Discomfort, expectations, and experiences during treatment of large overjet with Andresen Activator or Prefabricated Functional Appliance: a questionnaire survey

Abstract

Background: The purpose of this study was to investigate the amount of functional and social discomfort experienced after 1 and 6 months of appliance wear, comparing a slightly modified Andresen Activator (AA) and a Prefabricated Functional Appliance (PFA).

Methods: Ninety-seven patients randomly selected by lottery in an AA (40 subjects), and a PFA (57 subjects) group, with an Angle Class II, Division 1 malocclusion, were eligible for the study. One month and 6 months after start of treatment, a questionnaire, addressing discomfort, perception of treatment need and outcome, was used.

Results: The response rate was 69% after 1 month, and 45% after 6 months. The most common discomfort reported was the ‘appliance falling out during sleep’ followed by ’difficulties in remembering it’. The only difference was for pain, which was experienced more extensively in the AA group after 1 month of treatment. The dentist appeared to have the greatest impact on the decision to initiate treatment. Teasing, because of appearance, occurred in 13% of the cases.

Conclusions: No difference could be seen between groups for the experience of functional or social discomfort after 6 months of appliance use. Adequate time should be allowed for clarifying treatment difficulties, using treatment need as motivation.

Practical implications: The PFA eliminates the need for taking impressions. Furthermore, it can be economically advantageous to both patients and clinicians.

Keywords:

• Orthodontic appliances
• functional
• Angle Class II
• malocclusion
• activator appliances
• treatment discomfort
• pain

Acknowledgements

The authors wish to thank the dental students Amin Karzan and Rashed Rouhollah for helping with registration and processing of data and Professor Max Petzold for his great contribution of statistical knowledge and advice. We would also like to thank Professor emeritus Bengt Mohlin for contributing to the design of this study. We would also like to thank the general practitioners at the Public Dental Health Service and the consulting orthodontists at the Orthodontic Clinic, University Clinics of Odontology, Gothenburg, Sweden, for making this study possible. Last but not least our thanks to all patients completing the questionnaires.

Disclosure statement

The authors report no conflicts of interest.

Notes on contributors

Emina Čirgić, is a PhD resident in Institute of Odontology. She has contributed to conception and design of the work, acquisition of data, analysis and interpretation of data. She involved in drafting and revising the manuscript and also in submitting of article.

Heidrun Kjellberg, is an Associate Professor in Department of Orthodontics, University Clinics of Odontology. She has contributed to conception and design of the work and also assisted in the interpretation of the results and revised the manuscript.

Ken Hansen, is an Associate Professor in Department of Orthodontics, University Clinics of Odontology. He has contributed to conception and design of the work and also assisted in the interpretation of the results and revised the manuscript.

Additional information

Funding

We would like to thank the Council for Research and Development in the Västra Götaland Region, Gothenburg Dental Society and Swedish Dental Society for supporting this study.