Reverse Twin Block and Class III Malocclusion: A Systematic Review

Objective: Class III malocclusion requires a timely and early approach that usually improves control during growth and ultimately prognosis. Aim of the study was to investigate effects of reverse twin block compared to other appliances. Methods: Four databases were searched for randomized/non randomized clinical studies using reverse twin block compared to other appliances. Established the eligibility criteria and performed the studies selection, duplicates have been removed. Data have been extracted and risk of bias assessment with Cochrane ROBINS-I and Rob 2.0 tools was applied. If applicable, the results will be subjected to statistical and meta-analytical analysis. Results: One randomized clinical trial and four retrospective non-randomized studies with 358 children (8-11 years old) were finally included. Lacks in description and different methods of assessment used in the studies do not allow to find characteristics common to all the studies suitable for a statistical and subsequent meta-analytic approach. Conclusion: The reverse twin-block has dentoskeletal and functional advantages when used in patients in mixed dentition, also when affected by class III malocclusions with anterior open bite. The data currently available should be strengthened with further studies on larger samples accurately described to establish properly and completely indications and limitations of this orthodontic appliance.