A Functional Appliance System for the Correction of Class II Relationships

1989 ◽  
Vol 16 (3) ◽  
pp. 169-176 ◽  
Author(s):  
M. J. Trenouth

A technique is described for the correction of Class II malocclusion involving a functional appliance and consisting of three phases. 1. Adjustment of posterior arch width and dental alignment, using semi-rapid maxillary expansion by means of an upper removable appliance, to co-ordinate the anticipated positions for the arches. 2. Correction of the Class II dental relationships using a modification of the twin-block functional appliance. 3. Retention, using an upper removable appliance with a very steep anterior bite plane. The technique is illustrated by a case report.

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Sanjay Prasad Gupta ◽  
Dr. Shristi Rauniyar

Management of skeletal class II relation in growing patient require careful evaluation of growth status, proper diagnosis and treatment plan to address the patient’s need. Twin block is the appliance of choice among functional appliance to correct the skeletal class II malocclusion due to it’s acceptability by the patient and simplified design. Maxillary canine impaction is the second most prevalent impaction after the third molars. Treatment of maxillary canine impaction is usually a challenge to orthodontic approach as the defect lies in the esthetic region of the jaw. This case report describes the orthodontic management of a 9 years male patient having skeletal Class II malocclusion with horizontally impacted maxillary canine. Some modifications in the treatment mechanics are deemed essential to address the patient’s need for achieving the optimal esthetic and to improve the occlusion. Twin block is beneficial for the treatment of skeletal malocclusion in a growing patient to achieve the maximum benefit. The orientation of impacted teeth may change from horizontal to favorable one, hence it should be considered a viable treatment alternative. In such case, early diagnosis and interception at the right time along with radiographic follow-ups are necessary to achieve successful results. Keywords: Canine Impaction, Class II malocclusion, Growth modification, Twin block appliance


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jia-Nan Zhang ◽  
Si Chen ◽  
Cheng-Yi Huang ◽  
Chong Zhong ◽  
Jing Jin ◽  
...  

Abstract Background This is a retrospective study that compares mandibular growth changes in skeletal Class II patients treated by rapid maxillary expansion (RME) and following fixed appliance with those patients treated by Twin-Block (TB) and following fixed appliance. Methods Fourteen patients treated by RME and following fixed appliance were included into the RME group. Fifteen patients treated by Twin-Block and following fixed appliance were included into the TB group. Lateral cephalometric radiographs taken before treatment and immediately after fixed appliance treatment were used to evaluate mandibular growth effects. Results The starting forms of the patients in the two groups were examined to be of good comparability. The mandibular length increased significantly in both groups as measured by Co-Gn, Go-Gn and Ar-Gn, but the TB group didn’t show more mandibular growth than the RME group (P > 0.05). Skeletal changes of the mandible in vertical dimension were different in the two groups. The change in FMA was 0.35° in the RME group, while the change was 2.65° in the TB group (P < 0.001). The change in LAFH was 5.14 mm in the RME group, significantly smaller than the change of 10.19 mm in the TB group (P < 0.001). Conclusion The investigated Phase I treatment with RME followed by Phase II treatment of fixed appliance achieved the same increases in sagittal mandibular growth and facial profile improvements as the Twin-Block therapy. The treatment with RME followed by fixed appliance was better for vertical control, while the treatment with Twin-Block followed by fixed appliance significantly increased the mandibular plane angle.


Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 236-242
Author(s):  
Ram Mohan Parvathy ◽  
Sandeep Shetty ◽  
Parveen Katheesa

Introduction and Aim: Various functional appliances are developed to remodel the glenoid fossa and, thereby change the position of the mandible and correct Class II malocclusion. Many diagnostic aids have already been used to evaluate the changes ,but Cone Beam computed tomography (CBCT), three -dimensional diagnostic tool is rarely used .So this study was conducted with an aim is to evaluate the changes seen in the temporomandibular joint (TMJ) after mandibular advancement in class II malocclusions with functional appliance therapy, using CBCT, and also to assess and compare the efficacy of Twin Block, Power Scope and Forsus Fatigue Device used for the correction of class II malocclusion.Materials and Methods: The retrospective study was performed using the 52 CBCT scans of 26 patients with class II malocclusion due to retrognathic mandible. The subjects were divided into three groups based on appliance (Twin Block, Power Scope and Forsus Fatigue Resistant Device) used for the treatment. The changes seen in TMJ after mandibular advancement and condylar response to functional therapy was evaluated using the six. Data obtained were subjected to one-way Anova analysis with Posthoc Tukey test. Software SPSS version 20 was used to analyse the data. The level of significance was set at p < 0.05.Results: In subjects treated with Twin Block, the condyle was displaced slightly downwards and anteriorly; and condylar height was reduced. The decrease in the anterior and superior joint spaces were also found. In subjects treated with PowerScope and Forsus Fatigue Resistant Device, there was an increase in condylar height and width with a decrease in anterior and superior joint space.Conclusion: All three appliances were found to bring about changes in TMJ structures, but amongst them the Twin block has proved to be more efficient.


