Abstract
This study aimed to evaluate and compare the dentoalveolar effects of the myofunctional trainer T4KTM versus twin block in children with class II division I malocclusion. Two parallel arm randomized comparative clinical trial was conducted, including twenty healthy children, 9–12 years old, showing Angle’s class II division I malocclusion due to mandibular retrusion. Children were randomly assigned into two groups according to the appliance used; Group 1: T4k, and Group II: twin block. Follow-up was done every 4 weeks for 9 months. Postoperative cephalometric X ray, study casts and photographs were taken for measurements and comparison. T4K showed a statistically significant reduction in the overjet (−2.50 ± 1.00 mm) (p < 0.0001), and a significant increase in the lower arch perimeter (LAP) (1.19 ± 0.96 mm) (p = 0.01). The twin block showed a statistically significant reduction in the overjet (−3.75 ± 1.10 mm) (p < 0.0001), a significant reduction in the overbite (−16.22 ± 17.02 %) (p = 0.03), and a significant increase in the LAP (1.69 ± 0.70 mm) (p < 0.0001). The overjet showed a higher significant decrease in the twin block group than in T4K (p = 0.03). The mean values of the overbite were significantly decreased in twin block than in T4k (p < 0.0001). Both groups showed significant dentoalveolar improvements toward class I occlusion; however, the twin block showed significantly better results than T4K appliance.
Highlights
Developing class II malocclusion is one of the prevalent and dramatic problems in the mixed dentition stage, which demands early interception to decrease the severity of malocclusion, and the complexity and time of further orthodontic treatment [1]
Two children refused to wear the appliance in school time, which is a proximally 8 h, because they were mocked by their peers) and the statistical analysis was done only for 16 patients with a mean age of 10.6 ± 0.6 years
As we believe that one of the major goals for pediatric dentists is to guide occlusion in a normal direction as much as possible, and since not all pediatric dentists can use the twin block, this study showed that the T4k can help in minimizing the severity of the problem, so that when the child is 12 years old, the burden on the orthodontist to continue the treatment is much less
Summary
Developing class II malocclusion is one of the prevalent and dramatic problems in the mixed dentition stage, which demands early interception to decrease the severity of malocclusion, and the complexity and time of further orthodontic treatment [1]. Functional/myofunctional appliances are based on using muscle action to redirect dentoalveolar and skeletal growth toward normal occlusion. Isola et al 2018 [2] pointed out the importance of adaptive response of the muscle fibers on the functional significance of masticatory muscles which influences the craniofacial characteristics, and malocclusion and the treatment outcome. In a later study in 2019, they highlighted the importance of healthy temporomandibular joint (TMJ) on the oral musculature and on the quality of life [3]. It was found that functional appliances used in treatment of class II division. I did not produce any significant adverse effects on the TMJ in healthy patients, the appliances improved joints that initially presented with forward dislocation of the disk [4].
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