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Functional appliance treatment: Do long waiting lists really matter? A multicentre RCT. BOC 2021. Nicky Mandall. October 6th 2021. Episode 139

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Farooq Ahmed

Functional appliance treatment: Do long waiting lists really matter? A multicentre RCT. Nicky Mandall

 

Join me for Nicky Mandall’s lecture looking at the timing of functional appliance treatment

 

Background

  • Northwest patient waiting list of 20-40,000
  • Waiting time to start treatment 18 months

 

Aim

  • Clinical or psychological impact of delay in treatment for functional appliance

 

Method

  • RCT
  • 1st arm – start immediate – then night time 18 months  (annualization)
  • 2nd Arm – wait 18 months then start functional appliance
  • 7mm overjet
  • Twinblock standard design
  • End point – overjet less than 4mm
  • 3 year follow up study

 

Results

At 18 months

  • Immediate group 12-13
    • SNB: 1.5
    • ANB 2.2
    • OJ 9mm
    • Mand growth 5.4mm
    • Treatment time 13 months
  • Later group 13-14
    • SNB 1.5
    • ANB 1.4
    • OJ 4.6mm
    • 9mm – after further 18 months = 5.4mm
    • Treatment time 10 months
  • No difference in occlusal or skeletal parameters
  • Statistical significant difference in active treatment time favouring later group
  • No psychological difference immediate Vs later group

Conclusion

  • 12 F-13M no clinical or psychological difference in delay in 18 months of treatment
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