{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:41:10Z","timestamp":1776264070570,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical &amp;amp; Exp Dental Res"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study systematically searched the literature and assessed the available evidence to compare the efficacy of Forsus Fatigue Resistance Device (FRD) versus Twin Block Appliance (TBA) in treating class II malocclusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>The search for published literature was published up to May 28, 2024. The databases were included in the search: MEDLINE, PubMed, EMBASE, Cochrane Oral Trials Register, Tripe, Web of Science, and Scopus. Additionally, unpublished literature was searched on ClinicalTrials.gov, the National Research Register, and ProQuest Dissertations and Theses. All eligible studies were carefully reviewed and two reviewers independently extracted data. In cases of disagreement, an arbiter was consulted for resolution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two randomized controlled trials (RCTs) and five non\u2010RCTs were included in this review. The total number of patients included in the studies examining SNA, SNB, and ANB was 254. The studies also looked at the variables Go\u2010Gn, L1\u2010ML, and U1\u2010SN, with 279, 205, and 277 patients included for each variable, respectively. According to the evidence reported, TBA showed greater skeletal effects in terms of mandibular length and advancement. The pooled estimate revealed a statistically significant 1.3\u00b0 increase in the SNB, and a decrease of \u22121.34\u00b0 in the ANB angles for patients treated with TBA compared with those treated with FRD, with no statistically significant differences in the SNA angle. Most studies had a moderate risk of bias, while only two studies had a high risk of bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>FRD has been proven to be an effective treatment device for correcting ANB and restricting SNA angle, similar to TBA. However, TBA appears to offer better mandibular length and SNB outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cre2.70054","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T15:41:38Z","timestamp":1734018098000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Skeletal and Dental Effects of Forsus Fatigue Resistance Device Versus Twin Block Appliance for Class II Malocclusion Treatment in Growing Patients: A Systematic Review"],"prefix":"10.1002","volume":"10","author":[{"given":"Bahaa Aldeen","family":"Jeha","sequence":"first","affiliation":[{"name":"Department of Orthodontics University of Damascus Dental School Damascus Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rania","family":"Haddad","sequence":"additional","affiliation":[{"name":"Department of Orthodontics University of Damascus Dental School Damascus Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00056-019-00185-7"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2319\/061706-244"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ocr.12414"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2319\/032613-240.1"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/mod.2000.105571"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2019.12.016"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ortho.2021.01.003"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2319\/031107-123.1"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-014-1237-y"},{"key":"e_1_2_11_11_1","first-page":"40.e1","article-title":"Dentoskeletal Changes in Class ii Malocclusion Patients After Treatment With the Twin Block Functional Appliance","volume":"16","author":"Brunharo I.","year":"2011","journal-title":"Dental Press Journal of Orthodontics"},{"key":"e_1_2_11_12_1","volume-title":"Twin Block Functional Therapy: Application in Dentofacail Orthopaedics","author":"Clark W.","year":"2014"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/4.2.129"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejwf.2014.11.004"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2015.44"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cju030"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.2319\/090514-624.1"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/njcp.njcp_110_18"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1698915"},{"key":"e_1_2_11_20_1","first-page":"57","article-title":"A Comparison of the Treatment Effects of the Forsus Fatigue Resistance Device and the Twin Block Appliance in Patients With Class Ii Malocclusions","volume":"6","author":"Hanoun A.","year":"2014","journal-title":"Clinical, Cosmetic and Investigational Dentistry"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/13.6.471"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0544.2000.030406.x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40510-014-0045-x"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470712184.ch4"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2012.10.015"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2005.02.025"},{"key":"e_1_2_11_28_1","first-page":"666","article-title":"Forsus Nitinol Flat Spring and Jasper Jumper Corrections of Class ii Division 1 Malocclusions","volume":"76","author":"Karacay S.","year":"2006","journal-title":"Angle Orthodontist"},{"key":"e_1_2_11_29_1","first-page":"1","article-title":"An Assessment of the Occlusion of the Teeth of Children 6\u201011years, United States","volume":"11","author":"Kelly J. 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