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Myofunctional Trainer versus Twin Block in Developing Class II Division I Malocclusion: A Randomized Comparative Clinical Trial.

ABSTRACT: This study aimed to evaluate and compare the dentoalveolar effects of the myofunctional trainer T4KTM versus twin block in children with class II division I malocclusion. Two parallel arm randomized comparative clinical trial was conducted, including twenty healthy children, 9-12 years old, showing Angle's class II division I malocclusion due to mandibular retrusion. Children were randomly assigned into two groups according to the appliance used; Group 1: T4k, and Group II: twin block. Follow-up was done every 4 weeks for 9 months. Postoperative cephalometric X ray, study casts and photographs were taken for measurements and comparison. T4K showed a statistically significant reduction in the overjet (-2.50 ± 1.00 mm) (p < 0.0001), and a significant increase in the lower arch perimeter (LAP) (1.19 ± 0.96 mm) (p = 0.01). The twin block showed a statistically significant reduction in the overjet (-3.75 ± 1.10 mm) (p < 0.0001), a significant reduction in the overbite (-16.22 ± 17.02 %) (p = 0.03), and a significant increase in the LAP (1.69 ± 0.70 mm) (p < 0.0001). The overjet showed a higher significant decrease in the twin block group than in T4K (p = 0.03). The mean values of the overbite were significantly decreased in twin block than in T4k (p < 0.0001). Both groups showed significant dentoalveolar improvements toward class I occlusion; however, the twin block showed significantly better results than T4K appliance.

SUBMITTER: Elhamouly Y

PROVIDER: S-EPMC7345969 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Myofunctional Trainer versus Twin Block in Developing Class II Division I Malocclusion: A Randomized Comparative Clinical Trial.

Elhamouly Yasmine Y El-Housseiny Azza A AA Ismail Hanan A HA Habashy Laila M El LME

Dentistry journal 20200507 2

This study aimed to evaluate and compare the dentoalveolar effects of the myofunctional trainer T4K<sup>TM</sup> versus twin block in children with class II division I malocclusion. Two parallel arm randomized comparative clinical trial was conducted, including twenty healthy children, 9-12 years old, showing Angle's class II division I malocclusion due to mandibular retrusion. Children were randomly assigned into two groups according to the appliance used; Group 1: T4k, and Group II: twin block ...[more]

PMID: 32392835

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Project description:BackgroundOur meta-analysis aimed to evaluate the efficacy of applying Herbst and Twin Block appliances in the treatment of Class II malocclusion among children.MethodsDatabases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China VIP Database (VIP), and Wanfang were thoroughly searched from inception to August 9, 2023. The outcomes included skeletal, dental, and soft tissue changes. The weighted mean difference (WMD) was used as the effect indicator, and the effect size was expressed with a 95% confidence interval (CI). The heterogeneity of each outcome effect size was tested, and the heterogeneity statistic I2 ≥ 50% was analyzed by the random-effect model, otherwise, the fixed-effect model was conducted. Sensitivity analysis was performed.ResultsA total of 12 studies involving 574 patients were included in this meta-analysis. Herbst appliance had a statistically significant increase in mandibular body length (WMD: 1.44, 95% CI: 0.93 to 1.96, P < 0.001) compared with the Twin Block appliance. More increases in angle and distance of L1 to mandibular plane (MP) were found in the Herbst appliance compared with the Twin Block appliance. Significant and greater improvements in molar relationship (WMD: 0.79, 95% CI: 0.28 to 1.29, P = 0.002), posterior facial height (WMD: -1.23, 95% CI: -2.08 to -0.38, P = 0.005), convexity angle (WMD: -1.89, 95% CI: -3.12 to -0.66, P = 0.003), and Sella-Nasion plane angle (U1 to SN) (WMD: 3.34, 95% CI: 2.25 to 4.43, P < 0.001) were achieved in the Twin Block appliance. Herbst and Twin Block appliances produced similar effects in the skeletal and dentoalveolar changes including Sella-Nasion-point A (SNA), Sella-Nasion-point B, point A-Nasion-point B (ANB), overjet, and overbite.ConclusionAs the findings revealed both Herbst and Twin Block appliances contributed successfully to the correction of Class II malocclusion. Compared with the Twin Block appliance, the Herbst appliance may have more advantages in mandibular bone movement. Twin Block therapy resulted in more improvement in the aesthetics of the face.

Project description:Objective This study aimed to compare dentoskeletal changes in skeletal class-II malocclusion with removable twin block appliance and fixed AdvanSync2 appliance.Materials and methods A prospective randomized clinical trial was conducted over a span of 1 year at AFID at Rawalpindi. Thirty patients with skeletal class-II malocclusion, 16 males (53.3%) and 14 females (46.6%), were randomly selected and divided in two equal groups (15 each) to be treated with either fixed functional appliances (FFAs) or with removable functional appliances (RFAs). Out of 30 patients, 15 between cervical vertebral maturation (CVM) stages of 2 and 3 were treated with RFA (twin block appliances) and remaining 15 between CVM stages of 4 and 5 were treated with FFA (AdvanSync2 appliances). Pretreatment (T1) and posttreatment (T2), angular variable, and linear variable were measured to compare the dentoskeletal effects between the two groups.Statitical analysis Paired sample t-test was used to assess significant difference between variables at T1 (Pre-treatment) and T2 (Post-treatment) stage for both RFA and FFA group. Comparison among the RFA and FFA group was made using non-parametric Mann-Whitney U Test. IBM SPSS version 25.0 was used for evaluation.Results No significant difference was found in angular variables between the RFA and FFA groups (p > 0.05) with the exception of linear variables. Sella-posterior nasal spine (S-PNS) length significantly increased and Jarabak's ratio significantly decreased for FFA group (p = 0.010 and 0.045, respectively), when compared with RFA group.Conclusion Both the appliances, twin block (RFA) and AdvanSync2 (FFA), are effective for correction of skeletal class-II malocclusion. Both the appliances produced similar effects in the sagittal plane but for better vertical control twin block should be the appliance of choice. AdvanSync2 appliance could be preferred over twin block appliance when dentoalveolar and slight retrusive effect on the maxilla is desired especially for individuals in postpubertal growth spurt.

