Meta-analysis of condylar changes produced by a Twin-block appliance in Class Ⅱ malocclusion

doi:10.7518/hxkq.2023.2023052

Abstract

Abstract:

Objective To evaluate the effects of a Twin-block appliance on the condyles of patients with ClassⅡmalocclusion by conducting a systematic review and a Meta-analysis. Methods Pubmed, Embase, Cochrane Library, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, and VIP Database were electronically searched. Randomized controlled trials, controlled clinical trials, and single-arm trials on condylar changes produced by a Twin-block appliance in patients with ClassⅡmalocclusion were included. Two reviewers independently extracted and assessed the risk of bias. Meta-analyses were conducted with Review Manager 5.3. Results Eight studies were included; among which, seven were of high quality. After treatment with a twin block appliance, condyles moved anteriorly. The anterior joint spaces decreased (P<0.000 01), whereas the posterior spaces increased (P<0.000 01). The superior spaces were not changed (P=0.11). Moreover, a significant difference was observed in the increase of the condylar space index (P<0.000 01). After treatment, the anteroposterior diameters of the condyles and condylar height increased (P=0.000 2 and P<0.000 01, respectively). By contrast, no significant changes were discovered in the medial external diameters of the condyles (P=0.42). Conclusion A Twin-block appliance can promote the growth of a condyle in the posterior and upper direction and move it forward in favor of the correction of Class Ⅱ malocclusion.

Key words: Twin-block appliance, Class Ⅱ malocclusion, condyle, systematic review, Meta-analysis

CLC Number:

R 783.5

Li Yulin, Xu Jingchen, Jiang Xiaoge, Chen Song.. Meta-analysis of condylar changes produced by a Twin-block appliance in Class Ⅱ malocclusion[J]. West China Journal of Stomatology, 2023, 41(4): 463-470.

Figures/Tables 6

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PICOS框架	纳入标准	排除标准
参与者（Participants）	安氏Ⅱ类错畸形患者	唇腭裂或其他头面部综合征所致错畸形
干预（Intervention）	试验组患者在医生指导下佩戴Twin-block矫治器	其他矫治方法或手术治疗
对照（Control）	有无对照组不作为必要条件	治疗组未提供详细资料
结果（Outcomes）	颞下颌关节的形态学改变，包括髁突的生长改建、髁突位置变化、关节盘位置变化及关节窝的生长改建等	与颞下颌关节无关的其他结果
研究（Study）	随机对照试验；临床对照试验；单臂临床试验；队列研究	病例报道或回顾性系列病例研究

作者及年份	研究类型	样本数（失访）	年龄/岁	性别（男/女）	干预措施	结局指标	测量方法	测量时间点
吴建勇2007^[5]	单臂临床试验	13（0）	平均12.3	8/5	磁力Twin-block	髁突生长	螺旋CT、头侧位片	矫治前1周；戴用矫治器4个月；去除后1周及1年
Chavan 2014^[6]	临床对照试验	30（0）	9~14，平均11.5	13/7	Twin-block	髁突位置、关节盘位置	MRI	矫治前；去除后6个月
Elfeky 2018^[7]	临床对照试验	40（4）	10~13	0/18	Twin-block	关节间隙、髁突生长	CBCT	矫治前；去除后（具体时间不详）
贾文敏2009^[8]	单臂临床试验	20（0）	平均10.8	13/7	Twin-block	关节间隙	关节中位断层片	矫治前；去除后1周
麦理想2014^[9]	随机对照试验	60（0）	平均12	未提及	Twin-block	关节间隙、髁突生长、关节窝形态	CBCT、头侧位片	矫治前；去除后（具体时间不详）
刘博文2013^[10]	单臂临床试验	20（0）	平均11.4	12/8	Twin-block	关节间隙、髁突生长、关节窝形态	CBCT	矫治前；去除后1个月
刘丽2017^[11]	单臂临床试验	20（0）	9~15；平均12.8	11/9	Twin-block	关节间隙、髁突生长	MRI	矫治前；去除后1周
王鹏2009^[12]	单臂临床试验	21（0）	11~15	10/11	Twin-block	关节间隙	薛氏位片	矫治前；去除后1周

纳入研究	①	②	③	④	⑤	⑥	⑦	⑧	⑨	⑩	?	?	等级
吴建勇2007^[5]	Y	U	N	Y	U	Y	Y	U					A
Chavan 2014^[6]	Y	U	Y	Y	U	Y	Y	U	Y	Y	U	Y	A
Elfeky 2018^[7]	Y	U	Y	Y	U	Y	Y	U	Y	U	U	Y	A
贾文敏2009^[8]	Y	U	Y	Y	U	Y	Y	U					A
刘博文2013^[10]	Y	U	Y	Y	U	Y	Y	U					A
刘丽2017^[11]	Y	U	Y	Y	U	Y	Y	U					A
王鹏2009^[12]	Y	U	Y	Y	U	Y	Y	U					A

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