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
