Comparative evaluation of efficacy of two Class II correctors in treatment of skeletal Class II malocclusion: A multicenter randomized controlled trial.

Background: This article aims to compare clinical efficacy of newly introduced PowerScope 2 appliance with Forsus FRD in the treatment of Skeletal Class II malocclusion. Methods: This randomized controlled trial studied 40 patients at two centers (20 patients at each center, divided into two groups of 10 patients each as Group 1: Forsus FRD and Group 2: PowerScope 2 appliance. The skeletal, dental, soft tissue, and airway changes were noted at T0 (pretreatment), T1 (preappliance therapy), and T2 (postappliance therapy). Acoustic Pharyngometry (Eccovision® Acoustic Pharyngometer) was done to ascertain changes in mean airway volume and area with both modalities noninvasively. Treatment duration and chairside time in appliance installation and removal were noted. Patient comfort was compared using a customized questionnaire survey. Results: A significant change was observed in skeletal, dental, soft tissue, and airway parameters after treatment with both modalities (p-value <0.05 for all) with no significant intergroup difference (p-value >0.05). Chairside time spent in appliance insertion was significantly lower with PowerScope 2 appliance (10.33 min) as compared to the Forsus FRD appliance (18.28 min) (p-value <0.05). Visual Analogue Scale scores for parameters such as problems in mastication, problems in speech, and problems in oral hygiene maintenance were significantly lower with PowerScope 2 appliance as compared to the Forsus FRD appliance (p-value <0.05). Conclusions: Although both modalities are effective in the management of Class II malocclusion, the PowerScope 2 appliance scores better in terms of lesser chairside time in appliance installation and better patient comfort.

Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study.

Aim: This current study evaluated and compared the skeletal changes in the head of the condyle, glenoid fossa, and articular space between the twin block appliance and PowerScope™ a fixed functional appliance. Materials and methods: This study was a pilot, randomized, single-blinded, assessing the skeletal changes in the components of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT). The study was conducted in 20 subjects in the age range of 11-14 years with class II division 1 malocclusion. These subjects were distributed randomly between two groups with an allocation ratio of 1:1 (group I-twin block and group I-PowerScope™). Follow-ups of both groups were done till desirable skeletal correction was attained (clinical edge-to-edge incisor relation). Results: Condylar parameters such as position, height, and length were evaluated bilaterally in the CBCT scans. After using both devices, there was an increase in all condylar qualities; however, the twin block appliance showed a more noticeable difference, which has been determined to be statistically significant. In the twin block group, there was an average decrease of 0.56 mm in the anterior articular space and an increase of 1.2 and 2.64 mm in the middle and posterior articular spaces, respectively. In the PowerScope™ group, there was an average decrease of 0.23 mm in the anterior articular space and an increase of 2.55 and 1.85 mm in the middle and posterior articular spaces, respectively. In the case of the twin block device, the change in glenoid fossa angle was observed to be 6.1 mm on both sides and a mean difference of 1.25 mm on the right-side and 1.75 mm on the left-side was observed in the case of PowerScope™. The difference was established to be significant with a p < 0.05 in all cases. Conclusion: Condylar attributes increased after the application of both devices but the difference was more pronounced in the case of twin block appliances. The difference in articular space (middle and posterior) between the twin block group and PowerScope™ group, was not significant statistically. In the present study, the remodeling in the glenoid fossa was greater in the twin block group compared to the PowerScope™ group. How to cite this article: Halapanavar B, MN P, Deshmukh S, et al. Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study. Int J Clin Pediatr Dent 2024;17(1):7-14.

Assessment of Soft Tissue, Airway Dimension and Hyoid Bone Position in Class II Patients Treated by PowerScope Class 2 Corrector.

