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VOLUME 2 , ISSUE 3 ( 2017 ) > List of Articles


PowerScope: An Efficient Treatment Modality for Skeletal Class II Malocclusion

Manish Bansal, Kamal Bajaj, Rashmi Puri

Keywords : Alignment and leveling, Class II division 1 malocclusion, Nonextraction, PowerScope

Citation Information : Bansal M, Bajaj K, Puri R. PowerScope: An Efficient Treatment Modality for Skeletal Class II Malocclusion. J Mahatma Gandhi Univ Med Sci Tech 2017; 2 (3):171-175.

DOI: 10.5005/jp-journals-10057-0060

License: CC BY-NC-ND 3.0

Published Online: 01-03-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Skeletal class II malocclusion is one of the major complicated conditions to manage in orthodontics. Skeletal class II malocclusions due to lower jaw retrusion are usually treated by functional appliances during the peak of puberty. Due to the noncompliance with conventional myofunctional appliances, the evolution of fixed functional appliances took place. The present case report reports the ability of PowerScope in the correction of skeletal class II malocclusion due to lower jaw retrusion. This case report shows a patient aged 14 years who reported to the Department of Orthodontics and Dentofacial Orthopedics with a chief complaint of forwardly placed upper front teeth. In this case, McLaughlin, Bennett, Trevisi (MBT) 0.022” prescription was used to treat functional jaw retrusion initially, and then PowerScope was used. Cephalograms were obtained before treatment, during the middle stage of treatment, and after treatment. The results of cephalometric analysis showed considerable improvement in maxillomandibular relationship, facial profile, and appearance of patient. In this case, the chief component for correction of class II malocclusion was considerable displacement of mandible in the forward direction. Excellent results for management of class II malocclusion are provided by PowerScope, as such cases can be treated by a nonextraction approach if we use PowerScope as the treatment modality. How to cite this article Mittal K, Bajaj K, Bansal M, Puri R. PowerScope: An Efficient Treatment Modality for Skeletal Class II Malocclusion. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):171-175.

