{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:17:57Z","timestamp":1762507077359},"reference-count":26,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Braz. Dent. J."],"abstract":"<jats:p>Abstract The aim of this study was to evaluate the effects of the mandibular protraction appliance (MPA) for treating mild to moderate Class II malocclusion at different stages of dentofacial development. Lateral radiographs were evaluated before (T0) and at the end (T1) of orthodontic treatment with fixed appliance associated with MPA. Sixty-five consecutively treated patients were divided according to the stage of dentofacial development: 21 children in late mixed dentition, 22 adolescents and 22 young adults with full permanent dentition. The differences between and within groups were analyzed by MANOVA at p&lt;0.05. The correction of anteroposterior discrepancy (Wits) was significantly reduced in all development stages (p&lt;0.01), with no difference between groups. Class II was corrected predominantly by dental changes in the mandibular arch, with accentuated proclination of the mandibular incisors and mesial displacement of mandibular molars. The MPA had no skeletal effects in any of the groups, except for a mild reduction of SNA (p=0.018) and ANB angles (p&lt;0.0001) among the mixed dentition children. With regard to soft-tissue profile, facial convexity decreased significantly in all groups (p&lt;0.01). In conclusion, the MPA associated with fixed appliance corrected the Class II occlusion, basically by a mandibular arch protrusion. A mild skeletal maxillary change was significant only when this treatment protocol began during mixed dentition.<\/jats:p>","DOI":"10.1590\/0103-6440201701032","type":"journal-article","created":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T15:23:37Z","timestamp":1494516217000},"page":"225-233","source":"Crossref","is-referenced-by-count":12,"title":["Mandibular Protraction Appliance Effects in Class II Malocclusion in Children, Adolescents and Young Adults"],"prefix":"10.1590","volume":"28","author":[{"given":"Luana Farias","family":"Pontes","sequence":"first","affiliation":[{"name":"Universidade Federal do Par\u00e1,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Ajalmar","family":"Maia","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcio Rodrigues","family":"Almeida","sequence":"additional","affiliation":[{"name":"Universidade Norte do Paran\u00e1,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Flores-Mir","sequence":"additional","affiliation":[{"name":"University of Alberta,  Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Normando","sequence":"additional","affiliation":[{"name":"Universidade Federal do Par\u00e1,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2017,4]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"599.e1","DOI":"10.1016\/j.ajodo.2005.11.010","article-title":"Mandibular changes produced by functional appliances in Class II malocclusion: a systematic review","volume":"129","author":"Cozza P","year":"2006","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.2319\/033110-180.1","article-title":"Lower incisor inclination changes during Xbow treatment according to vertical facial type","volume":"80","author":"Flores-Mir C","year":"2010","journal-title":"Angle Orthod"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/j.ajodo.2008.01.021","article-title":"Short-term skeletal and dental effects of the Xbow appliance as measured on lateral cephalograms","volume":"136","author":"Flores-Mir C","year":"2009","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"ref4","first-page":"49","article-title":"The mandibular protraction appliance IV","volume":"7","author":"Coelho Filho CM","year":"2002","journal-title":"R Dental Press Ortodon Ortop Facial"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"485","DOI":"10.2319\/062709-359.1","article-title":"Treatment effects of twin-block and mandibular protraction Appliance-IV in the correction of Class II malocclusion","volume":"80","author":"Jena AK","year":"2010","journal-title":"Angle Orthod"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"485","DOI":"10.2319\/062709-359.1","article-title":"Treatment effects of twin-block and mandibular protraction Appliance-IV in the correction of Class II malocclusion","volume":"80","author":"Jena AK","year":"2010","journal-title":"Angle Orthod"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"334","DOI":"10.2319\/052912-450.1","article-title":"Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion","volume":"83","author":"Franchi L","year":"2013","journal-title":"Angle Orthod"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ajodo.2006.06.028","article-title":"Longitudinal growth changes in untreated subjects with Class II Division 1 malocclusion","volume":"134","author":"Stahl F","year":"2008","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1590\/S2176-94512013000500009","article-title":"Effects of mandibular protraction appliance associated to fixed appliance in adults","volume":"18","author":"Furquim BD","year":"2013","journal-title":"Dental Press J Orthod"},{"key":"ref10","first-page":"113","article-title":"Cephalometric evaluation of the effects of joint use of a mandibular protraction appliance (MPA) and a fixed orthodontic appliance on the skeletal structures of patients with Angle Class II, division 1 malocclusion","volume":"16","author":"Ara\u00fajo EM","year":"2011","journal-title":"Dental Press J Orthod"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/0002-9416(83)90177-X","article-title":"Longitudinal changes in the ANB angle and Wits appraisal: clinical implications","volume":"84","author":"Bishara SE","year":"1983","journal-title":"Am J Orthod"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1093\/ejo\/26.1.65","article-title":"Treatment effects produced by the Bionator appliance. 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