Lanteri Valentina, Abate Andrea, Donelli Margherita, Maspero Cinzia, Tessore Enrica, Grecolini Maria Elena, Olivi Francesca, Dalmazzini Matilde, Ugolini Alessandro
Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41124 Modena, Italy.
Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16132 Genova, Italy.
Children (Basel). 2025 Aug 28;12(9):1147. doi: 10.3390/children12091147.
This study aimed to compare the skeletal and dentoalveolar effects of a fully customized elastodontic appliance with those of the traditional Twin Block appliance in growing patients with Class II malocclusion during the mixed dentition phase.
A total of 35 patients were included: 18 treated with a customized elastodontic appliance (C-Ela group) and 17 with a Twin Block appliance (TB group). Digital dental models and lateral cephalometric radiographs were obtained at baseline (T1) and after 12 months of treatment (T2). All patients were treated by experienced clinicians according to standardized appliance protocols. Data analysis was performed by a blinded operator using Ortho Analyzer and Dolphin Imaging software. The Shapiro-Wilk test was applied to verify the normal distribution of the data. Paired-sample -tests were used to assess within-group changes between T1 and T2. For intergroup comparisons two-tail independent-sample -tests were used, and chi-square tests were used for categorical variables. Statistical significance was set at < 0.05.
Both groups showed significant intragroup improvements in overjet (C-Ela: -2.77 ± 2.07; TB: -2.30 ± 2.72 mm), overbite (C-Ela: -1.79 ± 1.95; TB: -1.40 ± 2.65 mm), and sagittal molar relationship ( < 0.05) after treatment. The C-Ela group exhibited a significantly greater reduction in anterior dental crowding ( < 0.05) and better control of upper (C-Ela: -4.93 ± 7.65°; TB: -1.80 ± 5.72°) and lower incisor inclination (C-Ela: +1.70 ± 4.80°; TB: +4.35 ± 6.22°). In intergroup comparisons, the TB group showed a significantly greater proclination of the lower incisors at T2 (L1/Go-Gn: +4.35°; L1/A-Pog: +1.44 mm), whereas the C-Ela more effectively limited these changes (L1/Go-Gn: +1.70°; L1/A-Pog: +1.18 mm). Skeletal analysis revealed an increase in ANB angle in both groups (C-Ela: -1.49 ± 2.62°; TB: -1.78 ± 2.78°), with no statistically significant intergroup differences, and no other skeletal parameters showed significant between-group changes.
Both appliances effectively corrected Class II malocclusions. However, the customized elastodontic device provided better dentoalveolar control, particularly in managing anterior crowding and incisor inclination. Its individualized fit may enhance biomechanical precision and improve overall treatment outcomes in growing patients.
本研究旨在比较完全定制的弹性正畸矫治器与传统双阻板矫治器对混合牙列期生长发育期II类错牙合患者的骨骼和牙-牙槽效应。
共纳入35例患者：18例采用定制弹性正畸矫治器治疗（C-Ela组），17例采用双阻板矫治器治疗（TB组）。在基线期（T1）和治疗12个月后（T2）获取数字化牙模型和头颅侧位片。所有患者均由经验丰富的临床医生按照标准化矫治器方案进行治疗。由一名盲法操作人员使用Ortho Analyzer和Dolphin Imaging软件进行数据分析。采用Shapiro-Wilk检验验证数据的正态分布。采用配对样本t检验评估T1和T2之间的组内变化。组间比较采用双尾独立样本t检验，分类变量采用卡方检验。设定统计学显著性水平为P<0.05。
两组治疗后在覆盖（C-Ela组：-2.77±2.07；TB组：-2.30±2.72mm）、覆合（C-Ela组：-1.79±1.95；TB组：-1.40±2.65mm）和矢状磨牙关系（P<0.05）方面均显示出显著的组内改善。C-Ela组在前牙拥挤度方面有显著更大程度的降低（P<0.05），并且对上颌（C-Ela组：-4.93±7.65°；TB组：-1.80±5.72°）和下颌切牙倾斜度（C-Ela组：+1.70±4.80°；TB组：+4.35±6.22°）有更好的控制。在组间比较中，TB组在T2时下颌切牙有显著更大程度的前倾（L1/Go-Gn：+4.35°；L1/A-Pog：+1.44mm），而C-Ela组更有效地限制了这些变化（L1/Go-Gn：+1.70°；L1/A-Pog：+1.18mm）。骨骼分析显示两组的ANB角均增加（C-Ela组：-1.49±2.62°；TB组：-1.78±2.78°），组间差异无统计学意义，且没有其他骨骼参数显示出显著的组间变化。
两种矫治器均能有效矫正II类错牙合。然而，定制的弹性正畸矫治器能提供更好的牙-牙槽控制，尤其是在处理前牙拥挤和切牙倾斜度方面。其个性化贴合可能会提高生物力学精度，并改善生长发育期患者的整体治疗效果。
