Comparative Analysis of Dentoskeletal Changes of the Twin Block Appliance and the AdvanSync2 Appliance in Treatment of Skeletal Class-II Malocclusion in Pakistani Population: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Fareena Ghaffar ◽  
Abdullah Jan ◽  
Obaid Akhtar ◽  
Alaina T. Mughal ◽  
Rooma Shahid ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Class Ii ◽  
Growth Spurt ◽  
Class Ii Malocclusion ◽  
Twin Block ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Significant Difference ◽  
Functional Appliances

Abstract Objective This study aimed to compare dentoskeletal changes in skeletal class-II malocclusion with removable twin block appliance and fixed AdvanSync2 appliance. Materials and Methods A prospective randomized clinical trial was conducted over a span of 1 year at AFID at Rawalpindi. Thirty patients with skeletal class-II malocclusion, 16 males (53.3%) and 14 females (46.6%), were randomly selected and divided in two equal groups (15 each) to be treated with either fixed functional appliances (FFAs) or with removable functional appliances (RFAs). Out of 30 patients, 15 between cervical vertebral maturation (CVM) stages of 2 and 3 were treated with RFA (twin block appliances) and remaining 15 between CVM stages of 4 and 5 were treated with FFA (AdvanSync2 appliances). Pretreatment (T1) and posttreatment (T2), angular variable, and linear variable were measured to compare the dentoskeletal effects between the two groups. Statitical Analysis Paired sample t-test was used to assess significant difference between variables at T1 (Pre-treatment) and T2 (Post-treatment) stage for both RFA and FFA group. Comparison among the RFA and FFA group was made using non-parametric Mann-Whitney U Test. IBM SPSS version 25.0 was used for evaluation. Results No significant difference was found in angular variables between the RFA and FFA groups (p > 0.05) with the exception of linear variables. Sella-posterior nasal spine (S-PNS) length significantly increased and Jarabak's ratio significantly decreased for FFA group (p = 0.010 and 0.045, respectively), when compared with RFA group. Conclusion Both the appliances, twin block (RFA) and AdvanSync2 (FFA), are effective for correction of skeletal class-II malocclusion. Both the appliances produced similar effects in the sagittal plane but for better vertical control twin block should be the appliance of choice. AdvanSync2 appliance could be preferred over twin block appliance when dentoalveolar and slight retrusive effect on the maxilla is desired especially for individuals in postpubertal growth spurt.

scholarly journals The Effects of Functional Appliances on Female Patients with Skeletal Class II Malocclusion 6 Months after Menarche

2016 ◽  
Vol 17 (4) ◽  
pp. 286-293
Author(s):  
Ali AM Jouybari ◽  
Valiallah Arash ◽  
Saeid Tavanafar ◽  
Soraya Khafri ◽  
Zahra Dehghan
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Growth Spurt ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Female Patients ◽  
Skeletal Class Ii ◽  
Soft Tissue Profile ◽  
Functional Appliances ◽  
The Mean

ABSTRACT Aim To investigate the skeletal, dental, and soft tissue changes in girls with class II division 1 malocclusion after growth spurt peak under the effect of activator appliance. Materials and methods In this clinical trial study, 15 female patients, with skeletal class II and mandibular growth deficiency and at least 5 mm overjet, were randomly selected 6 months after their menarche. The mean of their ages at the beginning was 12.33 ± 0.81 years, and in the end it was 13.73 ± 0.79 years; the mean duration of treatment was 12.2 ± 3.18 months. Lateral, cephalometric radiographs were taken from all the patients before and after the treatment. Data were analyzed with Statistical Package for the Social Sciences (SPSS) 20 using paired t-test. Results On an average, the ANB angle, the angle of the upper incisors with the S-N, facial convexity, and overjet decreased by 2.6° ± 0.9, 5.4° ± 0.8, 3.8° ± 3.4, and 5.6 ± 1.8 mm respectively. The SNB angle, the angle of the lower incisors with the N-B, the labiomental angle, the total length of the mandible, the lower anterior facial height, the lower lip distance, the first molar of the mandible, and the soft tissue pogonion to the vertical line from the S point increased by 2.8° ± 1.8, 3.4° ± 3, 14.7 ± 15, 3.7 ± 2.6, 2.1 ± 1.6, 6.3 ± 2.5, 4.4 ± 2.4, and 6 ± 3.3 mm respectively. All these figures were statistically significant (p = 0.000). Conclusion The functional appliance improved the dental–skeletal relations and the soft tissue profile of patients after growth spurt peak of puberty in a group of Iranian girls, whereas dental changes were more than skeletal ones. Clinical significance Functional appliances can be used for correction of skeletal class II malocclusion 6 months after menarche in girls. How to cite this article Jouybari AAM, Arash V, Tavanafar S, Khafri S, Dehghan Z. The Effects of Functional Appliances on Female Patients with Skeletal Class II Malocclusion 6 Months after Menarche. J Contemp Dent Pract 2016;17(4):286-293.

