Class II Malocclusion, Division 1 Clinical Trial
Official title:
Evaluation of 3D Printed Modified Twin Block Appliance for Correction of Skeletal Class II Malocclusion in Growing Subjects: A Randomized Controlled Trial
The study is to evaluate the effect of 3D printed modified Twin Block Appliance on skeletal
Class II profile correction.
The null hypothesis of this research is that use of 3D Printed Twin Block is not able to
induce skeletal rather than dental effects for correction of the skeletal Class II
malocclusion in comparison with untreated growing Class II control subjects.
I- For the treatment group:
A- Medical History Questionnaire will be filled by the patient to exclude the presence of any
systemic condition.
B- Clinical Examination:
Proper examination of the oral structures including;
- Teeth will be examined for caries, fracture or missing teeth
- Gingival tissues will be examined for gingivitis, periodontitis, attachment loss,
gingival recession, oral lesions and the nature of the gingival biotype.
- Thorough intraoral examination is needed to evaluate the need for referral for
consultation or intervention before the initiation of treatment.
C- Diagnosis:
- The patient is checked to fulfil the inclusion criteria.
- A clinical visualized treatment outcome (VTO) will be done by asking the patient to bite
in an advanced position and check the outcome of this advancement on the patient‟s
profile. Patients with positive results (better profiles were achieved upon advancement)
are included in the study.
- Full set of records (including standardized Lateral Cephalograms) will be taken for
every 8 patient as part of the routine procedure for treatment of patients in the
outpatient clinic of the Orthodontic Department, Cairo University.
D- Clinical Procedures:
After taking upper and lower impressions, the impressions are then poured into hard stone
that are then digitally scanned using 3D laboratory scanner (3Shape R500 Lab Scanner).
Designing the appliance is done on upper and lower virtual models (using 3Shape Appliance
Designer). The appliance covers the upper and lower dental arches with lingual horizontal
rectangular attachments to increase the retention.
Buccal triangular ramps for mandibular advancement are designed. They are positioned buccal
to the upper and lower posterior segments with a lock to ensure the desired mandibular
advancement.
3D printing of the appliance is then done using 3D printer (Dent2-Mogassam) with
biocompatible resin material (NextDent Resin OrthoRigid).
Post curing using ultraviolet light for 30min using postcuring unit (Postcuring- Mogassam).
The appliance is then delivered to the patient and instructions are given. Follow up every 4
weeks for 8 months or edge to edge occlusion (the sooner) and then full records taken
including Lateral Cephalogram.
II- For the Control group
- The subjects should be fulfilling the previously mentioned inclusion criteria and should
sign the informed consent of agreement to be recruited in the study.
- According to the randomization sheet, the patients allocated to the control group will
be immediately referred for the uptake of a Lateral Cephalogram which will be considered
(T1) without any treatment procedures.
- A "no treatment" phase of 8 months will be carried out through which the patients will
be followed up to monitor any factor that might have occurred to exclude the patient
from the study.
- Another Lateral Cephalogram will be taken after 8 months (T2).
- T2 images are to be considered the initial diagnostic images for the patient. The
patients will be then assessed and treatment will be provided for each patient as
required.
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