Review suggests twin-block appliance produces changes- but are they clinically important?


Fixed and removable functional appliances are used in the management of class II malocclusions. The Twin-block consists of upper and lower acrylic bite blocks with occlusal inclined planes that interlock at a 70 degree angle and guide the mandible forward and downward. It is considered that the twin-block is better tolerated by patients. The aim [read the full story…]

No good quality evidence on how to manage juvenile idiopathic arthritis with temporomandibular joint involvement


Juvenile idiopathic arthritis (JIA), also known as juvenile chronic arthritis and juvenile rheumatoid arthritis affects a range of joints. The temporomandibular joint (TMJ) can be the first and only affected joint. In the UK about 1 and 2 in every 10,000 children develop JIA each year. The prevalence of TMJ involvement in JIA patients ranges [read the full story…]

Early orthodontic treatment may reduce incisal trauma in children with class II malocclusions


This is the latest update of a Cochrane review looking at the treatment of class II malocclusion.  This is a common problem affecting about one in four of 12 year-olds in the UK.    The aim of the review was to assess the effects of orthodontic treatment for prominent upper front teeth (Class II malocclusion) when [read the full story…]

No evidence to recommend or discourage any type of orthodontic treatment to correct Class II division 2 malocclusion in children

shutterstock_59108206- orthodontic headgear

One of important differences about Cochrane reviews is their commitment of their authors to regularly review and update the content of their reviews.  This is an update of a Cochrane review published in 2006.  The aim of the review being to establish whether orthodontic treatment, carried out without the removal of permanent teeth, in children [read the full story…]

Functional orthodontic appliances have limited effect on mandibular growth

shutterstock_41854831 - removable orthodontic appliance

The ADA Centre for Evidence-Based Dentistry has published a critical summary of a systematic review published earlier this year  (see Dental Elf 20-07-11) The commentator noted that although the review was conducted thoroughly  only 4 studies were included two with a low risk of bias one with a high risk and the other an unclear [read the full story…]

The addition of a maxillary labial bow to the Clark Twin Block has no influence

shutterstock_41854831 - removable orthodontic appliance

The Clark Twin Block (CTB) is a functional orthodontic appliance. Functional appliances contribute to the correction of Class II malocclusions in growing patients through a combination of dentoalveolar and skeletal effects. The aim of this study was to investigate whether the addition of a maxillary labial bow has any effect on the inclination of the [read the full story…]

Functional orthodontic appliance treatment provides small beneficial changes in skeletal patterns

shutterstock_41854831 - removable orthodontic appliance

The aim of this review was assess the effectiveness of functional appliances on mandibular growth in the short term. Functional appliances consist of a range of removable and fixed devices that are designed to alter the position of the mandible, both sagittally and vertically, with the aim of inducing supplementary lengthening of the mandible by [read the full story…]