Ghaffar Fareena, Jan Abdullah, Akhtar Obaid, Mughal Alaina T, Shahid Rooma, Shafique Hafiza Z, Bibi Khadija, Mehmood Sundas, Afgan Nimra, Zaheer Rumeesha
Department of Orthodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan.
Department of Prosthodontics, HBS Dental College, Islamabad, Pakistan.
Eur J Dent. 2022 Jul;16(3):680-687. doi: 10.1055/s-0041-1739543. Epub 2021 Dec 15.
This study aimed to compare dentoskeletal changes in skeletal class-II malocclusion with removable twin block appliance and fixed AdvanSync2 appliance.
A prospective randomized clinical trial was conducted over a span of 1 year at AFID at Rawalpindi. Thirty patients with skeletal class-II malocclusion, 16 males (53.3%) and 14 females (46.6%), were randomly selected and divided in two equal groups (15 each) to be treated with either fixed functional appliances (FFAs) or with removable functional appliances (RFAs). Out of 30 patients, 15 between cervical vertebral maturation (CVM) stages of 2 and 3 were treated with RFA (twin block appliances) and remaining 15 between CVM stages of 4 and 5 were treated with FFA (AdvanSync2 appliances). Pretreatment (T) and posttreatment (T), angular variable, and linear variable were measured to compare the dentoskeletal effects between the two groups.
Paired sample t-test was used to assess significant difference between variables at T1 (Pre-treatment) and T2 (Post-treatment) stage for both RFA and FFA group. Comparison among the RFA and FFA group was made using non-parametric Mann-Whitney U Test. IBM SPSS version 25.0 was used for evaluation.
No significant difference was found in angular variables between the RFA and FFA groups ( > 0.05) with the exception of linear variables. Sella-posterior nasal spine (S-PNS) length significantly increased and Jarabak's ratio significantly decreased for FFA group ( = 0.010 and 0.045, respectively), when compared with RFA group.
Both the appliances, twin block (RFA) and AdvanSync2 (FFA), are effective for correction of skeletal class-II malocclusion. Both the appliances produced similar effects in the sagittal plane but for better vertical control twin block should be the appliance of choice. AdvanSync2 appliance could be preferred over twin block appliance when dentoalveolar and slight retrusive effect on the maxilla is desired especially for individuals in postpubertal growth spurt.
本研究旨在比较使用可摘式双阻板矫治器和固定AdvanSync2矫治器治疗骨性II类错牙合时牙颌面的变化。
在拉瓦尔品第的AFID进行了一项为期1年的前瞻性随机临床试验。随机选取30例骨性II类错牙合患者，其中男性16例（53.3%），女性14例（46.6%），平均分为两组（每组15例），分别使用固定功能矫治器（FFAs）或可摘功能矫治器（RFAs）进行治疗。30例患者中，15例颈椎成熟度（CVM）处于2至3期的患者采用RFA（双阻板矫治器）治疗，其余15例CVM处于4至5期的患者采用FFA（AdvanSync2矫治器）治疗。测量治疗前（T1）和治疗后（T2）的角度变量和线性变量，以比较两组之间的牙颌面效应。
采用配对样本t检验评估RFA组和FFA组在T1（治疗前）和T2（治疗后）阶段变量之间的显著差异。使用非参数曼-惠特尼U检验对RFA组和FFA组进行比较。使用IBM SPSS 25.0版本进行评估。
除线性变量外，RFA组和FFA组在角度变量上未发现显著差异（P>0.05）。与RFA组相比，FFA组的蝶鞍-后鼻棘（S-PNS）长度显著增加，贾拉巴克比率显著降低（分别为P=0.010和0.045）。
双阻板矫治器（RFA）和AdvanSync2矫治器（FFA）均对骨性II类错牙合的矫治有效。两种矫治器在矢状面上产生相似的效果，但为了更好地控制垂直方向，双阻板矫治器应作为首选。当希望对上颌产生牙牙槽骨和轻微后缩效果时，尤其是对于青春期后生长突增期的个体，AdvanSync2矫治器可能比双阻板矫治器更受青睐。