Project description:ObjectiveThis systematic review evaluated the available evidence regarding the skeletal, dentoalveolar, and soft tissue effects of orthodontic camouflage (OC) versus orthodontic-orthognathic surgical (OOS) treatment in borderline class III malocclusion patients.MethodsEligibility criteria. The included studies were clinical trials and/or follow-up observational studies (retrospective and prospective). Information sources. PubMed, Scopus, Science Direct, Web of Science, Cochrane, and LILACS were searched up to October 2021. Risk of bias. Downs and Black quality assessment checklist was used. Synthesis of results. The outcomes were the skeletal, dentoalveolar, and soft tissue changes obtained from pre- and post-cephalometric measurements.ResultsIncluded studies. Out of 2089 retrieved articles, 6 were eligible and thus included in the subsequent analyses. Their overall risk of bias was moderate. Outcome results. The results are presented as pre- and post-treatment values or mean changes in both groups. Two studies reported significant retrusion of the maxillary and mandibular bases in OC, in contrast to significant maxillary protrusion and mandibular retrusion with increased ANB angle in OOS. Regarding the vertical jaw relation, one study reported a significant decrease in mandibular plane inclination in OC and a significant increase in OOS. Most of the included studies reported a significant proclination in the maxillary incisors in both groups. Three studies reported a significant proclination of the mandibular incisors in OOS, while four studies reported retroclination in OC.ConclusionInterpretation. The OSS has a protrusive effect on the maxillary base, retrusive effect on the mandibular base, and thus improvement in the sagittal relationship accompanied with a clockwise rotational effect on the mandibular plane. The OC has more proclination effect on the maxillary incisors and retroclination effect on the mandibular incisors compared to OOS. Limitation. Meta-analysis was not possible due to considerable variations among the included studies. Owing to the fact that some important data in the included studies were missing, conducting further studies with more standardized methodologies is highly urgent. Registration. The protocol for this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO, No.: CRD42020199591).Clinical relevanceThe common features including skeletal, dental, and soft tissue characteristics of borderline class III malocclusion cases make it more difficult to select the most appropriate treatment modality that can be either OC or OOS. The availability of high-level evidence-systematic reviews-makes the clinical decision much more clear and based on scientific basis rather than personal preference.

Project description:Background and objectivesBoth invasive and minimally invasive surgical methods have recently gained popularity in accelerating orthodontic tooth movement. Traditional corticotomy (TC) was one of the first effective invasive surgical techniques in shortening orthodontic treatment time, whereas the flapless cortico-alveolar perforations (FCAPs) technique is a modern minimally invasive method that has recently shown good results in different types of orthodontic tooth movement. Therefore, this study aimed to compare the effectiveness of TC versus FCAPs in maxillary canine retraction when treating Class II division 1 malocclusion patients.Materials and methodsThis was a single-blinded, single-center, three-arm randomized controlled trial. A total of 51 patients (22 males, 29 females, mean age 20.98 ± 1.95) whose treatment planning included the extraction of maxillary first premolars were enrolled and randomly divided into three groups: the TC group, the FCAPs group, and the control group. The assessed outcomes were the amount of canine retraction, anchorage loss, and canines' rotation, which was evaluated at five-time points till the completion of canine retraction.ResultsThere were statistically significant differences in the amount of canine retraction between the three groups in the first two months (p < 0.001), with greater mean values in the TC group (p < 0.001) in the first month. However, the amount of canine retraction in the FCAPs group was significantly greater in the second month compared to the TC group (p = 0.003) and the control group (p < 0.001). In the first month of canine retraction, anchorage loss, and canine rotation were significantly lesser in the TC and FCAPs groups than in the control group (p < 0.001). On the contrary, the canines' rotation amount after the completion of retraction was greater in the TC group than in the other two groups (p < 0.001).ConclusionTC and FCAPs are efficient adjunctive surgical methods for accelerating canine retraction. At the end of the first month, the TC accelerated canine retraction by 59.85% and FCAPs by 44% compared to the conventional retraction. At the end of the second month, the acceleration was less than recorded in the first month (35.44% and 50.20%, respectively). The acceleration effect of the surgical interventions appeared transient and did not last in the following observation period.

Dataset Information

Myofunctional Trainer versus Twin Block in Developing Class II Division I Malocclusion: A Randomized Comparative Clinical Trial.

Publications

Myofunctional Trainer versus Twin Block in Developing Class II Division I Malocclusion: A Randomized Comparative Clinical Trial.

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