AIM: This study aims to assess the changes in the soft tissue, pharyngeal airway dimensions, and hyoid bone position in patients treated with PowerScope Class 2 corrector to correct the skeletal Class II pattern. MATERIALS AND METHODS: This study was conducted on a sample of 20 cases diagnosed with Class II malocclusion. The lateral cephalograms were taken before (T1) and after functional appliance therapy (T2) and were traced. The outcomes were compared for the mean changes in soft tissue, airway way dimension, and hyoid bone position. The paired t-test was used for the data comparisons wherein p < 0.05 was kept for statistical significance. RESULTS: The mean values before and after treatment for H angle, mentolabial angle, lower lip E-line, upper lip S-line, lower lip S-line, and lip strain were 19.88 ± 2.77 vs 17.13 ± 1.659, 94.09 ± 12.164 vs 101.75 ± 11.28, -2.47 ± 1.213 vs -1.38 ± 0.976, 3.99 ± 0.19 vs 2.64 ± 0.32, 9.01 ± 0.247 vs 9.43 ± 0.238, 10.24 ± 0.510 vs 10.64 ± 0.52, respectively, which were statistically significant (p < 0.05). All airway spaces (except for lower pharyngeal space) and hyoid bone parameters were significantly improved posttreatment. CONCLUSION: The facial convexity, upper E-line, Z-angle, nasolabial angle, and lower pharyngeal space did not show statistically significant changes. The rest of the soft tissue parameters, oropharyngeal air spaces, and hyoid positioning measured in the study showed significant improvement after treatment with the PowerScope appliance in Class II patients. CLINICAL SIGNIFICANCE: Class II malocclusion is the most common dental anomaly with a high degree of prevalence in the population. This study will help the clinician in understanding the improvement of soft tissue, airway dimension, and hyoid bone position changes on treatment with a fixed functional appliance for the correction of Class II cases, thereby ensuring the greater success of orthodontic therapy in the future.

PowerScope 2 functional appliance: A 3D finite element simulation of its action on the mandible.

PowerScope 2 is a fixed functional appliance for patients with Class II malocclusion and a retrognathic mandible, that has recently received attention due to its pronounced advantages, for both orthodontists and patients. Objective: of study: This study evaluated the action of the PowerScope 2 appliance for correcting Class II malocclusion and the stresses and displacement of the mandible during loading using three-dimensional finite element analysis (FEA). The sites of the mandibular skeletal and/or dental corrections were also distinguished. Materials and methods: Using the AutoCAD (2010) Program, a 3D model of the human mandible with teeth was created based on a CT image of a 20-yr-old patient. Orthodontic stainless-steel brackets with Standard Edgewise (0.022 in) slots bonded to five mandibular teeth and inserted into a bounded tube on the first molar were simulated. A rectangular archwire (0.019 × 0.025 in) ligated the brackets. The created models were uploaded to the Autodesk Inventor Professional Computer Program (FE) version (2020). Results: The FEA presented the three-dimensional results qualitatively and quantitatively as von Mises stress and displacement. The colour ruler on the upper left side demonstrates the stress and displacement distribution pattern of the mandible, with the minimum value in blue and the maximum value in red. Mandibular movement was achieved three-dimensionally. There was obvious sagittal forward mandibular movement, and high stress was observed at the chin prominence (the pogonion). In the transverse plane, the mandible was highly bent buccally, especially at the gonial angle and antegonial notch. In the vertical plane, the highest ranges of mandibular movements were seen in the chin, the anterior part of the mandibular body, and the associated dentoalveolar region. Conclusions: The results of this FEA, PowerScope 2 functional appliance proved to be effective as a Class II malocclusion corrector. Its mode of action on the mandible was achieved in three planes of space, and its orthodontic effects were gained dentally and skeletally. An bbvious sagittal forward mandibular movement was observed, particularly at the chin prominence. Apparent buccal bending, especially at the gonial angle and antegonial notch, was observed. Vertically, the chin and anterior part of the mandible, with the associated dentoalveolar structures, were clearly stressed under the action of this appliance.

Removable versus fixed myo-functional appliances in class II malocclusion among Indians.

It is of interest to compare two myofunctional appliances (frankal appliance and twin bloc) and two fixed orthodontic appliances (PowerScope and Forsus) in management of class II div 1 malocclusion. A total of 56 Class II division 1 malocclusion patients indicated for treatment with myofunctional appliances and fixed functional appliances were randomized. They were equally divided among frankal appliance (n=14), twin block appliance (n=14), PowerScope (American Orthodontics) (n=14), Forsus (3M Unitek Corp) groups (n=14). Skeletal and dentoalveolar effects of all appliances were compared. SNB increased remarkably by 4.2° in the Twin block group and it was high among all treatment groups. There was a significant decrease in vertical dimensions (SN-GoGn) in the Twin block (p = 0.002). Early treatment of Class II due to mandibular retrusion with Twin block functional appliance is recommended due to its favorable skeletal effect.

