ReviewFrontiers in dental medicine2026
Herbst and Twin Block appliances in Class II malocclusion management for children: a systematic review and meta-analysis.
Review in Frontiers in dental medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
- Erratum issued
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Class II malocclusion is a common skeletal abnormality in growing patients, often associated with mandibular retrusion. Functional appliances such as Herbst and Twin Block appliances aim to stimulate mandibular growth during puberty. However, evidence comparing their effectiveness remains inconsistent. Objective: To compare the skeletal, dental, and soft tissue effects of Herbst and Twin Block appliances in growing patients with Class II malocclusion through a systematic review and meta-analysis. Methods: Randomized controlled trials (RCTs) comparing both appliances in children ≤16 years of age with Class II malocclusion were included if they reported skeletal, dental, or soft tissue outcomes. Non-randomized studies, case reports, reviews, and those with incomplete data were excluded. PubMed, Scopus, Web of Science, the Cochrane Library, and EMBASE, among other sources, were searched until January 30, 2025, with no language or date restrictions. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and the certainty of the evidence was evaluated using the GRADE method. A random-effects meta-analysis calculated standardized mean differences (SMDs) with 95% confidence intervals. Results: Seven RCTs with 548 participants were included. Both appliances effectively managed Class II malocclusion, with generally similar effects on skeletal and soft tissue parameters. The Herbst appliance showed significant advantages in improving the mentolabial angle (SMD: 0.56; 95% CI: 0.15-0.96) and molar relationship (SMD: -0.31; 95% CI: -0.56 to -0.05). No significant differences were observed in other outcomes. Conclusions: Both the Herbst and Twin Block appliances are effective for Class II correction in growing patients. The Herbst appliance offers modest advantages in certain parameters, but clinical decisions should also consider patient-specific factors such as adherence, comfort, esthetics, and growth stage. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251011083, PROSPERO: CRD420251011083.
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