The objective of this study was to evaluate the long-term stability after successful nonextraction Class II malocclusion treatment with elastics. A sample of 43 patients with Class II malocclusion was divided into two groups. The elastic group (EG) consisted of 20 patients who were treated with fixed appliances associated with Class II elastics. The headgear group (HG), consisted of 23 patients treated with fixed appliances and extraoral headgear. Pre-, post-treatment, and long-term post-treatment lateral radiographs and dental casts were evaluated. T-tests were used to compare the treatment changes and long-term post-treatment changes between the groups. The groups were matched regarding initial age, time of long-term post-treatment evaluation, initial malocclusion severity, quality of treatment result, and all pretreatment cephalometric variables. Patients of the EG presented greater treatment time, were older at the post-treatment and at the long-term post-treatment evaluation stages. During treatment both groups showed similar changes. Intergroup comparisons of long-term post-treatment changes showed slight mandibular retrusion in the EG and mandibular protrusion in the HG. The maxillary molar showed significant mesialization in the HG group. There were no intergroup significant occlusal differences during the long-term post-treatment period, with exception of the overjet, which maintained stable in the EG and showed improvement in the HG group. Nonextraction Class II malocclusion treatment with elastics or with extraoral headgear have similar long-term post-treatment stability. / O objetivo do presente estudo foi avaliar a estabilidade do tratamento sem extrações da má oclusão de Classe II com elásticos. Uma amostra de 43 pacientes com má oclusão de Classe II foi dividida em dois grupos. O grupo elástico (GE) consistiu em 20 pacientes que foram tratados com aparelho fixo associado a elásticos de Classe II. O grupo controle (GC), consistiu em 23 pacientes tratados com aparelho fixo associado ao aparelho extrabucal. Telerradiografias e modelos iniciais (T1), finais (T2) e pós-tratamento (T3) foram avaliados. Os grupos foram compativéis em relação à idade inicial, tempo de avaliação pós-tratamento, severidade inicial da má oclusão, qualidade do resultado do tratamento e em relação às variáveis cefalométricas prétratamento. Os pacientes do GE apresentaram maior tempo de tratamento, e maior idade ao final e no pós-tratamento. Após o tratamento, ambos os grupos apresentaram alterações semelhantes. Com respeito as alterações no periodo póstratamento, no GE, a mandíbula se mostrou ligeiramente retruida e no GC ocorreu uma ligeira protrusão. Em relação às variáveis dentoalveolares, o molar maxilar mostrou mesialização significativa no GC. Não houve diferenças entre os grupos em relação às alterações oclusais no periodo pós-tratamento, com exceção do overjet, que manteve-se estável no GE e mostrou melhoras no GC. A estabilidade do tratamento de má oclusão de Classe II com elásticos ou com aparelho extrabucal é semelhante.

The objective of this study was to evaluate the long-term stability after successful nonextraction Class II malocclusion treatment with elastics. A sample of 43 patients with Class II malocclusion was divided into two groups. The elastic group (EG) consisted of 20 patients who were treated with fixed appliances associated with Class II elastics. The headgear group (HG), consisted of 23 patients treated with fixed appliances and extraoral headgear. Pre-, post-treatment, and long-term post-treatment lateral radiographs and dental casts were evaluated. T-tests were used to compare the treatment changes and long-term post-treatment changes between the groups. The groups were matched regarding initial age, time of long-term post-treatment evaluation, initial malocclusion severity, quality of treatment result, and all pretreatment cephalometric variables. Patients of the EG presented greater treatment time, were older at the post-treatment and at the long-term post-treatment evaluation stages. During treatment both groups showed similar changes. Intergroup comparisons of long-term post-treatment changes showed slight mandibular retrusion in the EG and mandibular protrusion in the HG. The maxillary molar showed significant mesialization in the HG group. There were no intergroup significant occlusal differences during the long-term post-treatment period, with exception of the overjet, which maintained stable in the EG and showed improvement in the HG group. Nonextraction Class II malocclusion treatment with elastics or with extraoral headgear have similar long-term post-treatment stability. / O objetivo do presente estudo foi avaliar a estabilidade do tratamento sem extrações da má oclusão de Classe II com elásticos. Uma amostra de 43 pacientes com má oclusão de Classe II foi dividida em dois grupos. O grupo elástico (GE) consistiu em 20 pacientes que foram tratados com aparelho fixo associado a elásticos de Classe II. O grupo controle (GC), consistiu em 23 pacientes tratados com aparelho fixo associado ao aparelho extrabucal. Telerradiografias e modelos iniciais (T1), finais (T2) e pós-tratamento (T3) foram avaliados. Os grupos foram compativéis em relação à idade inicial, tempo de avaliação pós-tratamento, severidade inicial da má oclusão, qualidade do resultado do tratamento e em relação às variáveis cefalométricas prétratamento. Os pacientes do GE apresentaram maior tempo de tratamento, e maior idade ao final e no pós-tratamento. Após o tratamento, ambos os grupos apresentaram alterações semelhantes. Com respeito as alterações no periodo póstratamento, no GE, a mandíbula se mostrou ligeiramente retruida e no GC ocorreu uma ligeira protrusão. Em relação às variáveis dentoalveolares, o molar maxilar mostrou mesialização significativa no GC. Não houve diferenças entre os grupos em relação às alterações oclusais no periodo pós-tratamento, com exceção do overjet, que manteve-se estável no GE e mostrou melhoras no GC. A estabilidade do tratamento de má oclusão de Classe II com elásticos ou com aparelho extrabucal é semelhante.

