Comparison Of The Effects Of Clear Aligners And Twinblock Appliances In Functional Treatment Of Class II Malocclusion

Bezmialem Vakif University34 enrolled

Overview

This prospective clinical study aimed to compare the skeletal and dentofacial effects of Twin Block (TWB) and clear aligners with mandibular advancement, and to evaluate mandibular trabecular bone changes through fractal analysis (FA).

A total of 34 patients with dentoskeletal Class II malocclusion were included in the study: 16 patients in the Invisalign® Mandibular Advancement (MA) group and 18 patients in the TWB group .Panoramic and lateral cephalometric radiographs were obtained at baseline(T0) and after functional treatment(T1). Skeletal, dental, and soft tissue structures were evaluated on the pretreatment and posttreatment radiographs using cephalometric analysis, while trabecular bone architecture was assessed by fractal analysis.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Class II Malocclusion Mandibular Retrognathism

Interventions

Invisalign Clear AlignersDEVICE

Functional appliances are used for mandibular advancement in the treatment of mandibular retrognathia in orthodontics. The Twinblock is a conventional functional appliance, and nowadays mandibular advancement can also be achieved with clear aligners. In this study, these two appliances were used.

Twinblock Functional ApplianceDEVICE

Eligibility

Sex: ALLMin age: 10 YearsMax age: 14 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with Angle Class II molar and canine relationship * Overjet greater than 6 mm * Patients in the growth spurt period Exclusion Criteria: * History of orthodontic treatment * Missing teeth * Patients in mixed dentition period * Systemic diseases affecting growth or bone metabolism

Locations (1)

Bezmialem Vakif University

Istanbul, Fatih, Turkey (Türkiye)

Outcomes

Primary Outcomes

Change from Baseline in Cephalometric Measurements (mm and degrees) After Functional Appliance Therapy

Cephalometric measurements will be evaluated on lateral cephalometric radiographs using a customized analysis derived from Steiner, McNamara, Tweed, Ricketts, and Arnett analyses. A total of 47 skeletal, dental, airway, hyoid, and soft tissue parameters will be assessed. Linear measurements will be recorded in millimeters (mm) and angular measurements in degrees. Landmarks will be manually identified on digital lateral cephalometric radiographs.

Time frame: Baseline and after completion of functional appliance therapy (approximately 7-13 months)

Change from Baseline in Mandibular Bone Fractal Dimension Values After Functional Appliance Therapy

Fractal dimension values will be calculated using the box-counting method on panoramic radiographs (mandibular condyle, angulus, and corpus) and lateral cephalometric radiographs (symphysis). Fractal dimension is a unitless numerical value used to evaluate trabecular bone complexity. Higher values indicate greater trabecular complexity, whereas lower values indicate reduced trabecular structure.

Time frame: Baseline and after completion of functional appliance therapy (approximately 7-13 months)

Data from ClinicalTrials.gov

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