O'Brien Kevin, Wright Jean, Conboy Frances, Appelbe Priscilla, Davies Linda, Connolly Ivan, Mitchell Laura, Littlewood Simon, Mandall Nicola, Lewis David, Sandler Jonathan, Hammond Mark, Chadwick Stephen, O'Neill Julian, McDade Catherine, Oskouei Mojtaba, Thiruvenkatachari Badri, Read Michael, Robinson Stephen, Birnie David, Murray Alison, Shaw Iain, Harradine Nigel, Worthington Helen
School of Dentistry, University of Manchester, Manchester, United Kingdom. Kevin.O'
Am J Orthod Dentofacial Orthop. 2009 May;135(5):573-9. doi: 10.1016/j.ajodo.2007.10.042.
The aim of this study was to evaluate the effectiveness of early orthodontic treatment with the Twin-block appliance for the treatment of Class II Division 1 malocclusion. This was a multi-center, randomized, controlled trial with subjects from 14 orthodontic clinics in the United Kingdom.
The study included 174 children aged 8 to 10 years with Class II Division 1 malocclusion; they were randomly allocated to receive treatment with a Twin-block appliance or to an initially untreated control group. The subjects were then followed until all orthodontic treatment was completed. Final skeletal pattern, number of attendances, duration of orthodontic treatment, extraction rate, cost of treatment, and the child's self-concept were considered.
At the end of the 10-year study, 141 patients either completed treatment or accepted their occlusion. Data analysis showed that there was no differences between those who received early Twin-block treatment and those who had 1 course of treatment in adolescence with respect to skeletal pattern, extraction rate, and self-esteem. Those who had early treatment had more attendances, received treatment for longer times, and incurred more costs than the adolescent treatment group. They also had significantly poorer final dental occlusion.
Twin-block treatment when a child is 8 to 9 years old has no advantages over treatment started at an average age of 12.4 years. However, the cost of early treatment to the patient in terms of attendances and length of appliance wear is increased.
本研究旨在评估使用双阻板矫治器进行早期正畸治疗对安氏II类1分类错牙合畸形的疗效。这是一项多中心、随机对照试验，研究对象来自英国14家正畸诊所。
该研究纳入了174名8至10岁的安氏II类1分类错牙合畸形儿童；他们被随机分配接受双阻板矫治器治疗或进入初始未治疗的对照组。然后对这些受试者进行随访，直至所有正畸治疗结束。研究考虑了最终骨骼类型、就诊次数、正畸治疗持续时间、拔牙率、治疗费用以及儿童的自我概念。
在为期10年的研究结束时，141名患者完成了治疗或接受了其咬合情况。数据分析表明，在骨骼类型、拔牙率和自尊方面，接受早期双阻板治疗的患者与在青春期接受1疗程治疗的患者之间没有差异。早期接受治疗的患者比青春期治疗组就诊次数更多、治疗时间更长且费用更高。他们的最终牙合情况也明显更差。
在儿童8至9岁时进行双阻板治疗相较于平均年龄12.4岁开始治疗并无优势。然而，早期治疗在就诊次数和矫治器佩戴时长方面会增加患者的费用。