scholarly journals Treatment of Class II Malocclusion With Removable Functional Appliances: A Narrative Review

2021 ◽  
Author(s):  
Saima Nizar Hirji ◽  
Irfan Qamruddin ◽  
Muhammad Adeel Mudassar ◽  
Zohaib Khurshid ◽  
Mohammad Khursheed Alam
Keyword(s):  
Class Ii ◽  
Vertical Dimension ◽  
Class Ii Malocclusion ◽  
Twin Block ◽  
Skeletal Class ◽  
Long Term Stability ◽  
Skeletal Class Ii ◽  
Functional Appliances ◽  
Growing Age ◽  
Short Time

AbstractAround half of all malocclusions that need orthodontic treatment are class II in nature. Patients with class II malocclusion primarily seek treatment for aesthetic improvement. Most of the skeletal class II malocclusions are because of mandibular deficiency, and can be best treated during the growing phase of development by removable functional appliances. The objective of this review is to evaluate and compare skeletal and dentoalveolar effects of various removable functional appliances in the treatment of class II malocclusion. Manual and electronic databases were searched, and out of 5,711 articles, 221 abstracts were shortlisted and reviewed. A total of 19 articles that fulfilled the selection criteria were then retrieved and analyzed. A significant increase in mandibular length and dentoalveolar effects with an increase in vertical dimension in a short time were observed with Twin-Block appliance treatment, followed by Bionator appliance treatment. The long-term stability of results achieved with Twin-Block appliance treatment is still questionable. In addition, Frankel appliance treatment effects are more skeletal in nature, with better control in the vertical dimension. However, it takes a more extended treatment duration to produce similar effects. Based on available evidence, we are convinced that removable functional appliances are valuable tools for correction of the class II malocclusion at a growing age with horizontal growth pattern.

scholarly journals Skeletal Class II Malocclusion Treatment with Combined Twin Block and Lip Bumper Appliances: A Case Report

2021 ◽  
Vol 16 (Supp. 1) ◽  
pp. 87-94
Author(s):  
Hilda Fitria Lubis ◽  
Nurhayati Harahap ◽  
Ananda Permata Sari
Keyword(s):  
Class Ii ◽  
Class Ii Malocclusion ◽  
Condylar Cartilage ◽  
Lower Lip ◽  
Mandibular Growth ◽  
Twin Block ◽  
Skeletal Class ◽  
Anterior Teeth ◽  
Skeletal Class Ii ◽  
Lip Bumper

Functional appliances have been used over a century in clinical orthodontic treatments for skeletal Class II malocclusion patients. Its popularity is attributed to its high patient adaptability and ability to produce rapid treatment changes. The twin block and lip bumper can be combined depending on the patient’s cases. The purpose of therapy with twin block is effective in mandibular growth deficiencies to induce supplementary lengthening of mandibular by stimulating increased growth at the condylar cartilage. The patient was a ten-year-old male patient with skeletal Class II malocclusion. He had a convex facial profile, SNA (sella, nasion, A point) angle of 77.5°, SNB (sella, nasion, B point) angle of 73.0°, ANB (A point, nasion, B point) angle of 4.5°, overjet of 6.5 mm, overbite of 11/41 = 5.0 mm, 21/31 = 4.5 mm, abnormal upper labial frenulum, crossbite in the second left premolar of maxilla, crowded anterior teeth of mandibular, deficiency of mandibular growth, lower lip sucking habit, anterior teeth of maxilla with diastema and proclination. Orthodontic treatment for patient is a combination of twin block and lip bumper appliances. After seven months, frenectomy is used to eliminate and correct the spacing in the frenulum. After 10 months, the patient’s skeletal and profile had improved to skeletal Class I malocclusion, SNA angle of 78.0°, SNB angle of 75.0°, ANB angle of 3.0°, overbite and overjet of 4.0 mm, and the lower lip sucking habit had stopped. Twin block and lip bumper appliances are particularly good alternative treatment in managing selected cases of skeletal Class II malocclusion.