Treatment effects of "PowerScope" fixed functional appliance - a clinical study.

AIM: To study the skeletal, dental effects and evaluate the soft tissue changes with PowerScope-fixed functional appliance in class II malocclusion. MATERIALS AND METHODS: This clinical study was carried out where a total of 10 growing (CVMS 3 and 4) Class II Division 1 malocclusion patients, indicated for treatment with fixed functional appliance were allocated based on specific inclusion criteria. PowerScope (American Orthodontics) was used as the fixed functional appliance. Skeletal, dental and soft tissue effects of the appliance with various angular and linear parameters on a digital lateral cephalogram were evaluated for all 10 participants. Records were collected before the insertion of PowerScope appliance (T0) and after 5 months, during the appliance removal (T1). All participants were treated with 0.018"×0.025" MBT (3M Unitek) prescription. Statistical analysis was performed using a paired t-test to compare individual mean changes for each treatment category. RESULTS: Statistically significant changes were seen in skeletal parameters such as forward positioning of the mandible with an increase in SNB angle and N perpendicular-Pogonion distance, the class II jaw base relationship improved with reduction in ANB angle and Wits appraisal. Significant changes were observed in dental parameters such as forward positioning of mandibular incisors, maxillary molar distalization and intrusion with reduction in overbite and overjet respectively. In the soft tissue, a significant improvement in facial profile was seen due to an increase in labiomental angle. CONCLUSIONS: The results of this study have shown that statistically significant changes in skeletal, dental and soft tissue parameters.

Management of Asymmetric Mandibular Retrognathia with Differential Loading Technique: A Case Report.

Class II malocclusion cases possess a constant challenge to orthodontists since time immemorial. Mandibular retrusion is the most common feature of class II malocclusion, rather than maxillary prognathism. Association of class II with asymmetry, a condition called asymmetric mandibular retrognathia (AMR), gives a tougher challenge to orthodontists for management. The following case presents effective management of AMR using differential loading technique. A young boy aged 12 years presented with mandibular retrognathia associated with facial asymmetry. He was treated with a differential force loading technique using a fixed functional appliance. RESULTS: Improved facial profile with increased mandibular length achieved. A significant reduction in facial asymmetry was also appreciable. CONCLUSION: Differential force loading technique using fixed functional appliance while being least troublesome for the patient may prove beneficial to harness excellent and satisfactory results with minimal efforts in such cases of mandibular retrusion with facial asymmetries and also decrease the need for surgical correction. HOW TO CITE THIS ARTICLE: Parihar AV, Angamuthu KP, Sahoo R, et al. Management of Asymmetric Mandibular Retrognathia with Differential Loading Technique: A Case Report. Int J Clin Pediatr Dent 2021;14(S-1):S107-S113.

Evaluation of Sagittal Changes in Class II Div 2 Patients with Decelerating Phase of Growth by PowerScope Appliance: A Retrospective Cephalometric Investigation.

BACKGROUND: Restricted mandibular growth is observed in Class II Div 2 malocclusions. The fixed functional appliances are used to effect the skeletal changes in patients with end stages of skeletal maturity. AIM: This cephalometric study aimed to distinguish the skeletal and dental corrections done in the mandible on skeletal Class II Div 2 subjects when treated with PowerScope appliance (American Orthodontics, Sheboygan, WI). MATERIALS AND METHODS: This is a cephalometric study based on the retrospective data. The patients selected for this study were with Class II Div 2 malocclusion and assessed to be in decelerating phase of skeletal growth. A total of 12 patients were selected after applying inclusion and exclusion criteria. A PowerScope was placed after incisor correction and followed up till Class I molar relation was achieved. The initial values (T1) at the time of placement of the appliance and the final values at the end of the molar correction (T2) were noted. The cephalometric parameters at T1 and T2 were assessed using sagittal occlusal (SO) analysis by Pancherz. The paired Student's t-test was used to analyze pre- and posttreatment changes. RESULTS: There was sufficient lengthening of the mandible (4.38 mm). Both the dental and skeletal alterations were observed in the mandible. These changes were marked compared to the maxilla. The pre- and posttreatment changes were statistically significant for the mandibular skeletal changes (P < 0.001) as well as mandibular incisor proclination (P < 0.001). CONCLUSION: The PowerScope can be used as a propeller for sagittal mandibular correction in Class II Div 2 patients.

