Malocclusion, Angle Class II, Division 1 Clinical Trial
Official title:
Prospective Multicentric, Open-label, Randomized Study Assessing the Efficacy of the Removable and Adjustable Preformed Twicare® Appliance Versus Removable Herbst Appliance Treatment in Class II Malocclusion
The aim of this prospective, multicentric, randomized, open-label study is to assess the efficacy of the removable Twicare® as mandibular propulsive appliance in children aged from 7 to 12 years old in the course of their orthodontic treatment, showing its noninferiority with the removable Herbst. One untreated group will be included to control the internal validity of the study as recommend in noninferiority trials. Patients will have a follow-up every two months during 6 to 12 months as planned in routine care.
A large number of functional appliances, mandibular advancement activators with various
designs, fixed or removable, are used in Class II malocclusion correction; one of the largest
means being used is the Herbst. These appliances can be individualized, made to measure by
the prosthetist or standardised (on market). A new medical device, EC marked and marketed
since 2011, the Twicare®, can be used as positioner, growth activator, but also for lingual
re-education.
There are numerous publications comparing the activators' effects or the appliance effects on
mandibular growth, but none have studied the Twicare®. The aim of this study is to assess the
efficacy of this specific removable appliance in mandibular advancement in Class II skeletal
in children aged from 7 to 12 years old. The appliance will be compared with the Herbst and
one untreated group will be included to control the internal validity of the study as
recommend in noninferiority trials.
Patients will have a follow-up every two months during 6 to 12 months until the Class I
occlusion is achieved. A lateral cephalogram and a dental silicon impression will be
performed at the beginning (T0) and at the end of the treatment (T1) in order to evaluate
cephalometric measurement changes, ANB, overjet and canine and molar class evolutions. The
data collected at the beginning and at the end of the treatment will be analyzed and compared
aware from patient, treatment and time, in order to assess the Twicare® noninferiority
compared to the Herbst and to confirm the superiority of these two appliances versus
observation. We will study, in parallel, the nasal ventilator function as well as comfort,
compliance, tolerance and acceptability of the device via an auto-questionnaire.
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