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  1. Graber, TM.; Rakosi, T.; Petrovic, A. Dentofacial orthopedics with functional appliances. St. Louis (MO): C. V. Mosby Co.; 1997. pp. 346-352.
  2. Proffit, WR. Malocclusion and dentofacial deformity in contemporary society. In: Profit WR, Fields HW, Sarver DM, editors. Contemporary orthodontics. 4th ed. St. Louis (MO): Mosby Elsevier; 2007. pp. 3-23.
  3. McNamara JA Jr. Components of class II malocclusion in children 8-10 years of age. Angle Orthod 1981 Jul;51(3):177-202.
  4. Nelson C, Harkness M, Herbison P. Mandibular changes during functional appliance treatment. Am J Orthod Dentofacial Orthop 1993 Aug;104(2):153-161.
  5. Patel HP, Moseley HC, Noar JH. Cephalometric determinants of successful functional appliance therapy. Angle Orthod 2002 Oct;72(5):410-417.
  6. Cozza P, Baccetti T, Franchi L, De Toffol L, McNamara JA Jr. Mandibular changes produced by functional appliances in class II malocclusion: a systematic review. Am J Orthod Dentofacial Orthop 2006 May;129(5):599.e1-599.e12.
  7. Schaefer AT, McNamara JA Jr, Franchi L, Baccetti T. A cephalometric comparison of treatment with the Twin-block and stainless steel crown Herbst appliances followed by fixed appliance therapy. Am J Orthod Dentofacial Orthop 2004 Jul;126(1):7-15.
  8. Ritto AK, Ferreira AP. Fixed functional appliances—a classification. Funct Orthod 2000 Spring;17(2):12-30, 32.
  9. Cetlin NM, Ten Hoeve A. Nonextraction treatment. J Clin Orthod 1983 Jun;17(6):396413.
  10. Pancherz H, Ruf S, Kohlhas P. “Effective condylar growth” and chin position changes in Herbst treatment: a cephalometric roentgenographic long-term study. Am J Orthod Dentofacial Orthop 1998 Oct;114(4):437-446.
  11. Nelson B, Hansen K, Hägg U. Class II correction in patients treated with class II elastics and with fixed functional appliances: a comparative study. Am J Orthod Dentofacial Orthop 2000 Aug;118(2):142-149.
  12. Heinig N, Göz G. Clinical application and effects of the Forsus spring. A study of a new Herbst hybrid. J Orofac Orthop 2001 Nov;62(6):436-450.
  13. Vogt W. The Forsus fatigue resistant device. J Clin Orthod 2006 Jun;40(6):368-377.
  14. El-Sheikh MM, Godfrey K, Manosudprasit M, Viwattanatipa N. Force-deflection characteristics of the fatigue-resistant device spring: an in vitro study. World J Orthod 2007 Spring;8(1):30-36.
  15. McKenna MJ, Cheney ML, Borodie G, et al. Management of facial paralysis after intracranial surgery. Contemp Neural 1991;62-67.
  16. Gillies HD. Experiences with fascia lata grafts in the operative treatment of facial paralysis. Proc R Soc Med 1934 Aug;27(10):1372-1378.
  17. May M, Drucker C. Temporalis muscle for facial reanimation. A 13-year experience with 224 procedures. Arch Otolaryngol Head Neck Surg 1993 Apr;119(4):378-382.
  18. Tessier, P.; Tulasne, JF. Surgical correction of Treacher-Collins syndrome. In: Bell WH, editor. Modern practice in orthognathic and reconstructive surgery. Philadelphia (PA): WB Saunders; 1992. p. 1600-1623.
  19. Matsuba HM, Hakki AR, Little JW 3rd, Spear SL. The temporal fossa in head and neck reconstruction: twenty-two flaps of scalp, fascia and full thickness cranial bone. Laryngoscope 1988 Apr;98(4):444-449.
  20. Hackett ML, Anderson CS. Predictors of depression after stroke: a systematic review of observational studies. Stroke 2005 Oct;36(10):2296-2301.
  21. Castillo CS, Schultz SK, Robinson RG. Clinical correlates of early-onset and late-onset poststroke generalized anxiety. Am J Psychiatry 1995 Aug;152(8):1174-1179.
  22. Aström M. Generalized anxiety disorder in stroke patients. A 3-year longitudinal study. Stroke 1996 Feb;27(2):270-275.
  23. Oladiji JO, Akinbo SR, Aina OF, Aiyejusunle CB. Risk factors of post-stroke depression among stroke survivors in Lagos, Nigeria. Afr J Psychiatry (Johannesbg) 2009 Feb;12(1):47-51.
  24. Chemerinski E, Robinson RG. The neuropsychiatry of stroke. Psychosomatics 2000 Jan-Feb;41(1):5-14.
  25. Angelelli P, Paolucci S, Bivona U, Piccardi L, Ciurli P, Cantagallo A, Antonucci G, Fasotti L, Di Santantonio A, Grasso MG, et al. Development of neuropsychiatric symptoms in poststroke patients: a cross-sectional study. Acta Psychiatr Scand 2004 Jul;110(1):55-63.
  26. Almeida OP, Xiao J. Mortality associated with incident mental health disorders after stroke. Aust N Z J Psychiatry 2007 Mar;41(3):274-281.
  27. Smitherman, TA.; Baskin, SM. Depression and anxiety in migraine patients. Mount Royal (NJ): American Migraine Foundation; 2015.