Influência do aparelho Powerscope na posição espacial das cabeças da mandíbula nas fossas mandibulares / Influence of Powerscope appliance on the spatial position of the mandible heads in mandibular fossae

A correção da Classe II e suas diferentes variáveis foram abordadas através de vários procedimentos. Os dispositivos híbridos funcionais fixos são uma alternativa no tratamento da má oclusão de Classe II com deficiência mandibular. Dentro dessa classificação, o PowerScope™ representa um dispositivo funcional híbrido com um mecanismo fixo, fácil de instalar e de gestão clínica simples, que não requer uma fase de laboratório e nem requer um alto grau de colaboração por parte do paciente. Materiais e métodos: Paciente do sexo feminino, 12 anos de idade, com biotipo, braquifacial. Classe II esquelética, por uma posição avançada da mandíbula superior e com diminuição do terço inferior da face. Nos estudos iniciais, o cefalograma articular de Ricketts foi realizado para determinar a posição inicial e final, pós-correção da Classe II, utilizando o aparelho PowerScope™ American Orthodontic, Sheboygan, Wisconsin, EUA. Discussão: A eficiência dos aparelhos funcionais fixos híbridos, na correção da Classe II, é satisfatória. Dentro do mecanismo de ação há uma grande controvérsia entre os diferentes trabalhos de pesquisa. O dispositivo PowerScope™ foi eficiente na correção da má oclusão de Classe II. Descobriu-se que a correção da Classe II foi principalmente dento-alveolar, distalização do molar superior, mesialização do molar inferior e protrusão dos incisivos inferiores, com algumas pequenas alterações significativas nos parâmetros do esqueleto e tecido mole. Conclusão: Durante o tratamento ativo e após a correção da má oclusão de Classe II, com o uso do PowerScope™, a relação aceitável do côndilo com a cavidade glenoidal e a eminência articular foi mantida, em relação à posição inicial, corroborada radiograficamente com os lamentos e o estudo cefalométrico do raquitismo (AU)

Class II correction and its different variables have been addressed through different procedures. The fixed functional hybrid appliances are an alternative in the treatment of Class II malocclusion with mandibular deficiency. Within this classification, the PowerScope™ represents a hybrid functional device with a fixed mechanism, easy to install and simple clinical management, which does not require a laboratory phase and it doesn´t require a high degree of patient collaboration. Materials and methods: 12 years female patient of age, brachifacial. Skeletal Class II with an advanced position of the upper jaw, and with decrease of the face lower third. In the initial studies, the Ricketts articular cephalogram was performed to determine the initial and final position, post-correction of Class II, using the PowerScope™ American Orthodontic device, Sheboygan, Wisconsin, USA. Discussion: The efficiency of hybrid fixed functional appliances, in the correction of Class II is satisfactory. Within the action mechanism there is a great controversy between different researches. PowerScope™ device was efficient in the correction of Class II malocclusion. We found that the Class II correction was mainly dentoalveolar, the upper molar distalization, lower molar mesialization and lower incisors protrusion, with some slight significant changes in the skeletal and soft tissue parameters. Conclusion: During the active treatment, and after the correction of Class II malocclusion with the use of PowerScope™, the acceptable relationship of the condyle with the glenoid cavity and joint eminence was maintained, with respect to the initial position, corroborated radiographically with the laments and the cephalometric study of Rickets (AU)

Aparelho de protrusão mandibular powerscope™ no tratamento das displasias crânio cérvico oclusais (dcco) ­ II com retrusão mandibular e assimetria dos arcos dentários e face ­ caso clínico / Powerscope™ mandibular protraction appliance for treatment of craniocervical occlusal dysplasia (ccod) type II associated with mandibular deficiency, facial and dental arch asymmetry ­ a clinical case

