Lee Robert T, Barnes Emma, DiBiase Andrew, Govender Ravichandram, Qureshi Usman
*Department of Orthodontics, Bart's & The London NHS Trust, London,
*Department of Orthodontics, Bart's & The London NHS Trust, London.
Eur J Orthod. 2014 Oct;36(5):512-21. doi: 10.1093/ejo/cjs076. Epub 2013 Jan 4.
The aim of this clinical trial was to compare the hard- and soft-tissue effects of 15 month full-time functional appliance therapy with Twin Block (TB) and Dynamax (Dx) appliances. The effects on both hard and soft tissue were analysed using cephalograms and three-dimensional optical surface laser scans. One hundred and three subjects with a class II division 1 malocclusion, and a minimum overjet of 7mm were available for analysis following stratified randomization according to gender and age. Data was collected at the start of treatment, 15 month therapy, and after 3 month post-treatment observation. Statistical analysis was conducted using analysis of covariance. The results demonstrated both appliances corrected the overjet with significantly increased skeletal dimensional changes with the TB compared with the Dx with forward movement of pogonion of 5.2mm (TB) and 0.7mm (Dx) P = 0.003. In addition, significant changes occurred particularly in the vertical dimension where there was also an increase in total anterior face height in both groups (TB = 6.4mm, Dx = 5.5mm) and significant (P = 0.003) mandibular length changes were also observed (TB = 7.2mm, Dx = 3.8mm). The cephalometric soft-tissue changes were significantly different between the two appliances at soft-tissue pogonion (TB = 9.8mm, Dx = 4.6mm, P = 0.001). Laser scan three-dimansional changes showed significant difference in the lower labial sulcus region where forward movements were observed (TB = 8.2mm, Dx = 6.2mm; P = 0.04). Overall these changes appear to be greater and more stable than those achieved in a previous 9 month study.
这项临床试验的目的是比较使用Twin Block（TB）矫治器和Dynamax（Dx）矫治器进行15个月全日制功能矫治治疗对硬组织和软组织的影响。使用头影测量X线片和三维光学表面激光扫描分析对硬组织和软组织的影响。103名安氏II类1分类错牙合畸形且覆盖至少7mm的受试者，根据性别和年龄进行分层随机分组后可供分析。在治疗开始时、15个月治疗期间以及治疗后3个月观察期收集数据。使用协方差分析进行统计分析。结果表明，两种矫治器均能矫正覆盖，与Dx矫治器相比，TB矫治器使颏点向前移动5.2mm（TB）和0.7mm（Dx），骨骼尺寸变化显著增加（P = 0.003）。此外，两组在垂直方向上均发生了显著变化，两组的前面部总高度均增加（TB = 6.4mm，Dx = 5.5mm），并且还观察到下颌长度有显著变化（P = 0.003）（TB = 7.2mm，Dx = 3.8mm）。两种矫治器在软组织颏点处的头影测量软组织变化显著不同（TB = 9.8mm，Dx = 4.6mm，P = 0.001）。激光扫描三维变化显示在下唇沟区域存在显著差异，观察到该区域向前移动（TB = 8.2mm，Dx = 6.2mm；P = 0.04）。总体而言，这些变化似乎比之前9个月研究中所取得的变化更大且更稳定。