  28. Mehlsteibl D, Schankin C, Hering P, Sostak P, Straube A. Anxiety disorders in headache patients in a specialised clinic: prevalence and symptoms in comparison to patients in a general neurological clinic. J Headache Pain 2011 Jun;12(3):323-329.
  29. Merikangas KR, Angst J, Isler H. Migraine and psychopathology. Results of the Zurich cohort study of young adults. Arch Gen Psychiatry 1990 Sep;47(9):849-853.
  30. Beghi E, Bussone G, D'Amico D, Cortelli P, Cevoli S, Manzoni GC, Torelli P, Tonini MC, Allais G, De Simone R, et al. Headache, anxiety and depressive disorders: the HADAS study. J Headache Pain 2010 Apr;11(2):141-150.
  31. Corchs F, Mercante JP, Guendler VZ, Vieira DS, Masruha MR, Moreira FR, Bernik M, Zukerman E, Peres MF. Phobias, other psychiatric comorbidities and chronic migraine. Arq Neuropsiquiatr 2006 Dec;64(4):950-953.
  32. Song TJ, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Anxiety and depression in tension-type headache: a population-based study. PLoS One 2016 Oct;11(10):e0165316.
  33. Puca F, Genco S, Prudenzano MP, Savarese M, Bussone G, D'Amico D, Cerbo R, Gala C, Coppola MT, Gallai V, et al. Psychiatric comorbidity and psychosocial stress in patients with tension-type headache from headache centers in Italy. The Italian Collaborative Group for the Study of Psychopathological Factors in Primary Headaches. Cephalalgia 1999 Apr;19(3):159-164.
  34. Holroyd KA, Stensland M, Lipchik GL, Hill KR, O'Donnell FS, Cordingley G. Psychosocial correlates and impact of chronic tension-type headaches. Headache 2000 Jan;40(1):3-16.
  35. Borkovec, TD.; Alcaine, O.; Behar. E. Avoidance theory of worry and generalized anxiety disorder. In: Heimberg RG, Turk CL, Mennin DS, editors. Generalized anxiety disorder in research and practice. New York: Guilford Press; 2004. pp. 77-108.
  36. Behar E, DiMarco ID, Hekler EB, Mohlman J, Staples AM. Current theoretical models of generalized anxiety disorders (GAD): conceptual review and treatment implications. J Anxiety Disord 2009 Dec;23(8):1011-1023.
  37. McWiliams LA, Goodwin RD, Cox BJ. Depression and anxiety associated with three pain conditions: results from a nationally representative sample. Pain 2004 Sep;111(1-2):77-83.
  38. Daniali S, Azadbakht L, Mostafavi F. Relationship between body satisfaction with self esteem and unhealthy body weight management. J Educ Health Promot 2013 Jul;2:29.
  39. Huang JS, Norman GJ, Zabinski MF, Calfas K, Patrick K. Body image and self-esteem among adolescents undergoing an intervention targeting dietary and physical activity behaviors. J Adolesc Health 2007 Mar;40(3):245-251.
  40. Wang, Y.; Wu, Y.; Wilson, RF.; Bleich, S.; Cheskin, L.; Weston, C.; Showell, N.; Fawole, O.; Lau, B.; Segal, J. Childhood obesity prevention programs: comparative effectiveness review and meta-analysis. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013. [cited 2013 Jun]. Available from:
  41. Khan MA, Mahomed MF, Ashshi AM, Faiz A. Drug resistance patterns of Acinetobacter baumannii in Makkah, Saudi Arabia. Pak J Med Res 2012 Oct-Dec;51(4):127-131.
  42. Shields RK, Clancy CJ, Gillis LM, Kwak EJ, Silveira FP, Massih RC, Eschenauer GA, Potoski BA, Nguyen MH. Epidemiology, clinical characteristics and outcomes of extensively drug-resistant Acinetobacter baumannii infections among solid organ transplant recipients. PLoS One 2012 Dec;7(12):e52349.
  43. Prashanth K, Badrinath S. In vitro susceptibility pattern of Acinetobacter species to commonly used cephalosporins, quinolones and aminoglycosides. Indian J Med Microbiol 2004 Apr-Jun;22(2):97-103.
  44. Armin S, Karimi A, Fallah F, Tabatabaii RS, Alfatemi SM, Khiabanirad P, Shiva F, Fahimzad A, Rahbar M, Mansoorghanaii R, et al Antimicrobial resistance pattern of Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus isolated from patients with nosocomial infection admitted to Tehran hospitals. Arch Pediatr Infect Dis 2015 Oct;3(4):e32554.
  45. Qureshi ZA, Abbasi SA, Mirza IA, Malik N, Amjad A, Sattar A, Ikram A. Antimicrobial susceptibility pattern of Acinetobacter species-one year experience in a tertiary care setting. Infect Dis J 2011 Mar;20(1):269-272.
  46. Spencer L, Bubner T, Bain E, Middleton P. Screening and subsequent management for thyroid dysfunction pre-pregnancy and during pregnancy for improving maternal and infant health. Cochrane Database Syst Rev 2015 Sep;9:CD011263.
  47. Li M, Yao Q, Xing A. A clinical analysis of 188 cases of pregnancy complicated with critical heart disease. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2014 Nov;39(11):1145-1150.