Nas últimas décadas pode-se afirmar que a Ortodontia vem sofrendo uma evolução sem precedentes. A descoberta de novos conceitos biológicos, o progresso tecnológico e a introdução de novas técnicas têm possibilitado facilitar e agilizar o tratamento de várias maloclusões, dentre elas a Classe II por retrusão mandibular. Diversos aparelhos e técnicas têm surgido nos últimos tempos e os propulsores mandibulares têm tido um destaque considerável. O presente caso clínico ilustra um tratamento ortodôntico corretivo compensatório de um paciente jovem com deficiência mandibular e assimetria através do uso do aparelho Powerscope™. Esse surge como uma alternativa para o tratamento de displasias crânio cérvico oclusais (DCCO) ­ II com retroposicionamento mandibular em pacientes com dentição permanente e relutantes ao tratamento ortodôntico-cirúrgico. De acordo com o fabricante, o aparelho possibilita maior amplitude de movimentos, maior simplicidade na instalação, bem como mais conforto e aceitação por parte do paciente. A queixa principal do presente caso consistia no tratamento da maloclusão Classe II após a falha do tratamento ortopédico funcional. A mecânica aplicada permitiu a correção da maloclusão, atingido-se relações oclusais satisfatórias de molares e caninos, bem como estéticas. Sendo possível obter uma melhoria no perfil e sorriso do paciente. O aparelho Powerscope™ revelou-se um ótimo acessório para o tratamento do presente caso clínico tendo cumprido com seu propósito, não sendo relatada qualquer intercorrência durante o seu uso. (AU)

In the last decades we can say that Orthodontics has undergone an unprecedented evolution. The discovery of new biological concepts, technological progress and the introduction of new techniques have been facilitating and accelerating the treatment of several malocclusions, among them Class II through mandibular retrusion. Several devices and techniques have emerged in recent times and the fixed functional appliances have had a considerable rise in interest. The present case report illustrates a corrective orthodontic treatment of a young patient with mandibular deficiency and asymmetry using the Powerscope™ device. This arises as an alternative for the treatment of craniocervical occlusal dysplasia (CCOD) ­ II with mandibular rebuilt in patients with permanent dentition and reluctant to orthodontic-surgical treatment. According to the appliance manufacturer, the device allows a greater range of movement, greater simplicity in the installation as well as more comfort and acceptance by the patient. The main complaint of the present case was the treatment of Class II malocclusion after failure of functional orthopedic treatment. The applied mechanics allowed the correction of the malocclusion, reaching satisfactory molars and canines occlusal relationships as well as aesthetics. It was possible to obtain an improvement in the patient profile and smile. The Powerscope™ device proved to be an excellent accessory for the treatment of the present clinical case having fulfilled its purpose and no intercurrences were reported during its use.(AU)

The Evaluation and Clinical Efficiency of Power Scope: An Original Research.

AIMS AND OBJECTIVES: Managing mild-to-moderate Class II malocclusion is one of the common and major challenges to orthodontists. Class II discrepancies with mandibular deficiency during active growth are usually treated using myofunctional appliances. Fixed functional appliances evolved due to the noncompliance with conventional myofunctional appliances. One of the latest Class II correctors is the PowerScope appliance. The purpose of this study was to determine the amount, time, and rate of molar correction and efficacy of PowerScope. MATERIALS AND METHODS: A total of 10 participants, between 15 and 19 years' age group (mean = 16.8 years; 5 males and 5 females), requiring treatment of Class II malocclusion were considered for this study. All routine records were made. After initial leveling and alignment, lateral cephalogram was taken in standardized natural head position using Planmeca ProMax unit. Later, PowerScope was installed and a patient was monitored every month for further adjustment and reactivation. On achieving Class I molar relation, skeletal, dental, and soft-tissue linear and angular parameters were measured using Dolphin Imaging Software. Amount, rate, and total treatment time for molar correction were measured. Molar correction was calculated by taking S vertical as reference plane. The obtained values were statistically analyzed using paired t-test. RESULTS: There were statistically significant changes seen in dentoalveolar parameters such as lower incisor proclination, mandibular molar advancement, and reduction in both overjet and overbite. In skeletal parameters, due to the anterior positioning of the mandible, sagittal parameters showed statistically significant changes. In the soft tissue, a significant improvement in facial profile was seen, due to the anterior movement of soft-tissue pogonion. CONCLUSION: The results of this study have shown that statistically significant differences were found in dentoalveolar, soft-tissue, and skeletal parameters.

