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Original Research

Open Access

Comparison between clear aligners and twin-block in treating class II malocclusion in children: a retrospective study

  • Jianfang He1,†
  • Longshuang Hu2,†
  • Yan Yuan3
  • Peipei Wang4
  • Feifei Zheng1
  • Han Jiang2
  • Wen Li1,*,

1Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, 310000 Hangzhou, Zhejiang, China

2Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang, China

3Department of stomatology, Hospital 302 attached to Guizhou aviation group, Anshun 561000, Guizhou, China

4Lishui Municipal Central Hospital, 323000 Lishui, Zhejiang, China

DOI: 10.22514/jocpd.2023.070

Submitted: 06 April 2023 Accepted: 06 June 2023

Online publish date: 28 September 2023

*Corresponding Author(s): Wen Li E-mail:

† These authors contributed equally.


The study herein evaluated and compared the efficacy of Clear Aligners (CA) and Twin-Block (TB) appliances as the early orthodontic treatments of developing class II division 1 malocclusion. Twenty-four patients each for CA (11.73 ± 0.33 y) and TB (11.87 ± 0.34 y) groups were selected according to the inclusion and exclusion criteria. The cephalometric X-rays and intraoral photos were taken for the patients after nearly 12 months of treatment. Treatment impacts were evaluated by the molar correction and overjet reduction. The vertical and sagittal changes were analyzed through cephalometric measurements. Sella-nasion-point B angle (SNB), point A-nasion-point B angle (ANB), Wits Appraisal (AO-BO) and overjet were statistically significant regarding the sagittal changes analyzed before and after the treatments in both groups, respectively. So, no significant difference was noted in the sagittal changes between CA and TB groups. However, for the vertical changes, OP (occlusal plane) angle of CA group and OP angle, AFH (anterior facial height) and PFH (posterior facial height) of TB group were statistically significant. Moreover, the Z angle and cranial facial difficulty (C.F. difficulty) were also statistically significant in both groups. Class II children with retrognathic mandible are effectively treated by employing the CA, which has almost the same impact as of TB in sagittal and vertical changes. Resultantly, the patient profile is improved. The CA and TB treatments thus minimize the subsequent treatment difficulty by reducing the C.F. difficulty.


Twin-block appliance; Clear aligner; Cephalometric measurement; Overjet; Class II malocclusion

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Jianfang He,Longshuang Hu,Yan Yuan,Peipei Wang,Feifei Zheng,Han Jiang,Wen Li. Comparison between clear aligners and twin-block in treating class II malocclusion in children: a retrospective study. Journal of Clinical Pediatric Dentistry. 2024.doi:10.22514/jocpd.2023.070.


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