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Orthodontic Appliance ComplicationNCT06403033

Mini-implant-supported Twin-Block in Treating Patients With Class II Division 1 Malocclusion

A study testing Mini-implant-supported Twin-Block and Twin-Block in people with Orthodontic Appliance Complication and Malocclusion, Angle Class II, Division 1, run by Damascus University at 1 site in Syria.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Correcting the skeletal class II using functional appliances, whether removable or fixed, always leads to skeletal and alveolar effects. However, some of these effects are unfavorable, the most significant being the loss of support in the lower dental arch. Read more about this study

Who is it for?
Ages 10 to 13 years
What is being tested?
Mini-implant-supported Twin-Block and Twin-Block
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
41 participants
Where
1 siteSyria
Study dates
10 Sep 2022to 26 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 10 to 13 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • The wrist radiograph (stage 4 S and stage 5 MP3 cap)
  • Skeletal Class II division 1 malocclusion caused by mandibular retrusion
  • ANB (5°- 9°)
  • SNB (72°- 77°)
  • overjet (5 - 8 mm),
  • Minimal crowding in dental arches (≤ 3 mm),
  • MM≤30°
  • lower second molars erupting.

Who cannot join

  • Previous orthodontic procedures.
  • Systemic diseases.
  • Temporal Mandibular Joint disorders.
  • Poor oral hygiene

Trial locations and contacts

1 site in 1 country.

Syria1 site
  • Department of Orthodontics, Faculty of Dentistry, University of Damsacus

    Damascus, DM20 HAJ72

Other trials in Syria

About this study

Official title: Evaluation of the Skeletal and Dentoalveolar Effects of Mini-implant-supported Twin-Block in Treating Growing Patients With Class II Division 1 Malocclusion: A Two-arm Randomized Controlled Clinical Trial

Correcting the skeletal class II using functional appliances, whether removable or fixed, always leads to skeletal and alveolar effects. However, some of these effects are unfavorable, the most significant being the loss of support in the lower dental arch. This loss of support leads to an uncontrolled labial inclination of the lower incisors and mesial movement of the lower; these dentoalveolar effects impact the degree of skeletal correction that can be achieved. Therefore, this study aimed to evaluate the skeletal and dentoalveolar effects following the use of a mini-implant-supported Twin-Block appliance compared to the conventional Twin-Block.

Read the detailed description

Many attempts have been made to modify the Twin-Block appliance to decrease the dentoalveolar effects, such as omitting the upper labial bow, including torquing spurs on the upper incisors, and adding acrylic capping on the lower incisors. However, these modifications have not been successful in eliminating the dentoalveolar effects. This is because the Twin-Block and other functional appliances are supported by teeth rather than bone. As a result, the components of the appliance exert force on the teeth while the mandible attempts to return to its natural resting position. No previous clinical trial described the use of the Twin-Block appliance supported by orthodontic mini-implants and the potential benefits of using mini-implants with Twin-Block in functional treatment.

Being tested
Mini-implant-supported Twin-Block, Twin-Block
Medical subject headings
Malocclusion, Angle Class II

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Mini-implant-supported Twin-BlockDevice

    Mini-implants will support the Twin-Block appliance during the functional treatment.

  • Twin-BlockDevice

    This is the main appliance that will be used to correct the Class II deformity.

Study groups in NCT06403033
Study groupRoleWhat they receive
Mini-implant-supported Twin-BlockExperimentalTreatment will be done using the Mini-implant-supported Twin-block appliance until the correction is achieved.
Receives: Device: Mini-implant-supported Twin-Block
Conventional Twin-Block groupActive comparatorTreatment will be done using the Twin-block appliance until the correction is achieved.
Receives: Device: Twin-Block

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in the overjet

    Lateral cephalometric images were taken for each patient. This was measured sagittally from the upper central incisor edge to the labial surface of the lower central incisor (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  2. Change in the overbite

    Lateral cephalometric images were taken for each patient. This was measured vertically from the upper to the lower central incisors' edges (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  3. Change in the molar relationship

    Lateral cephalometric images were taken for each patient. This was measured sagittally from the mesial cusp of the maxillary first permanent molar to the mesial cusp of the mandibular first permanent molar (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  4. Change in the position of the maxillary base

    Lateral cephalometric images were taken for each patient. This was measured sagittally from A point to a vertical reference plane (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  5. Change in the position of the mandibular base

    Lateral cephalometric images were taken for each patient. This was measured sagittally from Pogonion Point to a vertical reference plane (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  6. Change in the mandibular position relative to the upper jaw

    Lateral cephalometric images were taken for each patient. This was measured sagittally from A point to Pogonion Point (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  7. Change in condylar head position

    Lateral cephalometric images were taken for each patient. This was measured sagittally from Condylion point to the vertical reference plane (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  8. Change in the composite mandibular length

    Lateral cephalometric images were taken for each patient. This was measured sagittally from Condylion Point to the Pogonion Point (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  9. Change in position of the maxillary incisor

    Lateral cephalometric images were taken for each patient. This was measured sagittally from the upper central incisor edge to the A Point (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  10. Change in position of the mandibular incisor

    Lateral cephalometric images were taken for each patient. This was measured sagittally from the lower central incisor edge to the Pogonion Point (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  11. Change in position of the maxillary permanent first molar

    Lateral cephalometric images were taken for each patient. This was measured sagittally from the mesial cusp of the maxillary first permanent molar to A Point (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  12. Change in position of the mandibular permanent first molar

    Lateral cephalometric images were taken for each patient. This was measured sagittally from the mesial cusp of the mandibular first permanent molar to the Pogonion Point (in mm).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  13. Change in the ramus height

    Lateral cephalometric images were taken for each patient. The distance was measured vertically from the Articular Point (Ar) to the Gonion Point (Go) in millimeters.