scholarly journals Twin block appliance: Effect on pharyngeal airway

2018 ◽  
Vol 7 (4) ◽  
pp. 147-152
Author(s):  
Vivek Bikram Thapa ◽  
Amrita Shrestha ◽  
Prabesh Sherchan ◽  
Prakash Poudel ◽  
Luna Joshi
Keyword(s):  
Soft Palate ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Twin Block ◽  
Skeletal Class ◽  
Pharyngeal Airway ◽  
Skeletal Class Ii ◽  
Obstructive Sleep ◽  
Lateral Cephalograms ◽  
Mandibular Retrusion

Background: Mandibular retrusion is the main cause of Skeletal Class II malocclusion characterized by skeletal retrusion of mandible with skeletal or dentoalveolar protrusion of maxillary. Objectives: This study was conducted to evaluate effect of treatment with twin-block appliances on pharyngeal dimensions. Methodology: This study was conducted in in the Department of Orthodontics & Dentofacial Orthopedics in Kathmandu Medical College. Twenty patients of age group 7 to 14 years with skeletal class II malocclusion with mandibular retrusion were selected. Variables evaluated were depth of nasopharynx; height of nasopharynx; depth of oropharynx; depth of hypopharynx; soft palate length; soft palate thickness and soft palate inclination. The lateral cephalograms were obtained for all subjects before the start of treatment and after a follow-up period of approximately three months in treatment. Results: Results showed that depth of nasopharynx increased by 1 mm, height of nasopharynx increased by 0.78 mm, depth of nasopharynx increased by 1.97 mm, depth of hypopharynx increased by 0.79 mm, soft palate length decreased by 4 mm, soft palate thickness increased by 2 mm and soft palate inclination decreased by 7.01 mm. The results for depth of pharynx and soft palate thickness were statistically significant. Conclusion: This study concluded that the use of twin block appliance for class II patients corrects sagittal dimension of oropharynx and hypopharynx. Early intervention for mandibular retrognathism in class II malocclusion helps enlarge the airway dimensions and decrease potential risk of obstructive sleep apnea syndrome for growing patients in the future.

scholarly journals A Retrospective Cephalometric Evaluation of Dental Changes with Activator and Activator Headgear Combination in the Treatment of Skeletal Class II Malocclusion

2011 ◽  
Vol 12 (1) ◽  
pp. 14-18 ◽  
Author(s):  
G Anil Kumar ◽  
Amit Maheshwari
Keyword(s):  
Class Ii ◽  
Combination Group ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Mandibular Incisor ◽  
Lower Incisor ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Lateral Cephalograms ◽  
Functional Appliances

ABSTRACT Aim The aims of this study were to evaluate the dental changes brought about by activator and activator headgear combination (ACHG) and to determine whether we can achieve control over the lower incisor proclination which is a side effect of using functional appliances; or not, while treating cases of skeletal class II malocclusions. Methods Lateral cephalograms of 45 skeletal class II division 1 patients were selected for the study. Fifteen of them were successfully treated with an Andresen activator and the other 15 with an activator headgear combination. Fifteen class II subjects who had declined treatment served as the control group. Cephalometric landmarks were marked by one author to avoid interobserver variability. Results The results revealed that both the activator and the activator headgear combination significantly (p < 0.001) affected dental variables measured. The mandibular incisor proclination was effectively controlled in the activator headgear combination group. Conclusion An activator headgear combination would offer itself as a better option compared with activator alone in the treatment of skeletal class II malocclusions especially in cases with proclined mandibular incisors. Clinical significance When one of the treatment goals is to achieve a greater control over mandibular incisor proclination in the treatment of Skeletal Class II malocclusions, employing a combination of activator and headgear may substantially improve clinical outcomes. How to cite this article Lall R, Kumar GA, Maheshwari A Kumar M. A Retrospective Cephalometric Evaluation of Dental Changes with Activator and Activator Headgear Combination in the Treatment of Skeletal Class II Malocclusion. J Contemp Dent Pract 2011;12(1):14-18.

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