Objectif : Évaluer les effets sur la croissance des maxillaires, ainsi que les effets dentaires, de l'utilisation du Forsus versus celle des élastiques de classe II. Matériel et méthode : Un échantillon de 30 patients a été traité sans extraction et a eu une phase d'alignement préliminaire avec appareillage orthodontique fixe complet. Vingt-trois (23) patients (14 filles, 9 garçons) ont été traités à l'aide de Forsus (âge moyen : 13,4 ans) et 7 patients (4 filles, 3 garçons) ont été traités avec des élastiques de classe II (âge moyen : 14,3 ans). Une radiographie céphalométrique a été prise à la fin de la phase d'alignement, juste avant la mise en place de l'appareil myofonctionnel choisi, et une autre au moment de l'enlèvement de l'appareil (temps de port moyen : 0,5 an). Les radiographies ont ensuite été tracées à l'aveugle et 17 mesures ont été sélectionnées pour évaluer l'effet des appareils sur les maxillaires (ANS-PNS, SNA, SNB, ANB, Go-Pg, Ar-Go, Co-Gn, axe Y, Ar-Gn, Ar-Go-Me, FMA, POF/FH, PP/FH, B-Pg(PM), 1/-FH, 1/-/1, /1-PM). Un questionnaire pour évaluer le confort face à leur appareil a été remis aux patients à environ la moitié du temps de port estimé. Résultats : Il n'y a aucune différence statistiquement significative entre les deux traitements sur la croissance du maxillaire (ANS-PNS p = 0,93, SNA p = 0,12). De façon générale, il n'y a pas non plus de différence significative entre les deux traitements sur la croissance de la mandibule (Ar-Gn p = 0,03, SNB p = 0,02 et pour les 6 autres mesures p > 0,05). Pour la composante dento-alvéolaire, les deux traitements proclinent les incisives inférieures et rétroclinent les incisives supérieures, le Forsus causant une plus forte rétroclinaison des incisives supérieures (1/-FH p = 0,007, /1-PM p = 0,10). Pour les changements angulaires des plans, le Forsus cause de manière significative une augmentation de l’inclinaison du plan occlusal (POF/FH p = 0,001). Pour le questionnaire sur l'évaluation du confort, il n'y a pas de différence entre les deux traitements en ce qui concerne la gêne face aux activités quotidiennes (p = 0,19). L'hygiène est plus facile avec les élastiques (p = 0,03). Le sommeil n’est perturbé par aucun des appareils (p =0,76). La différence entre le groupe «élastiques» et le groupe «Forsus» pour le confort en général n'est pas significative (p = 0,08). Conclusions : Le but de l’étude étant de vérifier l’efficacité des élastiques de classe II bien portés versus celle des Forsus, on peut conclure que leurs effets sont relativement similaires sur les maxillaires. Cependant, le Forsus cause de manière statistiquement significative une augmentation de l'angle du plan occlusal et une rétroclinaison plus importante des incisives supérieures. / Objective : To compare the effects on jaw growth of using Forsus Springs versus class II elastics. Material and Method : A sample of 30 patients was treated non extraction. Following a preliminary alignment phase with full fixed braces, 23 patients (14 girls, 9 boys) were treated with Forsus and 7 patients (4 girls, 3 boys) were treated with elastics (mean age : 14,3yo). Average wearing time : 0,5 y. Cephalometric radiographs were taken at the end of the alignment phase and at the end of the functional phase. Radiographic measurements were taken to assess the effects of both appliance types (ANS-PNS, SNA, SNB, ANB, Go-Pg, Ar-Go, Co-Gn, axe Y, Ar-Gn, Ar-Go-Me, FMA, POF/FH, PP/FH, B-Pg(PM), 1/-FH, 1/-/1, /1-PM). Questionnaires to assess comfort with the appliances were given to the patients approximately halfway through treatment. Results : No statistically significant differences in maxillary growth (ANS-PNS p = 0,93, SNA p = 0,12) or mandibular growth (Ar-Gn p = 0,03, SNB p = 0,02 and for the other 6 measurements p > 0,05) were noted between groups. Both treatments proclined lower incisors and retroclined upper incisors, with the Forsus causing more retroclination of the upper incisors (1/-FH p = 0,007, /1-PM p = 0,10). Forsus caused a statistically significant steepening of the occlusal plane (POF/FH p = 0,001). With respect to patient comfort, there was no statistically significant difference between the two treatments, although maintaining oral hygiene was easier in the elastics group (for daily activities p = 0,19, oral hygiene p = 0,03, sleep p =0,76, general comfort p = 0,08). Conclusions : The aim of this study being to assess the effectiveness of well worn class II elastics versus the effectiveness of Forsus, we can conclude that their effects are relatively similar on the maxillary bones. However, Forsus cause a statistically significant increase of the inclination of the occlusal plane and greater retroclination of upper incisor.

