This systematic review aims to assess skeletal, dental and soft tissue treatment effects of the conventional Twin-block appliance compared to control in Class II malocclusion till date. The electronic databases of Medline, PubMed and Cochrane library were systematically searched until September 2019. The human studies that had used the conventional Twin block appliance with a control group evaluated by a Lateral Cephalogram were included. A total of 321 articles were examined. 10 articles were selected. Majority studies reported a significant improvement in the mandible and in the vertical height, maxillary restrictive effect was less consistently reported. A restrictive maxillary molar effect and an advancement in the mandibular molar has been suggested. Retroclination of the maxillary incisors and proclination of mandibular incisor inclination has been reported. There is some evidence to suggest a retrusive upper lip effect and a protrusive lower lip effect. Increase in Nasolabial angle and some decrease in the mentolabial sulcus to be expected. In conclusion the conventional Twin Block appliance have shown desirable skeletal, dental and soft tissue effects. However certain inevitable side effects are also seen mainly its effect on lower anterior proclination.
<strong>Introduction:</strong> The fixed lingual bonded retainers have gained preference over removable retainers because they are more aesthetic, comfortable, convenient and free of patient compliance, but their periodontal effects, the incidences of breakages and failure to maintain incisor alignment are the some concerns. Therefore, this study aims to systematically evaluate the efficiency of retention and periodontal effects of lingual bonded retainers in orthodontically treated patients. <strong>Materials and Methods:</strong> The PRISMA guidelines were followed. The databases of Cochrane Library, PubMed and Google Scholar were systematically searched. All human, original research studies in English evaluating the fixed lingual bonded retainers, in orthodontically treated patients, in single group or in comparison with different fixed lingual bonded retainers, with or without control were included. All articles were subjected to assessment of risk of bias. <strong>Results:</strong> A total of 17 studies were selected meeting the inclusion criteria. These were divided into two Group 1 - addressing the periodontal status; Group 2 - addressing the lower incisor stability. The 7 selected studies for group 1, reported that periodontal effects like gingival inflammation, plaque and calculus accumulation are associated with all kinds of lingual bonded retainers, but more in multistranded retainer. The lower incisor stability and alignment during retention phase was shown to be very efficient with multistranded retainers compared to others, in the 14 selected studies for group 2. From the 17 selected studies, 8 studies had a high risk of bias, 5 studies had a medium of bias and 4 studies had a low risk of bias. <strong>Conclusion:</strong> Even though newer types of retainers are being introduced to improve the survival rate, the multistranded retainers still prove to be a good choice with respect to maintenance of incisor alignment.
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