Impact of orthodontic treatment of class II division 1 malocclusion with twin block or Sander bite-jumping appliance during puberty on oral health-related quality of life and family functioning : Randomized controlled trial.

OBJECTIVE

To investigate quality of life changes, family impacts, and predictors of successful overjet (OJ) reduction in patients treated with removable functional appliances for prominent upper front teeth.

PATIENTS AND

METHODS

A total of 86 cases were analyzed, whose ages ranged from 11 to 13 years (median 12; 43% female). They were randomly allocated to treatment by twin block (TB) and Sander bite-jumping appliance (SBJ). OJ was measured before and after 1 year, and the Child Perceptions Questionnaire, Parental-Caregivers Perceptions Questionnaire, and Family Impact Scale were self-administered.

RESULTS

Treatment was unsuccessful in 33% of patients (discontinued regular check-ups or OJ reduction ≤ 40%). In successfully treated individuals, there was a reduction in problems related to child emotional well-being (EW) and oral symptoms, parental EW, and family impacts (p ≤ 0.010). In unsuccessfully treated individuals, there was a reduction in problems related to child EW and social well-being (p ≤ 0.036). In the multiple logistic regression model, sex, type of appliance, and parental perception of the child's functional limitations before treatment were predictors of successful OJ reduction (p < 0.001). Success odds were 8.1 times increased with TB compared to SBJ appliance (95% confidence interval [CI] 2.4-27.6; p = 0.001), 5 times in males (95% CI 1.6-15.5; p = 0.006) and 5 times when parents observed lowered functional limitations (≤ 4) in their child (95% CI 1.5-16.4; p = 0.008).

CONCLUSION

Appliance type, sex, and parental perceptions of a child's functional limitations predicted treatment success. Both successfully and unsuccessfully treated young adolescents reported improvement in oral health-related quality of life, implying that unsuccessfully treated patients convinced themselves that it was worth being treated.