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CompletedNCT07056829Updated Jul 9, 2025

The Effect of Mandibular Advancement With Clear Aligners on Maxillary and Mandibular Volumes

An interventional study of Mandibular Advancement Appliance (Invisalign MA) and Activator Appliance in Mandibular Retrognathia, sponsored by Batman University. Completed at 1 site in Turkey (Türkiye). Per ClinicalTrials.gov, last updated 2025-07-09.

Sponsored by Batman University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
55
Allocation
Randomized
Sex
All
01

Study summary

The aim of this study is to compare the effectiveness of two different orthodontic treatment methods used in patients with skeletal Class II malocclusion, a condition in which the lower jaw is positioned backward. Approximately 80% of Class II malocclusions are due to mandibular retrusion. Therefore, functional appliances that stimulate mandibular growth in growing individuals have been widely used in orthodontics for many years.

In recent years, clear aligner systems have become increasingly popular in orthodontic practice. A mandibular advancement feature was recently integrated into these aligners, allowing for simultaneous tooth alignment and forward positioning of the lower jaw. In this study, the newly developed Mandibular Advancement Appliance (MAA), based on clear aligners, will be compared to the traditional functional appliance known as the Activator.

Who Can Participate in the Study? Children with retrusive lower jaws who are in the growth and development period Individuals with no prior orthodontic treatment Patients with specific levels of dental protrusion (overjet) Those with good general health and no contraindications for CBCT imaging What Will the Treatment Process Involve?

Participants will be randomly assigned to one of three groups:

MAA group (clear aligners with mandibular advancement) Activator group (traditional removable appliance) Control group (no treatment, only observation) The active treatment period will last approximately 7-8 months, followed by a retention phase. All patients will be monitored regularly, and strict adherence to appliance use will be expected.

How Will the Outcomes Be Assessed? Before and after the treatment period, participants will undergo cone-beam computed tomography (CBCT) scans to obtain detailed three-dimensional images of the jaws. These images will be analyzed to evaluate volumetric changes. All measurements will be performed by a trained orthodontic specialist using dedicated software.

Potential Benefits for Participants:

Participants will receive close clinical monitoring throughout the study period. The use of advanced imaging technologies may support the development of more effective and individualized treatment plans.

Safety and Confidentiality:

This study has received ethical approval and will be conducted in accordance with relevant data protection and research ethics standards. All personal data will be kept confidential. Written informed consent will be obtained from all participants and/or their legal guardians.

02

Conditions studied

  • Mandibular Retrognathia

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Keywords

  • clear aligners
  • mandibular retrognathia
  • mandibular advancement
03

In context

Micrognathism

26 studies on the registry are indexed under Micrognathism; 7 are open to participants now.

This study's enrollment of 55 is above the median of 24 across 22 interventional studies indexed under Micrognathism.

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Lead sponsor

Batman University is the lead sponsor of 13 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Cervical vertebral maturation (CVM) stage 2 or 3
  • Bilateral full or half cusp Class II molar relationship
  • Skeletal Class II relationship associated with mandibular retrognathia (ANB angle > 4° and SNB angle \< 78°)
  • Horizontal or average growth pattern (SN-GoGn ≤ 38°)
  • Overjet distance between +4 mm and +8 mm; (6) Good patient compliance throughout the treatment.

Exclusion criteria

Exclusion Criteria:

  • CVM stage 5 or 6;(2) Previous orthodontic treatment;
  • Presence of maxillary prognathism
  • High-angle growth pattern (SN-GoGn > 38°)
  • Transverse orthodontic anomalies or facial asymmetry
  • Palpation-induced tenderness or pain in the masticatory muscles
  • Presence of clicking, crepitus, pain, or tenderness in the temporomandibular joint (TMJ)
  • Congenital or acquired craniofacial deformities
  • Poor patient compliance or oral hygiene
  • Any condition that could interfere with CBCT imaging.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
55 participants (actual)

Study arms

  • Experimental
    MAA Group

    Patients receive orthodontic treatment using clear aligners (Invisalign) with integrated mandibular advancement features (MAA). Advancement is performed in 2 mm increments every 8 weeks over \~8 months.

    Device: Mandibular Advancement Appliance (Invisalign MA)

  • Active comparator
    Activator Group

    Patients receive traditional removable functional appliance therapy (Activator) for \~7 months.

    Device: Activator Appliance

  • No intervention
    Control Group

    Patients receive no orthodontic treatment but are monitored for the same duration as the treatment groups.

Interventions

  • DeviceMandibular Advancement Appliance (Invisalign MA)

    Clear aligner system with integrated buccal precision wings to posture the mandible forward. Advancement protocol: 2 mm increments every 8 weeks. Total active treatment duration: \~8.15 months, followed by retention phase. Patients instructed to wear aligners ≥20 h/day, removing only for eating and oral hygiene.

  • DeviceActivator Appliance

    Traditional removable functional appliance fabricated on a standardized bite registration. Patients instructed to wear appliance 24 h/day except during meals and sports. Total active treatment duration: \~7.15 months, followed by retention phase.

06

What researchers measure

Primary outcomes

  1. Change in mandibular volume (mm³)

    Mandibular volume change will be measured using CBCT scans analyzed via Mimics software. The MAA and Activator groups will be compared to evaluate treatment effects.

    Time frame: Baseline and post-treatment (~8 months)

07

Study locations

1 site
  • Batman University Faculty of Dentistry
    Batman, Turkey (Türkiye)
08

References and documents

Publications

  • Kavasoglu N, Nai̇boglu E. The effect of mandibular advancement with clear aligners compared with activator therapy on maxillary and mandibular volumes: a randomized controlled trial using CBCT. BMC Oral Health. 2026 Feb 19;26(1):443. doi: 10.1186/s12903-026-07924-4. PubMed 41709259 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 9, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07056829
Lead sponsor
Batman University
Responsible party
Nursezen Kavasoglu (Assistant Professor Dr., Batman University) — Principal investigator
First posted
Jul 9, 2025
Start date
May 1, 2025
Primary completion
Jun 1, 2025
Completion
Jun 1, 2025
Last update
Jul 9, 2025

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jun 2025. You cannot join it, but the record below documents what was studied.

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