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  14. Change in the corpus length

    Lateral cephalometric images were taken for each patient. This was measured sagittally from the Gonion (Go) Point to the Mention (Me) Point. The distance is measured in mm.

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  15. Change in MM angle

    Lateral cephalometric images were taken for each patient. This angle, measured in degrees, represented the amount of vertical divergence between the upper and lower jaws in the cephalometric analysis. It is calculated for the internal angle formed by the intersection between the maxillary and mandibular planes.

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  16. Change in the SN-OP

    Lateral cephalometric images were taken for each patient. This angle, measured in degrees, represented the relationship between the occlusal plane (OP) and the anterior cranial base (the distance between Sella (S) and Nasion (N)) in the vertical direction.

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  17. Change in the SN-MP

    Lateral cephalometric images were taken for each patient This angle, measured in degrees, represented the relationship between the lower jaw plane and the cranial base in the vertical direction.

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  18. Change in the Bjork sum (N-S-Ar + S-Ar-Go +Ar-Go-Me)

    Lateral cephalometric images were taken for each patient. This angle, measured in degrees, was the sum of three angles: the saddle angle (N-S-Ar angle), the articular angle (S-Ar-Go), and the gonial angle (Ar-Go-Me).

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  19. Change in the inclination of the upper incisors.

    Lateral cephalometric images were taken for each patient. This angle, measured in degrees, represented the relationship between the upper incisor axis and the anterior cranial base in the anteroposterior direction. It was measured between the upper incisor axis and the SN plane.

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

  20. Change in the L1-MP angle

    Lateral cephalometric images were taken for each patient. This angle, measured in degrees, represented the relationship between the lower incisor axis and the mandibular base in the anteroposterior direction. It was measured between the lower incisor axis and the Go-Me plane.

    Measured: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 May 2024
  2. Study start10 Sep 2022
  3. Primary completion27 Nov 2023
  4. Study completion26 Dec 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
41 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06403033
Sponsor's protocol ID
UDDS-Ortho-3-2024
Status last verified
May 2024
First submitted
3 May 2024
Last updated
9 May 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Abdulhadi A, Burhan AS, Hajeer MY, Hamadah O, Mahmoud G, Nawaya FR, Namera MO. Evaluation of the Functional Treatment of Patients With Skeletal Class II Malocclusion Using Low-Level Laser Therapy-Assisted Twin-Block Appliance: A Three-Arm Randomized Controlled Trial. Cureus. 2022 Mar 24;14(3):e23449. doi: 10.7759/cureus.23449. eCollection 2022 Mar.

    PubMed 35345811
  • Burhan AS, Nawaya FR. Dentoskeletal effects of the Bite-Jumping Appliance and the Twin-Block Appliance in the treatment of skeletal Class II malocclusion: a randomized controlled trial. Eur J Orthod. 2015 Jun;37(3):330-7. doi: 10.1093/ejo/cju052. Epub 2014 Oct 8.

    PubMed 25296729
  • Tripathi T, Singh N, Rai P, Gupta P. Mini-implant-supported twin-block appliance: An innovative modification. Niger J Clin Pract. 2019 Mar;22(3):432-438. doi: 10.4103/njcp.njcp_342_18.

    PubMed 30837435
  • O'Brien K, Wright J, Conboy F, Sanjie Y, Mandall N, Chadwick S, Connolly I, Cook P, Birnie D, Hammond M, Harradine N, Lewis D, McDade C, Mitchell L, Murray A, O'Neill J, Read M, Robinson S, Roberts-Harry D, Sandler J, Shaw I. Effectiveness of early orthodontic treatment with the Twin-block appliance: a multicenter, randomized, controlled trial. Part 1: Dental and skeletal effects. Am J Orthod Dentofacial Orthop. 2003 Sep;124(3):234-43; quiz 339. doi: 10.1016/S0889540603003524.

    PubMed 12970656
  • Ehsani S, Nebbe B, Normando D, Lagravere MO, Flores-Mir C. Short-term treatment effects produced by the Twin-block appliance: a systematic review and meta-analysis. Eur J Orthod. 2015 Apr;37(2):170-6. doi: 10.1093/ejo/cju030. Epub 2014 Jul 22.

    PubMed 25052373
  • Ghareeb RA, Sultan K, Hajeer MY, Ajaj MA, Alzoubi H. Comparison of skeletal and dentoalveolar effects of mini-implant-supported twin block versus conventional twin block in treating growing patients with Class II Division 1 malocclusion: a two-arm randomized controlled clinical trial. Eur J Orthod. 2025 Oct 16;47(6):cjaf093. doi: 10.1093/ejo/cjaf093.

    PubMed 41347939

Questions about this trial

What is this clinical trial studying?

A study testing Mini-implant-supported Twin-Block and Twin-Block in people with Orthodontic Appliance Complication and Malocclusion, Angle Class II, Division 1, run by Damascus University at 1 site in Syria.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Syria. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in the overjet (time frame: T0: One day before the beginning of the functional treatment, T1: After completing functional treatment which which is expected within 11 months.). The study lists 20 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06403033, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 May 2024.

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