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OBJECTIVE: This retrospective study compared the skeletal and dental effects of the Invisalign Mandibular Advancement Appliance with Enhanced Precision Wings (MA-EPW) and the conventional Twin Block (TB) in growing patients with skeletal Class II malocclusion. MATERIALS AND METHODS: Thirty-two patients (TB: n = 18; MA-EPW: n = 14) were included. Pre- and post-treatment cephalometric radiographs and digital models were analysed to assess skeletal, dental and transverse changes. Statistical analysis was performed using parametric and non-parametric tests, with significance set at p < 0.05. RESULTS: Both appliances improved ANB angle, Wits appraisal, overjet and overbite, with no significant intergroup differences in skeletal correction. The MA-EPW group showed greater maxillary and mandibular transverse expansion and better maintenance of lower incisor inclination, whereas the TB group exhibited greater proclination of the lower incisors. The observation period was longer in the MA-EPW group. CONCLUSION: Both TB and Invisalign MA-EPW appliances were effective in correcting skeletal Class II malocclusion in growing patients. The TB appliance showed greater efficiency relative to treatment duration, whereas the MA-EPW appliance provided superior lower incisor control and clinically relevant transverse expansion. Further long-term randomised controlled trials with defined and standardised protocols are needed to validate the clinical outcomes of mandibular advancement with clear aligners.
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Kırcelli et al. (2025) studied this question.
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