google Scholar Back to article
Pancherz H. A cephalometric analysis of skeletal and dental changes contributing to Class II correction in activator treatment. Am J Orthod 1984;85:125–34.
Search in Google Scholar Back to article
Pacha MM, Fleming PS, Johal A. A comparison of the efficacy of fixed versus removable functional appliances in children with Class II malocclusion: a systematic review. Eur J Orthod 2016;38:621–630.
Search in Google Scholar Back to article
Clark WJ. The Twin Block Traction Technique. Eur J Orthod 1982;4:129–138.
Search in Google Scholar Back to article
Chadwick SM, Banks P, Wright JL. The use of myofunctional appliances in the UK: a survey of British orthodontists. Dent Update 1998;25:302.
Search in Google Scholar Back to article
Ab Rahman N, Low TF, Idris NS. A survey on retention practice among orthodontists in Malaysia. Korean J Orthod 2016;46:36.
Search in Google Scholar Back to article
Salant P, Dillman I, Don A. How to conduct your own survey 1994; New York: Wiley.
Search in Google Scholar Back to article
Macey-Dare LV, Nixon F. Functional appliances: mode of action and clinical use. Dent Update 1999;26:240–6.
Search in Google Scholar Back to article
O’Brien K, Wright J, Conboy F. Effectiveness of treatment for Class II malocclusion with the Herbst or twin-block appliances: a randomized, controlled trial. Am J Orthod Dentofacial Ortho 2003;124:128–37.
Search in Google Scholar Back to article
Tulloch JC, Phillips C, Proffit WR. Benefit of early Class II treatment: progress report of a two-phase randomized clinical trial. Am J Orthod Dentofacial Orthop 1998;113:62–74.
Search in Google Scholar Back to article
Flores-Mir C, Major PW. A systematic review of cephalometric facial soft tissue changes with the Activator and Bionator appliances in Class II division 1 subjects. Eur J Orthod 2006;28:586–93.
Search in Google Scholar Back to article
Makhbul MZM, Hassan WNW. A clinical audit of the success rate of removable functional appliances treatment. Malays Dent J 2019;1:61–73.
Search in Google Scholar Back to article
Baccetti T, Franchi L, McNamara JA Jr. The cervical vertebral maturation (CVM) method for the assessment of optimal treatment timing in dentofacial orthopedics. Semin Orthod 2005;11:119–29.
Search in Google Scholar Back to article
Ghafari J, Shofer FS, Jacobsson-Hunt U. Headgear versus functional regulator in the early treatment of Class II division I malocclusion: a randomised clinical trial. Am J Orthod Dentofacial Orthop 1998;113:51–61.
Search in Google Scholar Back to article
Tulloch JFC, Medland W, Tuncay OC. Methods used to evaluate growth modification in Class II malocclusion. Am J Orthod Dentofacial Orthop 1990;98:340–7.
Search in Google Scholar Back to article
Dolce C, Mc Gorray SP, Brazeau L. Timing of Class II treatment: skeletal changes comparing 1-phase and 2-phase treatment. Am J Orthod Dentofacial Orthop 2007;132:481–9.
Search in Google Scholar Back to article
Seehra J, Fleming PS, Newton T, DiBiase AT. Bullying in orthodontic patients and its relationship to malocclusion, self-esteem and oral health-related quality of life. J Orthod 2011;38:247–56.
Search in Google Scholar Back to article
Thiruvenkatachari B, Harrison J, Worthington H, O’Brien K. Early orthodontic treatment for Class II malocclusion reduces the chance of incisal trauma: results of a Cochrane systematic review. Am J Orthod Dentofacial Orthop 2015;148:47–59.
Search in Google Scholar Back to article
Al-Moghrabi D, Salazar FC, Pandis N, Fleming PS. Compliance with removable orthodontic appliances and adjuncts: a systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2017;152:17–32.
Search in Google Scholar Back to article
El-Huni A, Salazar FBC, Sharma PK, Fleming PS. Understanding factors influencing compliance with removable functional appliances: a qualitative study. Am J Orthod Dentofacial Orthop 2019;155:173–81.
Search in Google Scholar Back to article