Evaluation of the skeletal and dental effects of a hybrid aesthetic functional appliance (HAF) in skeletal class II division 1 malocclusion: A prospective uncontrolled clinical trial.

Background: The present study investigated the skeletal and dental effect in class II division I growing patients due to mandibular deficiency treated with the hybrid aesthetic functional (HAF) appliance.

Methods: A sample of 16 growing patients (5 boys and 11 girls; mean age: 9.50 years, standard deviation: 1.15) with class II division I malocclusion were treated using the HAF appliance for an average period of 10±3 months. For each patient, a cephalometric radiograph was taken before and after treatment, and digital analysis was applied using the WebCeph program. The statistical analysis was performed to evaluate dental and skeletal changes associated with the HAF appliance and determine if there were any statistically significant variations in anatomical measurements between the start and completion of the treatment.

Results: The data showed a significant increase in SNB angle (P=0.002), leading to a significant decrease in ANB angle (P=0.001). The mandibular length significantly increased (P=0.008), the lower incisors were flared significantly (P=0.028), and the lower molars were extruded significantly (P≤0.001). Also, this study revealed a significant decrease in Wits appraisal (P≤0.001), overjet (P≤0.001), and overbite (P=0.041). Additionally, a significant increase in lower anterior facial height (P≤0.001), total facial height (P=0.001), and posterior facial height (P=0.037) were observed.

Conclusion: The HAF appliance showed that it could be used to correct class II division 1 skeletal discrepancy by mandibular advancement. The HAF appliance increased all facial heights significantly.