Comparative evaluation of treatment effects between two fixed functional appliances for correction of Class II malocclusion: A single-center, randomized controlled trial.

OBJECTIVE: The objective of this study was to evaluate and compare the effects of PowerScope and Forsus in the treatment of Class II division 1 malocclusion. MATERIALS AND METHODS: This was a 2-arm parallel, double-blind, randomized, controlled trial. A total of 28 Class II division 1 malocclusion patients indicated for treatment with fixed functional appliances were randomized and equally divided (n = 14) among PowerScope (American Orthodontics, Sheboygan, Wis; mean age 14.11 ± 1.3 years) and Forsus (3M Unitek Corp, Monrovia, Calif; mean age 15.5 ± 1.1 years) groups. Skeletal and dentoalveolar effects of PowerScope and Forsus were compared. The secondary outcomes were evaluation of patient comfort and operator convenience. Randomization was accomplished with a 1:1 allocation ratio, and concealment was achieved by sealed opaque envelopes. The participants and data collectors were all blinded to study group allocation. Data were analyzed for 26 patients, 13 in each group, as one patient from each group discontinued treatment. Statistical comparisons were carried out using Student's t-tests and chi square tests ( P ≤ .05). RESULTS: A significantly greater mesial mandibular movement and improvement in sagittal skeletal relation were found in the Forsus patients ( P ≤ .05). The forward movement of the mandibular molar and incisors were greater in the PowerScope patients (2.3 mm and 2.80 mm) than in the Forsus patients (1.9 mm and 2.38 mm). CONCLUSIONS: Both PowerScope and Forsus are effective in correcting Class II malocclusion. The percentage of dentoalveolar effects in correcting Class II malocclusion is more for PowerScope when compared with Forsus. Patient comfort was the same with both appliances. This trial was registered.

PowerScope a Class II corrector - A case report.

Managing mild to moderate Class II malocclusion is a one of the common and major challenges to orthodontists. Class II discrepancies with mandibular deficiency during active growth are usually treated by myofunctional appliances. Fixed functional appliances evolved due to the noncompliance with conventional myofunctional appliances. This case report illustrates the efficiency of PowerScope in correction of skeletal Class II with mandibular deficiency in a patient aged 13 years who has reported to the department with a chief complaint of forwardly placed upper front teeth. This case with functional jaw retrusion was treated initially with MBT 0.022" prescription followed by PowerScope. Pre-, mid- and post-treatment cephalograms were obtained, and cephalometric analysis was performed. Stable and successful results were obtained with a substantial improvement in facial profile, skeletal jaw relationship, and overall esthetic appearance of the patient. A significant forward displacement of the mandible was the principal element for successful correction of Class II malocclusion. PowerScope provides the best results for Class II management, thus enables us to treat such cases by a nonextraction approach rather than contemplating extractions.

Early prevention and intervention of Class II division 1 in growing patients.

Early screening and diagnosis help in preventing and intercepting the severity of the malocclusion which helps in addressing the esthetic and functional concerns. Growth modulation such as mandibular advancement has been an effective procedure in orthodontics. Mandibular growth advancer (MGA) and PowerScope are gaining popularity recently as these are effective in achieving the mandibular advancement and ease of fabrication, placement, and wear. MGA was fabricated by making the upper and lower splints separately and are placed in the oral cavity by joining the two splints in the new construction bite using cold cure, MGA when worn during growth phase helps in condylar remodeling in the temporomandibular joint thus helps in advancement of the mandible. The proclination of the upper anteriors in Class II division 1 can be moved lingually by activating the labial bow in the splint. Dr. Andy Hayes worked in conjunction with American orthodontics developed PowerScope. PowerScope delivers Class II correction with a combination of patient comfort and ease of use that was unmatched among other appliances. This ready to use chairside solution required no laboratory setup, making for a much quicker, and easier installation process and appointment. PowerScopes high quality, fixed one-piece design requires no patient compliance. These superior qualities of PowerScope help in correction of Class II skeletal growing patient in conjunction with fixed orthodontic therapy. MGA and PowerScope were chosen as a functional appliance for this study, which shows decreased ANB angle and effective mandible length was increased.