Affiliation:
1. Maxillofacial Unit, East Kent Hospitals University NHS Foundation Trust, Kent
2. Orthodontic Department, Dental Institute, Barts Health NHS Trust, London, UK
Abstract
Summary
Objectives
To assess the post-treatment changes in Class II adolescent patients treated with two different functional appliances for an extended time period.
Design
Randomized clinical trial.
Setting
One university and one district general hospital in the UK.
Participants
Caucasian adolescent patients with a Class II malocclusion.
Methods
Pairs of patients of similar age and gender were randomly allocated to one of two functional appliance systems, the Twin Block or Dynamax appliance. The appliances were used for 15 months full time. Changes were measured from lateral cephalograms taken at the start (T1) and at the end of treatment at 15 months (T2) and 30 months (T3).
Results
Hundred patients completed the trial, 52 Twin Block and 48 Dynamax. Mandibular forward movement was 3.5 mm (±2.5) in the Twin Block group and 1.7 mm (±2.1) in the Dynamax group (P < 0.01; T1–T2) and, subsequently, by 0.3 mm (±2.6) and 0.9 mm (±2.5), respectively (P = 0.3; T2–T3). Mandibular length increased by 6.3 mm (±2.7) in the Twin Block group and 4.0 mm (±2.5) in the Dynamax group (P < 0.01; T1–T2) with treatment and, subsequently, by 0.5 mm (±2.3) and 1.5 mm (±3.1; P = 0.05). Anterior face height increased in both groups.
Conclusions
Treatment resulted in greater mandibular growth with the Twin Block than the Dynamax. In the follow-up period, there was less growth in the Twin Block group compared to the Dynamax
Trial Registration
This trial was not registered on any major database of clinical trial.
Protocol
The protocol was not published before the commencement of the trial but can be given on request.
Publisher
Oxford University Press (OUP)
Reference25 articles.
1. Treatment effects of removable functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis;Koretsi;European Journal of Orthodontics,,2015
2. Outcomes in a 2-phase randomized clinical trial of early Class II treatment;Tulloch;American Journal of Orthodontics and Dentofacial Orthopedics,,2004
3. Timing of Class II treatment: skeletal changes comparing 1-phase and 2-phase treatment;Dolce;American Journal of Orthodontics and Dentofacial Orthopedics,,2007
4. Early treatment for Class II Division 1 malocclusion with the Twin-block appliance: a multi-center, randomized, controlled trial;O’Brien;American Journal of Orthodontics and Dentofacial Orthopedics,,2009
5. Prospective clinical trial comparing the effects of conventional Twin-block and mini-block appliances: Part 1. Hard tissue changes;Gill;American Journal of Orthodontics and Dentofacial Orthopedics,,2005
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