Dentoskeletal and airway effects of the X-Bow appliance versus removable functional appliances (Frankel-2 and Trainer) in prepubertal Class II division 1 malocclusion patients


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Australasian Orthodontic Journal

Australian Society of Orthodontists

Subject: Dentistry, Orthodontics & Medicine


ISSN: 2207-7472
eISSN: 2207-7480





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VOLUME 33 , ISSUE 1 (May 2017) > List of articles

Dentoskeletal and airway effects of the X-Bow appliance versus removable functional appliances (Frankel-2 and Trainer) in prepubertal Class II division 1 malocclusion patients

Ezgi Atik * / Hande Görücü-Coşkuner / Ilken Kocadereli

Citation Information : Australasian Orthodontic Journal. Volume 33, Issue 1, Pages 3-13, DOI:

License : (CC BY 4.0)

Published Online: 30-July-2021



Objectives: The aim of the present study was to evaluate the dentoskeletal and airway effects of three different functional appliances (Frankel-2, Trainer and X-Bow) in prepubertal Class II division 1 patients.

Methods: The sample consisted of 54 patients with a Class II relationship as a result of mandibular retrognathia and relative maxillary constriction. Group I included 15 patients treated with a Frankel-2 appliance. Group II consisted of 14 patients treated with a T4-K Trainer. Group III consisted of 15 patients treated with the X-Bow appliance. Group IV consisted of 10 untreated Class II patients who served as a control group. Pretreatment (T1) and post-treatment (T2) cephalograms were used to evaluate dentoskeletal and airway changes. Parametric one-way variance analysis (ANOVA) and a paired t-test were used to perform statistical analysis.

Results: The decrease in SNA angle was significant in groups I and III, compared with the control group (p < 0.05). SNB angle and Co-GN length changes from T1 to T2 were statistically significant in groups I and II (p < 0.05), but not relative to the control group. The upper and lower incisors were significantly retruded and protruded, respectively, in all treatment groups (p < 0.05). Except PNS-AD2 and MAS measurements in group I, nasopharyngeal and oropharyngeal airway dimensions did not significantly change from T1 to T2 in all groups.

Conclusions: The Frankel-2 and X-Bow appliances were efficient in restricting the forward growth of the maxilla. The Frankel-2 and Trainer appliances produced a larger sagittal increase in mandibular length than the X-Bow appliance. Lower incisor proclination was more pronounced in the X-Bow group. The effect of the treatment protocols was similar and matched the control group with respect to the airway.

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