The intervention will be twelve sessions (two per week). Laser parameters: wavelength - 786.94 nm; conventional tip; energy density - 25 J/cm²; intensity - 1.675 mW/cm²; output power - 70 mW (0.070 W); and exposure time - 20 seconds per point. The point application method will be used with direct contact with the skin (spot beam of 0.04 cm²), following the protocol suggested by Carvalho et al.50 and Venezian et al.44 A potentiometer will be used to determine the mean power of the laser equipment to ensure the safety of the operator.

The intervention will be a maxillary occlusal splint will be used on the maxilla with palatal and occlusal coverage. Following the protocol established by Hachmann et al., the children will only use the splint at night for two months, with weekly adjustments of a quarter turn.46

Placebo laser will be performed using the same equipment.

Sleep Bruxism

Low-level laser therapy administrated to acupoints

Laser

Occlusal splint

Placebo laser (Low-level laser therapy administrated to acupoints)

Placebo laser

Evaluation of Muscle Activity, Bite Force and Salivary Cortisol in Children With Bruxism

Evaluation of Muscle Activity, Bite Force and Salivary Cortisol in Children With Bruxism Before and After Laser Use of Low Power in Acupoints- Controlled Clinical Trial

six-channel BTS TMJOINT electromyograph (BTS Engineering)

Bite force will be measured using a digital gnathodynamometer (DMD, Kratos Equipamentos Industriais Ltda, Cotia, São Paulo, Brazil) adapted for oral conditions

Saliva will be collected on cotton swabs, which will be left in the mouth for two minutes. The cotton will then be placed into a centrifuge tube and the sample will be stored at -20° C until analysis.25 Salivary cortisol will be measured prior to therapy and on Day 50 to measure the degree of stress. Two collections will be performed in the home of the participant at 9 am and prior to going to sleep with at least one hour of fasting prior to the collection and will be followed with oral hygiene with water. The collection will be performed on a Sunday following the manufacturer's recommendations and will be delivered on the following Monday for analysis at University Nove de Julho (Brazil).

Monica Canuto Salgueiro

University of Nove de Julho

Upper will be bonded, levelled and aligned until reaching 0.019 x 0.025 ss archwires.
2 Y shaped mini plates will be inserted in the mandibular symphysis Insertion of the FFRD with Direct application over the mandibular mini plates

Upper and lower arches will be bonded, levelled and aligned until reaching 0.019 x 0.025 ss archwires.
Insertion of FFRD with application over the lower archwire

Patients will be observed for an average duration of 6-8 months

Malocclusion, Angle Class II, Division 1

FFRD direct loading over mini plates inserted in the mandibular symphysis

FFRD and mini plates group

FFRD inserted between maxillary and mandibular arches with the pushrods placed distal to mandibular canines

Conventional FFRD

Ritto A. Fixed Functional Appliances-A Classification (Updated). Orthod Cyber J. 2001

Orthodontic department, Faculty of Oral and Dental Medicine, Cairo University

Evaluation of Mini Plates Anchorage With Forsus Fatigue Resistant Device

Evaluation of Mini Plates Anchorage in Conjunction With Forsus Fatigue Resistant Device for Correction of Skeletal Class II Malocclusion in Growing Subjects: A Randomized Controlled Trial

This outcome will be detected through measurement of the mean change in the effective mandibular length and position from baseline data that when increased will result in a decrease in profile convexity. This measurement will be done after FFRD removal and correction of the sagittal relationship.
Cone-beam computed tomography (CBCT) images will be used for analysis of this outcome where changes in effective mandibular length (Co-Gn) will be measured in mm

The dento-alveolar side effects of the appliance therapy are to be detected. CBCT images will be used for analysis of this outcome where changes in the inclination and positions of incisors will be measured in degrees and mm respectively.

Changes in the soft tissue angle of convexity will be detected by CBCT (in degrees) that contribute to soft tissue profile correction

Will be detected by CBCT; the position of the upper and lower lips and chin will be measured in mm relative to a frontal plane

malocclusion/vermoeidheid

Evaluation of Muscle Activity, Bite Force and Salivary Cortisol in Children With Bruxism

Evaluation of Mini Plates Anchorage With Forsus Fatigue Resistant Device

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