title: Comparison of Twin-block and Dynamax appliances for the treatment of Class II malocclusion in adolescents: a randomized controlled trial.
abstract: BACKGROUND
  The aim of this study was to compare the effectiveness of Twin-block and Dynamax appliances for the treatment of Class II Division 1 malocclusion.
  
  
  METHODS
  This was a randomized controlled trial involving 32 boys and 32 girls aged 10 to 14 years with Class II Division 1 malocclusion. They were randomly allocated to either the Dynamax appliance group or the Twin-block appliance group. Treatment was provided by 4 clinicians at 2 centers. Records were taken at the start and the end of the functional phase and after all treatment. In addition, incisal overjet, the number of appliance breakages, and adverse events or side effects of the treatment were recorded at each patient visit.
  
  
  RESULTS
  The data monitoring committee in an interim analysis at 18 months after the start of the trial found significantly greater overjet reduction in the Twin-block group than in the Dynamax group and more breakages and adverse events with the Dynamax appliance. As a result, treatment with the Dynamax appliance was terminated, and those patients completed treatment with the Twin-block or a fixed appliance. Regression analysis showed a statistically significant difference in the performance over time between the Twin-block and Dynamax appliances in terms of reduction in overjet, with the Twin-block appliance performing significantly better than the Dynamax. The incidence of adverse events was greater in the Dynamax group (82%) than in the Twin-block group (16%), with a statistically significant difference (P <0.001) between the 2 groups.
  
  
  CONCLUSIONS
  The Twin-block appliance was more effective than the Dynamax appliance when overjet was evaluated and the Dynamax appliance patients reported greater incidence of adverse events with their appliance than those who were treated with the Twin-block appliance.
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Manchester, Higher Cambridge St., Manchester, United Kingdom. badri.t@manchester.ac.uk
authors.forename: Badri
authors.initials: B
authors.lastname: Thiruvenkatachari
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sandler
authors.forename: Alison
authors.initials: A
authors.lastname: Murray
authors.forename: Tanya
authors.initials: T
authors.lastname: Walsh
authors.forename: Kevin
authors.initials: K
authors.lastname: O'Brien
mesh_terms: D000293:Adolescent; D002648:Child; D057239:Early Termination of Clinical Trials; D055094:Evidence-Based Dentistry / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D019186:Mandibular Advancement / Q000295:instrumentation* / Q000379:methods; D016382:Orthodontic Appliance Design; D017289:Orthodontic Appliances, Functional; D009971:Orthodontics, Corrective / Q000295:instrumentation* / Q000379:methods; D010352:Patient Dropouts; D018709:Statistics, Nonparametric; D016896:Treatment Outcome