Early treatment for Class II Division 1 malocclusion with the Twin-block appliance: A multi-center, randomized, controlled trial

O’Brien, Kevin; Wright, Jean L.; Conboy, Frances; Appelbe, Priscilla; Davies, Linda; Connolly, Ivan; Mitchell, Laura E.; Littlewood, Simon; Mandall, Nicky; Lewis, David H.; Sandler, Jonathan; Hammond, Mark; Chadwick, Stephen; O’Neill, Julian; McDade, Catherine; Oskouei, Mojtaba; Thiruvenkatachari, Badri; Read, Michael J.F; Robinson, Stephen; Birnie, David; Murray, Alison; Shaw, I. S.; Harradine, Nigel; Worthington, Helen V

doi:10.1016/j.ajodo.2007.10.042

Cited by 141 publications

(78 citation statements)

References 14 publications

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“…Taken individually none of these studies found any difference in the incidence of trauma between those patients who had undergone early treatment and patients who had undergone comprehensive treatment in adolescence. [15][16][17] A recent systematic review has combined the results for the three studies and found a small, but statistically significant difference, with the early treatment group experiencing less trauma; 18 however the authors of one of the original studies noted that most of the trauma experienced was minor and in order to reduce the risk of trauma, orthodontic treatment would need to be started in the early mixed dentition stage, fairly soon after the maxillary incisors had erupted, in all children with an increased overjet. 15 Considering the greater financial burden it would incur to treat all these children, it is probably not cost effective in the majority of cases.…”

Section: Prevention Of Dentoalveolar Traumamentioning

confidence: 99%

What is the value of orthodontic treatment?

2015

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SummaryOrthodontic treatment is as popular as ever. Orthodontists frequently have long lists of people wanting treatment and the cost to the NHS in England was £261m in 2013-14 (approximately 11% of the NHS annual spend on dentistry). It is important that clinicians and healthcare commissioners constantly question the contribution of interventions towards improving the health of the population. In this article the authors outline some of the evidence for and against the claims that people with a malocclusion are at a disadvantage compared with those without a malocclusion and that orthodontic treatment has significant health benefits. The authors would like to point out that this is not a comprehensive and systematic review of the entire scientific literature. Rather the evidence is presented in order to stimulate discussion and debate.

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Section: Prevention Of Dentoalveolar Traumamentioning

confidence: 99%

What is the value of orthodontic treatment?

2015

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“…15 Late treatment with the twin block starting during or slightly after the onset of the peak in mandibular growth appears to be more effective than early treatment, as it induces more favorable mandibular skeletal modifications. 16 The current trend of treating in a single phase, starting at the late mixed dentition ensures maximum patient cooperation at an age when the patient is becoming increasingly conscious of his/her appearance and actively participates in the process.…”

Section: Discussionmentioning

confidence: 99%

Correction of Skeletal Class II Malocclusion using Functional-Fixed Appliance Therapy

Surana¹,

Chakrabarty²,

Dhar³

2012

JIOS

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Single-phase treatment started during late mixed dentition using functional followed by fixed appliance therapy has proven to be the most effective approach to achieve correction of Class II malocclusion. This case report demonstrates the use of this treatment approach in an 11-year-old girl with skeletal and dental Class II malocclusion, large overjet, deep overbite, increased incisor exposure and a gummy smile. She was given a functional appliance for 1 year which was immediately followed by fixed mechanotherapy for final finishing and detailing of the occlusion. The magnitude of skeletal and dental correction achieved, along with the dramatic improvement in facial appearance of the patient, provides a strong case for establishing the efficacy of this treatment modality.

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“…For more than a century, this deformity has been treated with various functional appliances. Many studies have shown the positive effects of different functional appliances such as the Activator, Bionator, Frän-kel-2, Herbst, Twin block, and R-appliance on the treatment of mandibular deficiency (3)(4)(5)(6)(7)(8)(9)(10)(11). Functional appliances can be classified into two groups: tooth-borne and tissue-borne.…”

Section: Introductionmentioning

confidence: 99%

Effect of Bionator and Farmand Appliance on the Treatment of Mandibular Deficiency in Prepubertal Stage

et al. 2017

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Objective: The present study aimed to compare dentoskeletal changes in mandibular-deficient patients treated with Bionator and Farmand appliances.Methods: This study included 54 subjects treated for class II division I malocclusion. All subjects fulfilled the following criteria: ANB>5°, SNB<77°, and overjet >5 mm. The Bionator group consisted of 27 patients (15 girls, 12 boys) with the mean age of 11 (SD 1) years and the Farmand group consisted of 27 patients (17 girls, 10 boys) with the mean age of 11.1 (SD 1.4) years. Statistical analyses were performed using t-test, paired t-test, Wilcoxon, and Mann-Whitney test. Results:In the Farmand group, SNB significantly increased from 74.3° (SD 1.7) to 77.6° (SD 2.3) and ANB decreased by 3.2° (SD 1.7) (p<0.001). In the Bionator group, SNB significantly increased from 75.5° (SD 0.9) to 79° (SD 0.9), and ANB decreased by 3.3° (SD 1.3) (p<0.001). The increase in IMPA showed that the lower incisors were significantly tipped using both appliances. T-test did not show any significant differences between the two groups. Conclusion:Despite the different designs of the appliances, both were successful in the treatment of class II division 1 malocclusion in mandibular-deficient patients.

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Early treatment for Class II Division 1 malocclusion with the Twin-block appliance: A multi-center, randomized, controlled trial

Cited by 141 publications

References 14 publications

What is the value of orthodontic treatment?

What is the value of orthodontic treatment?

Correction of Skeletal Class II Malocclusion using Functional-Fixed Appliance Therapy

Effect of Bionator and Farmand Appliance on the Treatment of Mandibular Deficiency in Prepubertal Stage

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