Review Article

Year : 2025 | Volume : 16 | Issue : 1 | Page : 24-37

Prognostic Factors for Successful Functional Appliance Therapy in Skeletal Class II Malocclusion- A Systematic Review

Rajkumaran Rajamanickam1, Bhadrinath Srinivasan2, Keerthi Venkatesan3 , Vignesh Kailasam4

1-Post Graduate Resident, 2-Associate Professor, 3-Senior Lecturer, 4-Professor and Head, Department of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra Dental College & Hospital, Porur, Chennai-600116, India.

Address for Correspondence:

Dr Bhadrinath Srinivasan

Associate professor,

Department of Orthodontics and Dentofacial Orthopedics,

Sri Ramachandra Dental College & Hospital, Porur, Chennai-600116.

E-mail – bhadrinath.s@sriramachandra.edu.in

Phone - +91 9841879224

ABSTRACT

AIM: To investigate clinical or cephalometric parameters that contribute to favourable outcomes with functional appliance therapy in skeletal class II malocclusion.

MATERIALS AND METHODS: Six electronic databases were searched PubMed, Ovid, Lilacs, Cochrane, Scopus, and Web of Science up to 25thFebruary 2025. All study designs which evaluated factors associated with favourable and unfavourable outcome with functional appliance therapy for the treatment of skeletal class II malocclusion were included. The electronic search, initial screening, data extraction, risk of bias assessment was independently performed by the two reviewers. The collected data were analysed from the finally selected articles based on type of study, sample size, type of functional appliance used, and patient characteristics or factors studied which could be considered as positive predictive factors for functional appliance.

RESULTS: Seven retrospective studies and one prospective study were included. Prognostic factors like  the Co-Go-Me angle, chin position, growth pattern and other occlusal factors such as overbite, overjet were evaluated in the selected studies. Four studies were rated very good with 9 points and four other studies were rated as satisfactory with 7 points using the Newcastle Ottawa Scale. Due to heterogeneity of the factors studied, a meta–analysis could not be conducted in this systematic review.

CONCLUSION: Two included studies reported Co- Go-Me angle as the single most important predictive factor for successful outcome. Cephalometric factors pointing to horizontal growth pattern or hypo divergence, chin position and occlusal variables like increased overbite and overjet were identified as positive predictive factors. However future studies with definitive comparison groups can strengthen the current evidence.

REGISTRATION: PROSPERO(CRD42022312039).

CONFLICT OF INTEREST DISCLOSURE

All the authors disclose they do not have any financial or non-financial interests that are directly or indirectly related to the work submitted for publication.

 All the authors declare that the manuscript has been read and approved by all  of them , that the requirements for authorship as stated earlier in this document have been met, and that each author believes that the manuscript represents honest work.

All the authors declare that they do not have any competing interests

FUNDING

There was no external funding.

How to cite this article: Rajkumaran Rajamanickam, Bhadrinath Srinivasan, Keerthi Venkatesan , Vignesh Kailasam. Prognostic Factors for Successful Functional Appliance Therapy in Skeletal Class II Malocclusion- A Systematic Review. Int J Orthod Rehabil 2025; 16 (1) 24-37.