Evaluation of MARA Appliance with Skeletal Anchorage in Early Treatment of Class II Malocclusion

Objective: To investigate the effects of the fixed functional appliance Mandibular Anterior Repositioning Appliance
(MARA) with skeletal anchorage on growing patients with skeletal Class II malocclusion. Materials and Methods:
This study was conducted on 10 patients with a mean age of 10.3 years with skeletal Class II malocclusion. These
patients were treated simultaneously with the MARA appliance with skeletal anchorage for 16.5 months on average. All
the patients had the following criteria: skeletal Class II due to mandibular retrusion, overjet more than 4mm, no
systemic diseases, no previous orthodontic treatment, or abnormal habits. Photographs and study casts were obtained
before and after treatment. Lateral head films were taken before MARA appliance treatment and after MARA appliance
removal. The collected data were analyzed using IBM SPSS software Version 22.0.Results: Restricted maxillary
growth and significant mandibular growth were observed upon using the MARA appliance. Overjet was improved, and
also maxillary molar distalization, and improvement of soft tissue profile were observed. Conclusions: The MARA
appliance was effective in the treatment of Class II malocclusion by a combination of slight skeletal and dental changes.
Restriction of maxillary growth and dentoalveolar changes in the maxillary and mandibular arches were responsible for
the correction of the Class II malocclusion.