Mandibular Advancement in Dentofacial Orthopaedics: Effects on Pharyngeal Airway, Dentoskeletal Characteristics and Quality of Life: A Randomised Controlled Trial

Abstract

Objective: To explore which effects of jaw orthopaedics in class II during puberty are related to daily functioning and family impacts. Materials and Methods: Seventy-one subjects in their pre-pubertal and peri-pubertal stages with skeletal class II and procumbent incisors (median age 12 years; 56% females) were treated with the Sander bite jumping appliance (BJA; N = 37) and Twin block (TB; N = 35). They were matched by the same number of untreated class II subjects. Lateral cephalograms before and after treatment (one-year distance) were analysed. Children's and parental perspectives of oral health-related quality of life (OHRQoL) were assessed by the Child Perceptions Questionnaire, Parental-Caregiver Perceptions Questionnaire and Family Impact Scale. Results: The change in pharyngeal airway width in treated groups was not significantly greater than in the group without orthodontic treatment. Treated groups, compared to the untreated group, demonstrated an increase in mandibular length and a reduction in sagittal skeletal intermaxillary discrepancy (p ≤ 0.002). Retroclination of the maxillary incisors, accompanied by a reduction in overjet, overbite and upper lip prominence, was observed in both treated groups compared to the untreated (p ≤ 0.001). Parents of children in the TB group reported a reduction in impairment of OHRQoL when compared to BJA (p = 0.003). There were no correlations between the change in the airway width, dentofacial characteristics and OHRQoL. Conclusion: Treatment with both appliances stimulated mandibular growth, retroclined maxillary incisors and improved facial profile and OHRQoL. However, the changes in the airway were not greater than normal growth and were not related to alterations in other dentofacial characteristics or OHRQoL. Trial Registration: ClinicalTrials.gov identifier: NCT03455634.