Comparison Between Mandibular Advancement With Aligners and Twin Block in Class II Malocclusion in Growing Patients

Analysis of the Efficacy of AngelAligner A6 Mandibular Advancer and Twin Block in the Treatment of Class II Malocclusion in Growing Patients: a Prospective Clinical Study

To analyze mandibular advancement between the traditional Twin Block and the Angel Aligner A6 mandibular advancement clear aligners using cephalometric analysis in growing patients and a repeatable and reproducible digital measurement technique.

This study compared three early orthodontic treatments for Class II division 1 malocclusion in 60 growing patients (mean age: 12.4 ± 1.3 years): Twin Block, standard Angel Aligner, and Angel Aligner A6 with mandibular advancement.

After 10 months, both Twin Block and A6 showed greater skeletal correction and mandibular advancement than standard aligners, achieving higher rates of Class I correction. The A6 group also had the shortest overall treatment time.

Cephalometric analyses were performed using a digital and reproducible measurement technique. For each patient, lateral cephalograms were taken before treatment (T0) and after treatment (T1, after the functional phase or aligner completion). Thus, a total of 120 lateral cephalograms were analysed. The following skeletal, dental, and soft tissue parameters were analysed.

Inclusion criteria:

• Aged between 9 and 14 years with late mixed or early permanent dentition
• Class II/1 malocclusion (molar relationship ≥ half-cusp Class II and overjet ≥ 5 mm)
• ANB angle greater than 5º
• SNB lower than 78º
• CVMS 2-3, a growing patients.

Exclusion criteria:

• Previous orthodontic treatment or orthognathic surgery
• Patients with severe malformations or syndromes
• Extraction treatment.