Comparison Of Mandibular Changes After Fixed Functional Appliance And Twin Block Appliance In The Treatment Of Class Ii Malocclusion: A Systematic Review

Background: Skeletal class II malocclusion presenting with retruded lower jawis one of the predominant malocclusions occurring in about one third of the total population. In growing individuals, treatment is usually done as an attempt to correct such developing malocclusion, either with the use of removable or fixed appliances which would redirect growth in the desired direction. But the outcome of these treatment is often debatable, since it is dependent on variety of factors patients treated at various ages. Aim: This systematic review aimed at assessing the scientific evidence on the comparison of efficiency of using conventional Twin Block and fixed functional appliance (FFA) in bringing about the mandibular changes based in the correction of developing class II in patients with retrognathic mandible. Methodology: A search of database was performed in the Medline database, Cochrane Clinical Trials Register, PubMed and google scholar till August 2020 using the MeSH terms. Search criteria included only the Randomized clinical trials (RCTs) and controlled clinical trials (CCTs). Results: Using the search strategies in various database 127 articles were obtained. After extraction using the inclusion and exclusion criteria, further sorting was done based on the relevance of titleand the abstract. Out of these 127 articles, only 6 (2 RCT and 4 CCT) articles met with all the requirements of the study and were included in the systematic review. Quality analysis of these articles revealed a quality rangefrom low (1) to medium (4) and high (1). Conclusion: Nearly half of the patients who underwent treatment with Twin Block appliance showed significant changes in the total mandibular length whereas with FFA only one third of the samples showed significant changes. The co-efficient of efficiency was 0.73mm per month in Twin Block samples and 0.45mm per month in FFA samples. Adolescents showed a better response to treatment compared to other age groups.