40- Do Precision Wings Really Correct Class II
Show notes
Explore the effectiveness of Invisalign's precision wings for class 2 correction:
- Recent systematic review by Mecenas et al. (2025).
- Seven clinical studies included, mostly retrospective with high bias risk.
- Evidence of very low certainty.
- Minimal skeletal effects; overjet reduction via incisor movement.
- Performed similarly to twin-block and Herbst appliances in minor shifts.
- Authors call for more rigorous trials to support use as orthopedic treatment.
…………………….
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Show transcript
00:00:00: Are precision wings just another orthodontic trend or a real game changer for class two correction?
00:00:07: Hey guys, today we're looking at how these innovative appliances perform in growing patients compared to traditional methods.
00:00:15: Let's find out what the latest research says about their effectiveness comfort and long-term results.
00:00:25: I want to talk today about a recent systematic review by Messinos and colleagues published in Progress in orthodontics, in twenty-twenty five.
00:00:33: It examined whether Invisalign's precision wings really advanced the mandible of growing class II patients.
00:00:40: Seven clinical studies were included mostly retrospective none randomized all at moderate high risk of bias.
00:00:49: Using Prisma and Greight methodology, the authors concluded that the available evidence is of very low certainty.
00:00:58: The key numbers are small – the S&B angle increased by about half a degree And A & B decreased by about zero point eight degrees.
00:01:06: Statistically significant perhaps but far below what we would consider clinically relevant mandibular growth.
00:01:14: In essence, the appliance produces modest dental and negligible skeletal effects.
00:01:19: Overjet reduction was achieved mainly through incisor movement rather than real mandibular advancement.
00:01:27: Vertical dimensions and maxilloposition remained unchanged when compared to twin-block and Herbst appliances.
00:01:33: precision wings performed similarly in minor angular shifts but fell short in achieving orthopedic changes.
00:01:41: The twin block still shows a greater skeletal response while Herbst exerts stronger sagittal control.
00:01:50: Only two studies reported soft tissue outcomes, slight improvement in chin projection and minor lip protrusion.
00:01:56: but again these were minimal.
00:01:59: methodologically the review highlights our current evidence gap.
00:02:03: Different growth stages, unclear aligner protocols and limited follow-up make it difficult to draw solid conclusions.
00:02:11: The field has moved ahead commercially faster than scientifically.
00:02:16: So what does this mean clinically?
00:02:19: Precision wings may have a place in mild class two cases especially when aesthetics comfort & compliance are priorities.
00:02:29: but for genuine mandibular advancement, traditional functional appliances remain more effective.
00:02:36: The author's call to well-designed randomized trials with standardized treatment protocols and long term follow up before clear liner based advancements can be recommended as an orthopedic treatment.
00:02:48: In summary while Invisalign With Precision Wings is an elegant patient friendly concept its current evidence base shows only minor skeletal benefits.
00:02:58: For now, we should view it as a dental reviewer tool not the true growth modifying appliance.
00:03:04: Thanks for watching!
00:03:04: I'm Dr.
00:03:05: Martin Baxman and let's bring science back to orthodontics.
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