Objectif : Évaluer les effets sur la croissance des maxillaires, ainsi que les effets dentaires, de l'utilisation du Forsus versus celle des élastiques de classe II. Matériel et méthode : Un échantillon de 30 patients a été traité sans extraction et a eu une phase d'alignement préliminaire avec appareillage orthodontique fixe complet. Vingt-trois (23) patients (14 filles, 9 garçons) ont été traités à l'aide de Forsus (âge moyen : 13,4 ans) et 7 patients (4 filles, 3 garçons) ont été traités avec des élastiques de classe II (âge moyen : 14,3 ans). Une radiographie céphalométrique a été prise à la fin de la phase d'alignement, juste avant la mise en place de l'appareil myofonctionnel choisi, et une autre au moment de l'enlèvement de l'appareil (temps de port moyen : 0,5 an). Les radiographies ont ensuite été tracées à l'aveugle et 17 mesures ont été sélectionnées pour évaluer l'effet des appareils sur les maxillaires (ANS-PNS, SNA, SNB, ANB, Go-Pg, Ar-Go, Co-Gn, axe Y, Ar-Gn, Ar-Go-Me, FMA, POF/FH, PP/FH, B-Pg(PM), 1/-FH, 1/-/1, /1-PM). Un questionnaire pour évaluer le confort face à leur appareil a été remis aux patients à environ la moitié du temps de port estimé. Résultats : Il n'y a aucune différence statistiquement significative entre les deux traitements sur la croissance du maxillaire (ANS-PNS p = 0,93, SNA p = 0,12). De façon générale, il n'y a pas non plus de différence significative entre les deux traitements sur la croissance de la mandibule (Ar-Gn p = 0,03, SNB p = 0,02 et pour les 6 autres mesures p > 0,05). Pour la composante dento-alvéolaire, les deux traitements proclinent les incisives inférieures et rétroclinent les incisives supérieures, le Forsus causant une plus forte rétroclinaison des incisives supérieures (1/-FH p = 0,007, /1-PM p = 0,10). Pour les changements angulaires des plans, le Forsus cause de manière significative une augmentation de l’inclinaison du plan occlusal (POF/FH p = 0,001). Pour le questionnaire sur l'évaluation du confort, il n'y a pas de différence entre les deux traitements en ce qui concerne la gêne face aux activités quotidiennes (p = 0,19). L'hygiène est plus facile avec les élastiques (p = 0,03). Le sommeil n’est perturbé par aucun des appareils (p =0,76). La différence entre le groupe «élastiques» et le groupe «Forsus» pour le confort en général n'est pas significative (p = 0,08). Conclusions : Le but de l’étude étant de vérifier l’efficacité des élastiques de classe II bien portés versus celle des Forsus, on peut conclure que leurs effets sont relativement similaires sur les maxillaires. Cependant, le Forsus cause de manière statistiquement significative une augmentation de l'angle du plan occlusal et une rétroclinaison plus importante des incisives supérieures. / Objective : To compare the effects on jaw growth of using Forsus Springs versus class II elastics. Material and Method : A sample of 30 patients was treated non extraction. Following a preliminary alignment phase with full fixed braces, 23 patients (14 girls, 9 boys) were treated with Forsus and 7 patients (4 girls, 3 boys) were treated with elastics (mean age : 14,3yo). Average wearing time : 0,5 y. Cephalometric radiographs were taken at the end of the alignment phase and at the end of the functional phase. Radiographic measurements were taken to assess the effects of both appliance types (ANS-PNS, SNA, SNB, ANB, Go-Pg, Ar-Go, Co-Gn, axe Y, Ar-Gn, Ar-Go-Me, FMA, POF/FH, PP/FH, B-Pg(PM), 1/-FH, 1/-/1, /1-PM). Questionnaires to assess comfort with the appliances were given to the patients approximately halfway through treatment. Results : No statistically significant differences in maxillary growth (ANS-PNS p = 0,93, SNA p = 0,12) or mandibular growth (Ar-Gn p = 0,03, SNB p = 0,02 and for the other 6 measurements p > 0,05) were noted between groups. Both treatments proclined lower incisors and retroclined upper incisors, with the Forsus causing more retroclination of the upper incisors (1/-FH p = 0,007, /1-PM p = 0,10). Forsus caused a statistically significant steepening of the occlusal plane (POF/FH p = 0,001). With respect to patient comfort, there was no statistically significant difference between the two treatments, although maintaining oral hygiene was easier in the elastics group (for daily activities p = 0,19, oral hygiene p = 0,03, sleep p =0,76, general comfort p = 0,08). Conclusions : The aim of this study being to assess the effectiveness of well worn class II elastics versus the effectiveness of Forsus, we can conclude that their effects are relatively similar on the maxillary bones. However, Forsus cause a statistically significant increase of the inclination of the occlusal plane and greater retroclination of upper incisor.