Dental and skeletal changes in mild to moderate Class II malocclusions treated by either a Twin-block or Xbow appliance followed by full fixed orthodontic treatment

Abstract

Objective: To compare the short-term skeletal and dental effects of two-phase orthodontic treatment including either a Twin-block or an XBow appliance. Materials and Methods: This was a retrospective clinical trial of 50 consecutive Class II cases treated in a private practice with either a Twin-block (25) or XBow (25) appliance followed by full fixed orthodontic treatment. To factor out growth, an untreated Class II control group (25) was considered.Results: A MANOVA of treatment/observation changes followed by univariate pairwise comparisons showed that the maxilla moved forward less in the treatment groups than in the control group. As for mandibular changes, the corpus length increase was larger in the Twin-block group by 3.9 mm. Dentally, mesial movement of mandibular molars was greater in both treatment groups. Although no distalization of maxillary molars was found in either treatment group, restriction of mesial movement of these teeth was seen in both treatment groups. Both treatment groups demonstrated increased mandibular incisor proclination with larger increases for the XBow group by 3.3u. The Wits value was decreased by 1.6 mm more in the Twin-block group. No sexrelated differences were observed. Conclusions: Class II correction using an XBow or Twin-block followed by fixed appliances occurs through a relatively similar combination of dental and skeletal effects. An increase in mandibular incisor inclination for the XBow group and an increased corpus length for the Twin-block group were notable exceptions. No overall treatment length differences were seen. (Angle Orthod. 2015;85:997-1002.)

Dentoskeletal and airway effects of the X-Bow applian ce versus removable functional appliances (Frankel-2 and Trainer) in prepubertal Class II division 1 malocclusion patients

“…The lack of mandibular skeletal growth in the X-Bow appliance group might have been due to the short duration of active treatment or the fact that the X-Bow appliance is a non-protrusive Class II corrector. 25 Paired t-test, comparison of pre-and post-treatment measurements within groups, the significance level was p < 0.05. *Statistically significant.…”

“…Previous studies have compared fixed functional appliances with removable functional appliances with regard to dentoskeletal effects. Ehsani et al 25 compared the effects of the Twin-block and X-Bow appliances and found a greater increase in mandibular incisor inclination using the X-Bow appliance and corpus length increase in the Twin-block group. Similar to the findings of Ehsani et al, 25 the present study found a larger sagittal increase in the mandible in the Frankel and Trainer groups compared with the X-Bow group, while the X-Bow group experienced greater mandibular incisor proclination.…”

“…Ehsani et al 25 compared the effects of the Twin-block and X-Bow appliances and found a greater increase in mandibular incisor inclination using the X-Bow appliance and corpus length increase in the Twin-block group. Similar to the findings of Ehsani et al, 25 the present study found a larger sagittal increase in the mandible in the Frankel and Trainer groups compared with the X-Bow group, while the X-Bow group experienced greater mandibular incisor proclination. Giuntini et al 31 also compared removable (Twin-block) and fixed (Forsus) functional appliances in growing patients.…”

The Jaw Epidemic: Recognition, Origins, Cures, and Prevention

“…The jaw epidemic is therefore a recent phenomenon and temporal and geographic correlation strongly suggests that it can be traced to changes in environmental factors due to agriculture and industrialization, but exactly what those factors are and how they operate remain uncertain. Indeed, environmental influences on skeletal growth are largely ignored by the orthodontic profession, which often accepts jaw skeletal development as genetic in nature, although the teeth themselves are recognized as subject to environmental influences (Proffit 1978 , Tulloch et al 1998 , 2004 , Dolce et al 2007 , Siara-Olds et al 2010 , Ehsani et al 2015 ).…”

Early prevention and intervention of Class II division 1 in growing patients

“…[ 2 ] The Class II division 1 patients with deficient mandible should be diagnosed and treated during the pubertal period. [ 3 ] The assessment of growth is important to identify abnormal growth from normal growth which can be assessed by pubertal markers and skeletal maturity indicators. [ 4 ] Various appliances were indicated for this treatment but failed to reach the expectations of the orthodontists.…”