  48. Bhatla N, Lal S, Behera G, Kriplani A, Mittal S, Agarwal N, Talwar KK. Cardiac disease in pregnancy. Int J Gynaecol Obstet 2003 Aug;82(2):153-159.
  49. Gelson E, Curry R, Gatzoulis MA, Swan L, Lupton M, Steer P, Johnson M. Effect of maternal heart disease on fetal growth. Obstet Gynecol 2011 Apr;117(4):886-891.
  50. Arora N, Kausar H, Jana N, Mandal S, Mukherjee D, Mukherjee R. Congenital heart disease in pregnancy in a low-income country. Int J Gynaecol Obstet 2015 Jan;128(1):30-32.
  51. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000 Jul;183(1):S1-S22.
  52. Agency for Healthcare Research and Quality. Management of chronic hypertension during pregnancy. Evidence Report/Technology Assessment no.14. AHRQ publication no. 00-E011. Rockville, MD: Agency for Healthcare Research and Quality; 2000.
  53. Ferrer RL, Sibai BM, Mulrow CD, Chiquette E, Stevens KR, Cornell J. Management of mild chronic hypertension during pregnancy: a review. Obstet Gynecol 2000 Nov;96(5 Pt 2):849-860.
  54. Sridharan R, Murthy BN. Prevalence and pattern of epilepsy in India. Epilepsia 1999 May;40(5):631-636.
  55. Viale L, Allotey J, Cheong-See F, Arroyo-Manzano D, McCorry D, Bagary M, Mignini L, Khan KS, Zamora J, Thangaratinam S, et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet 2015 Nov;386(10006):1845-1852.
  56. Smyth A, Oliveira GH, Lahr BD, Bailey KR, Norby SM, Garovic VD. A systematic review and meta-analysis of pregnancy outcomes in patients with systemic lupus erythematosus and lupus nephritis. Clin J Am Soc Nephrol 2010 Nov;5(11):2060-2068.
  57. Hazes JM, Coulie PG, Geenen V, Vermeire S, Carbonnel F, Louis E, Masson P, De Keyser F. Rheumatoid arthritis and pregnancy: evolution of disease activity and pathophysiological considerations for drug use. Rheumatology (Oxford) 2011 Nov;50(11):1955-1968.
  58. Velu PP, Gravett CA, Roberts TK, Wagner TA, Zhang JS, Rubens CE, Gravett MG, Campbell H, Rudan I. Epidemiology and aetiology of maternal bacterial and viral infections in low- and middle-income countries. J Glob Health 2011 Dec;1(2):171-188.
  59. UNAIDS: UNAIDS report on the global AIDS epidemic. 2010. Available from
  60. Ioannidis JP, Abrams EJ, Ammann A, Bulterys M, Goedert JJ, Gray L, Korber BT, Mayaux MJ, Mofenson LM, Newell ML, et al. Perinatal transmission of human immunodeficiency virus type 1 by pregnant women with RNA virus loads <1000 copies/ml. J Infect Dis 2001 Feb;183(4):539-545.
  61. Anglemyer A, Rutherford GW, Horvath T, Baggaley RC, Egger M, Siegfried N. Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples. Cochrane Database Syst Rev 2013 Apr;4:CD009153.
  62. Rimoin DL, Connor JM, Pyeritz RE, Korf BR. Emery and Rimoin's principles and practice of medical genetics. Churchill Livingstone Elsevier; 2007.
  63. Verma IC, Puri RD. Global burden of genetic disease and the role of genetic screening. Semin Fetal Neonatal Med 2015 Oct;20(5):354-363.
  64. White SJ, Boldt KL, Holditch SJ, Poland GA, Jacobson RM. Measles, mumps, and rubella. Clin Obstet Gynecol 2012 Jun;55(2):550-559.
  65. American College of Obstetricians and Gynecologists. ACOG educational bulletin: viral hepatitis in pregnancy. Int J Gynaecol Obstet 1998 Nov;63:195-202.
  66. Geeta MG, Riyaz A. Prevention of mother to child transmission of hepatitis B infection. Indian Pediatr 2013;50:189-192.
  67. Swamy GK, Beigi RH. Maternal benefits of immunization during pregnancy. Vaccine 2015 Nov;33(47):6436-6440.
  68. Sukumaran L, McCarthy NL, Kharbanda EO, McNeil MM, Naleway AL, Klein NP, Jackson ML, Hambidge SJ, Lugg MM, Li R, et al. Association of Tdap vaccination with acute events and adverse birth outcomes among pregnant women with prior tetanus-containing immunizations. JAMA 2015 Oct;314(15):1581-1587.
  69. Singru SA, Tilak VW, Gandham N, Bhawalkar JS, Jadhav SL, Pandve HT. Study of susceptibility towards Varicella by screening for the presence of IgG antibodies among nursing and medical students of a Tertiary Care Teaching Hospital in Pune, India. J Glob Infect Dis 2011 Jan-Mar;3(1):37-41.
  70. Nathwani D, Maclean A, Conway S, Carrington D. Varicella infections in pregnancy and the newborn. A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection. J Infect 1998;36 (Suppl 1):59-71.
  71. Michaan N, Amzallag S, Laskov I, Cohen Y, Fried M, Lessing JB, Many A. Maternal and neonatal outcome of pregnant women infected with H1N1 influenza virus (swine flu). J Matern Fetal Neonatal Med 2012 Feb;25(2):130-132.
  72. Smith NM, Bresee JS, Shay DK, Uyeki TM, Cox NJ, Strikas RA. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006 Jul;55(RR-10):1-42.
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