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G.J MACK and R.T.LEE Royal London Hospital, U.K

A Prospective Comparison of the Effects of the Twin Block Appliance and the Dynamax Appliance on the Skeletal and Dental Tissues. G.J MACK and R.T.LEE Royal London Hospital, U.K. The Royal London Hospital. AIMS. To compare the dental and skeletal effects of the Dynamax and the Twin block

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G.J MACK and R.T.LEE Royal London Hospital, U.K

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  1. A Prospective Comparison of the Effects of the Twin Block Appliance and the Dynamax Appliance on the Skeletal and Dental Tissues G.J MACK and R.T.LEE Royal London Hospital, U.K

  2. The Royal London Hospital

  3. AIMS • To compare the dental and skeletal effects of the Dynamax and the Twin block • To investigate the incidence of breakages and the compliance rates

  4. SUBJECTS and METHODS • Inclusion Criteria • Caucasians • Overjet  7mm, Class II molars • Males 12-14 years • Females 10-13 years • No relevant Medical History • No extractions

  5. The Dynamax Appliance Bass and Bass, JCO, 2003

  6. The Twin Block Appliance Gill and Lee, AJODO, 2005

  7. Treatment Protocol

  8. Cephalometry Constructed Horizontal 7º to SN N ANS A-Point Pog Me

  9. RESULTS Patients enrolled into Trial N=62 Males=28 Females=34

  10. RESULTS Patients enrolled into Trial N=62 Males=28 Females=34 Allocated to Dynamax N=31 Males=14 Females=17 Allocated to Twin block N=31 Males=14 Females=17

  11. RESULTS Patients enrolled into Trial N=62 Males=28 Females=34 Allocated to Dynamax N=31 Males=14 Females=17 Allocated to Twin block N=31 Males=14 =1 Females=17 Completed trial N=28 Males=13 Females=15 Completed trial N=28 Males=13 Females=15

  12. RESULTS • Statural Height • Dental Changes • Skeletal Changes • Compliance • Breakages

  13. Statural Height Changes 0-12 months (P=0.88) m= 57 mm 150 m= 67 mm 100 millimeters 50 0 Dynamax Twin block

  14. RESULTS • Statural Height • Dental Changes • Skeletal Changes • Compliance • Breakages

  15. Overjet Reduction 0-9 months (P=0.20) 12 m= 6mm m= 5mm 8 millimeters 4 0 Dynamax Twin block

  16. U1-Maxillary Plane (P=0.96) m= -1.7º m= -3.0º 6 0 degrees -6 -12 Dynamax Twin block

  17. L1-Mandibular Plane (P=0.41) m= 2.3º 10 m= 2.3º 5 degrees 0 -5 Twin block Dynamax

  18. RESULTS • Statural Height • Dental Changes • Skeletal Changes • Compliance • Breakages

  19. A-Point to S-Vertical (P=0.77) 4 m= 0.1mm m= 0.4mm 2 millimeters 0 -2 Dynamax Twin block

  20. Pogonion to S-Vertical (P=0.19) 1 m= 2.1mm m= 2.0mm 5 millimeters 0 Twin block Dynamax -5

  21. Total Anterior Face Height (P=0.03) 8 m= 2.8mm m= 3.2mm 6 4 millimeters 2 0 -2 Dynamax Twin block

  22. RESULTS • Statural Height • Dental Changes • Skeletal Changes • Compliance • Breakages

  23. Compliance

  24. RESULTS • Statural Height • Dental Changes • Skeletal Changes • Compliance • Breakages

  25. Appliance Breakages

  26. CONCLUSIONS • The dental changes were similar for both appliances • The antero-posterior skeletal changes, including mandibular advancement, were similar for both appliances • The vertical dimension increased to a lesser extent with the Dynamax • Both appliances were well tolerated • More breakages occurred with the Dynamax

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