{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:58:21Z","timestamp":1790600301675,"version":"4.1.0"},"reference-count":0,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,21]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To evaluate and compare the efficiency of Hanks Herbst (HH) and twin block (TB) functional appliances in the treatment of adolescents with Class II malocclusion.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A two-arm parallel randomized controlled trial, stratified by sex, was conducted in a single United Kingdom hospital. Eighty adolescents (10\u201314 years) with overjet \u2265 7 mm were randomized 1:1 to HH or TB. Participants received either a fixed HH or removable TB appliance, followed by comprehensive fixed appliance therapy. Skeletal and dental outcomes were assessed as well as patient-reported outcomes. The primary outcome was time to reduce overjet to < 4 mm; secondary outcomes included skeletal or dental changes, peer assessment rating scores, treatment duration and failure, and oral health\u2013related quality of life.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At the completion of the functional phase (T1), HH demonstrated significantly greater overjet reduction (1.3 mm;\n P<\/jats:italic>\n < .001), improved molar relationships, and increased mandibular length (2 mm;\n P<\/jats:italic>\n = .03). By the completion of full treatment (T2), most skeletal and dental differences were no longer significant, except for a small residual overjet favoring TB (0.6 mm). Peer assessment rating scores improved substantially in both groups, with no significant differences at T2 (HH = 4.6 \u00b1 4.2; TB = 4.1 \u00b1 3.4;\n P<\/jats:italic>\n = .60). Patient-reported outcomes at T2 were largely similar, although TB participants reported higher embarrassment at T1 (46% vs 18%). Treatment failures were higher in the TB group (37.5% vs 17.5%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The HH appliance provides efficient short-term overjet correction. However, following comprehensive fixed appliance therapy, skeletal, occlusal, and patient-reported outcomes are comparable between HH and TB. Both clinical effectiveness and patient experience should guide functional appliance selection.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/121525-1036.1","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:33:33Z","timestamp":1784648013000},"source":"Crossref","is-referenced-by-count":1,"title":["Comparison of the effects of Hanks Herbst vs twin block following the removal of fixed appliances in Class II correction: a randomized controlled trial"],"prefix":"10.2319","author":[{"given":"Ama","family":"Johal","sequence":"first","affiliation":[{"name":"Professor, Centre for Oral Bioengineering, Institute of Dentistry, Queen Mary University London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balraj","family":"Gill","sequence":"additional","affiliation":[{"name":"Specialty Registrar, Centre for Oral Bioengineering, Institute of Dentistry, Queen Mary University London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shree","family":"Patel","sequence":"additional","affiliation":[{"name":"Specialty Registrar, Centre for Oral Bioengineering, Institute of Dentistry, Queen Mary University London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth Koh Shou","family":"Bin","sequence":"additional","affiliation":[{"name":"Specialist Orthodontist, Centre for Oral Bioengineering, Institute of Dentistry, Queen Mary University London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moaiyad M.","family":"Pacha","sequence":"additional","affiliation":[{"name":"Specialist Orthodontist, Centre for Oral Bioengineering, Institute of Dentistry, Queen Mary University London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/aop\/article-10.2319-121525-1036.1\/article-10.2319-121525-1036.1.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/aop\/article-10.2319-121525-1036.1\/article-10.2319-121525-1036.1.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:03:13Z","timestamp":1790596993000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/aop\/article-10.2319-121525-1036.1\/article-10.2319-121525-1036.1.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2319\/121525-1036.1","relation":{},"ISSN":["1945-7103","0003-3219"],"issn-type":[{"value":"1945-7103","type":"electronic"},{"value":"0003-3219","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,21]]}}}