Impact of initial correction of Class II division 1 malocclusion with a Modified Twin Block appliance: what difference does it make to the child and parent?

Aim To assess the impact of initial correction of Class II division I malocclusion (II/1M) with a Modified Twin Block (MTB) appliance on children and their parents compared to untreated children with II/1M and their parents. Methods Sixty participants with II/1M received MTB treatment and 47 participants with II/1M served as controls. At baseline (T1) and following MTB treatment or recall (T2), all assessed Oral Health Related Quality of Life (OHRQoL), self-esteem and rated perceived aesthetic component of orthodontic treatment need (AC-IOTN). At T1 and T2, a 3D facial soft tissue image was captured at rest. Similarly, at T1 and T2, a parent assessed their child’s OHRQoL and perception of AC-IOTN. Appropriate statistical comparisons were made between and within groups. Results MTB treatment was completed by 42 participants; 35 controls were recalled. At T1, groups were similar in age and gender (p>0.05), mean overjet was 1 mm greater in the MTB group (p<0.01). At T2 in the MTB group, child reported OHRQoL, self-perception of AC-IOTN, and parent-perception of their child’s OHRQoL and AC-IOTN improved as did Family Quality of Life (QoL) (p<0.001); self-esteem remained unchanged. At T1 and T2 for both groups, parents rated their child’s OHRQoL poorer than the child. From T1 to T2, soft tissue changes in both groups and inter-group differences were modest (p<0.05). Conclusion MTB treatment positively impacted child OHRQoL, Family QoL and child and parent perception of AC-IOTN but did not impact child self-esteem. 3D facial soft tissue changes were modest. Child and parent perception of OHRQoL and AC-IOTN were discordant.