Three-dimensional skeletal, dentoalveolar and temporomandibular joint changes produced by Twin Block functional appliance

Elfeky, Hanem Younes; Fayed, Mona M. Salah; Alhammadi, Maged Sultan; Soliman, Sanaa A.; Boghdadi, Dalia Mohamed El

doi:10.1007/s00056-018-0137-1

Cited by 48 publications

(81 citation statements)

References 32 publications

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“…Two studies reported changes of condylar dimensions. [5,15] Because Elfeky et al reported both left and right condylar changes after treatment, we extracted data of both sides as well for meta-analysis.…”

Section: Synthesized Results Of Treatment Effectsmentioning

confidence: 99%

“…Two studies reported the effects of Twin-block appliance on the anterior, superior and posterior joint space. [5,15] We also extracted data of both sides of patients in Elfeky's study for this metaanalysis.The meta-analysis revealed that there was no significant change in the anterior joint space (mean difference: -0.15mm; 95%CI: -0.48 to 0.19mm; P=0.39; I²=68%). However, superior joint space increased with statistically significance (mean difference: 0.70mm; 95%CI: 0.43 to 0.97mm; P<0.00001; I²=0%), as well as posterior joint space (mean difference: 0.29mm; 95%CI: 0.03 to 0.56mm; P=0.03; I²=0%) (Fig 3).…”

Section: Synthesized Results Of Treatment Effectsmentioning

confidence: 99%

“…After screening the titles and abstracts, full texts of 13 studies were retrieved for final consideration, among which 10 studies were eliminated for specific reasons. Finally, 3 studies [5,11,15] were included in the meta-analysis (Fig 1).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…To date, the changes of dentofacial structures and soft tissues produced by Twin-block appliance have been clarified by sufficient studies. [5][6][7][8][9][10] However, reliable scientific evidence about the effects on the temporomandibular joint (TMJ) of Twin-block appliance is insufficient, with a few articles reporting conflicting results. Some studies reported that Twin-block appliance enables forward movement of the condylar and promotes new bone deposition on the condylar.…”

mentioning

confidence: 99%

“…Some studies reported that Twin-block appliance enables forward movement of the condylar and promotes new bone deposition on the condylar. [5,[11][12][13][14] However, some studies found that the treatment effects of Twin-block appliance on TMJ, such as changes of joint spaces, were small. [15] Therefore, it is of great significance to critically evaluate the corresponding studies by systematic evidence-based review, to provide more accurate and reliable conclusions about treatment effects of Twin-block appliance on TMJ in Class II malocclusion patients, especially in terms of condylar position and dimensions.…”

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confidence: 99%

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Twin-block appliance promotes condylar remodeling in patients with Class II malocclusion: a systematic review

Yin

et al. 2020

Preprint

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Background: To evaluate the changes of condylar in patients with Class II malocclusion treated with Twin-block appliance. Methods: Six electronic databases, including PubMed, Embase, Cochrane library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and VIP Database were searched until October 15, 2019 without language restrictions. Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) reporting condylar changes produced by Twin-block appliance in Class II malocclusion patients were included. Literature filtering, data extraction, and methodological quality assessment were finished by two reviewers independently. Meta-analysis was performed with Review Manager (version5. 3; Nordic Cochrane Centre, Cochrane Collaboration, Copenhagen, Denmark). For continuous data, the mean difference and their 95% confidence intervals were used for statistical pooling. Results: Three studies with a total of 100 patients were included (1 RCT and 2 CCTs). The meta-analysis indicated a significant increase of condylar dimensions after Twin-block treatment in Class II malocclusion patients, including 0.91mm in height, 1.03mm in width, and 1.08mm in length. There were statistically significant increments in the superior and posterior joint spaces and no significant change in the anterior joint space. Conclusions: Twin-block appliance promotes the remodeling of condylar and stimulates forward and downward movement of condylar. Further high-quality studies with large samples and long-term evidence are still required to obtain more reliable conclusions. Keywords: Twin-block appliance; Class II malocclusion; Temporal Mandibular Joint; Systematic review; Meta-analysis

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Section: Synthesized Results Of Treatment Effectsmentioning

confidence: 99%

Section: Synthesized Results Of Treatment Effectsmentioning

confidence: 99%

Section: Description Of Included Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Twin-block appliance promotes condylar remodeling in patients with Class II malocclusion: a systematic review

Yin

et al. 2020

Preprint

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Expression of lubricin in rat posterior mandibular condylar cartilage following functional mandibular forward repositioning

Cheng

Mai

et al. 2019

J Orofac Orthop

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Recommendations for standard criteria for the positional and morphological evaluation of temporomandibular joint osseous structures using cone-beam CT: a systematic review

Almashraqi,

Sayed,

Mokli

et al. 2023

Eur Radiol

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Objective This systematic review aimed to appraise the reliability and comprehensiveness of imaging methods in studies that used three-dimensional assessment of the temporomandibular joint (TMJ) in order to propose a standardized imaging method. Methods Six databases/search engines were searched up until September 2022. The outcomes of interest included measurements of the mandibular condyle, glenoid fossa, joint spaces, or the entire TMJ. Two checklists were utilized: one to assess the risk of bias, with a maximum score of 37, and the other, a pre-designed checklist consisting of 22 items to evaluate the comprehensiveness of the methods used, with a maximum score of 33. Results Out of the 2567 records retrieved, only 14 studies, which used cone bean computed tomography (CBCT), were deemed eligible and thus included in the qualitative analysis. Three studies were deemed of low risk of bias, while the remaining studies were rated as moderate to high risk of bias, primarily due to improper reporting of inter-observer agreement, varying reliability values, and a limited number of cases included in the reliability analysis. Regarding the comprehensiveness of the methods used, only four studies achieved relatively high scores. The deficiencies observed were related to the reporting of variables such as slice thickness and voxel size, absence of or improper reporting of intra- and inter-examiner reliability analyses, and failure to assess all osseous components of the TMJ. Conclusion CBCT-based methods used to assess the positions and morphology of TMJ bony structures appear to be imperfect and lacking in comprehensiveness. Hence, criteria for a standardized assessment method of these TMJ structures are proposed. Clinical relevance statement Accurately, comprehensively, and reliably assessing the osseous structures of the temporomandibular joint will provide valid and valuable diagnostic features of the normal temporomandibular joint, and help establish potential associations between these osseous features and temporomandibular disorders. Registration The protocol for this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO, No.: CRD42020199792). Key Points •Although many methods have been introduced to assess the osseous structure of the temporomandibular joint, they yielded inconsistent findings. •None of the published studies comprehensively assessed the temporomandibular joint. •Recommendations for a comprehensive temporomandibular joint osseous assessment method were suggested for better validity and reliability of future research.

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Three-dimensional skeletal, dentoalveolar and temporomandibular joint changes produced by Twin Block functional appliance

Abstract: Treatment with the Twin Block functional appliance results in significant skeletal, dentoalveolar, and condylar changes in both dimensions and positions.

Cited by 48 publications

References 32 publications

Twin-block appliance promotes condylar remodeling in patients with Class II malocclusion: a systematic review

Twin-block appliance promotes condylar remodeling in patients with Class II malocclusion: a systematic review

Expression of lubricin in rat posterior mandibular condylar cartilage following functional mandibular forward repositioning

Recommendations for standard criteria for the positional and morphological evaluation of temporomandibular joint osseous structures using cone-beam CT: a systematic review

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