2019 ◽  
Vol 9 (2) ◽  
pp. 77-81
Author(s):  
Akram Ansari ◽  
Abhay Kumar Jain ◽  
Ankit Singh ◽  
Priya Sharma ◽  
Muneeb Adil

Class II malocclusion in pubertal phase presents a major and a common challenge to orthodontists. Proper diagnosis and treatment planning in early stage help in preventing and intercepting the severity of malocclusion. In pubertal phase skeletal Class II malocclusion due to mandibular retrusion are best treated with functional appliance. In recent time PowerScope fixed functional appliance is gaining immense popularity as noncompliant Class II corrector. In the present case report an adolescent male patient having Class II division 1 malocclusion with functional jaw retrusion was treated using MBT 0.022” prescription and PowerScope appliance. 7-8 months of PowerScope wear obtained stable and successful results with improvement in facial profile, skeletal jaw relationship and mild increase in IMPA. It can thus be concluded that PowerScope gives good results in Class II correction with a combination of patient comfort and ease of use that was unmatched among other appliances


1996 ◽  
Vol 23 (2) ◽  
pp. 103-108 ◽  
Author(s):  
H. C. Moseley ◽  
E. N. Horrocks ◽  
R. R. Welfare

A case is described in which a Class II malocclusion with severe Class II skeletal pattern was treated with a modified Twin Block Appliance. The patient, an II-year-old girl, had initially presented with an ameloblastoma located in the right maxilla. The subsequent defect produced by surgery was obturated by the appliance during her orthodontic treatment, which was undertaken during her pubertal growth spurt Two years later the result was stable, allowing the provision of a more definitive prothesis to restore the occlusion.


2015 ◽  
Vol 85 (6) ◽  
pp. 1070-1079 ◽  
Author(s):  
Murilo Fernando Neuppmann Feres ◽  
Hasnain Raza ◽  
Adel Alhadlaq ◽  
Tarek El-Bialy

ABSTRACT Objective:  To evaluate the effectiveness of rapid maxillary expansion (RME) on the sagittal dental or skeletal parameters of growing children with Class II malocclusion. Materials and Methods:  A systematic review intended to identify relevant literature was conducted. The search was performed on Medline, Embase, Cochrane Library, and Scopus databases. Reference lists of the included articles were also screened for relevant documents. The qualitative assessment was performed according to the Methodological Index for Non-Randomized Studies (MINORS) tool, and the resultant data were grouped and analyzed concerning dental and skeletal sagittal effects of RME. Results:  Of 25 screened studies, seven articles met eligibility criteria and were included. Study samples were observed during mixed dentition stage and characterized as having either Class II dental malocclusion or skeletal discrepancy. None of the included studies was a randomized clinical trial. Included controlled studies presented several inadequacies related to control group or lacked appropriate comparative statistical analysis. Besides being frequently based on deficient methodology, dental and skeletal sagittal effects of RME were either controversial or lacked clinical relevance. Conclusion:  The effect of RME on the sagittal dimension of Class II malocclusions has not been proved yet. Future randomized controlled clinical trials are still needed to definitely address this question.


2020 ◽  
Vol 47 (3) ◽  
pp. 235-247
Author(s):  
Himchan Kang ◽  
Koeun Lee ◽  
Misun Kim ◽  
Okhyung Nam ◽  
Hyo-seol Lee ◽  
...  

The purpose of this study was to evaluate the skeletal and dentoalveolar effects and optimal timing for treatment of class II malocclusion with functional appliances in children and adolescents.A group of 30 patients with class II malocclusion were divided into 3 groups according to their use of functional appliance: Twin block, Activator, Fränkel appliance. The group was also divided into 2 groups according to the cervical vertebrae maturation method. Lateral cephalometric radiographs were analyzed pretreatment (T0) and posttreatment (T1). Among the functional appliances, treatment with Twin block and Activator showed significant increase in the length of the mandible (Co-Gn) and the lower anterior facial height (ANS to Me), whereas the overjet and overbite were significantly reduced. Treatment with Fränkel appliance showed significant improvement in the relationship of maxilla and mandible. In addition, if the functional appliance was used during the period of pubertal growth peak, there was a significant increase in mandibular length, improvement in the relationship of maxilla and mandible, labial inclination of lower incisors and decrease in overjet compared to the treatment before pubertal growth peak. Therefore, this study indicates that using functional appliances for patients with class II malocclusion is effective and the optimal timing for using functional appliances is during pubertal growth peak.


2020 ◽  
Author(s):  
Jia-Nan Zhang ◽  
Si Chen ◽  
Cheng-Yi Huang ◽  
Chong Zhong ◽  
Jing Jin ◽  
...  

Abstract Background: This is a retrospective study that compares mandibular growth changes in skeletal Class II patients treated by rapid maxillary expansion (RME) and following fixed appliance with those patients treated by Twin-Block (TB) and following fixed appliance. Methods: Fourteen patients treated by RME and following fixed appliance were included into the RME group. Fifteen patients treated by Twin-Block and following fixed appliance were included into the TB group. Lateral cephalometric radiographs taken before treatment and immediately after fixed appliance treatment were used to evaluate mandibular growth effects. Results: The starting forms of the patients in the two groups were examined to be of good comparability. The mandibular length increased significantly in both groups as measured by Co-Gn, Go-Gn and Ar-Gn, but the TB group didn’t show more mandibular growth than the RME group (P>0.05). Skeletal changes of the mandible in vertical dimension were different in the two groups. The change in FMA was 0.35° in the RME group, while the change was 2.65° in the TB group (P<0.001). The change in LAFH was 5.14mm in the RME group, significantly smaller than the change of 10.19mm in the TB group (P<0.001).Conclusions: The investigated Phase I treatment with RME followed by Phase II treatment of fixed appliance achieved the same increases in sagittal mandibular growth and facial profile improvements as the Twin-Block therapy. The treatment with RME followed by fixed appliance was better for vertical control, while the treatment with Twin-Block followed by fixed appliance significantly increased the mandibular plane angle.


2020 ◽  
Vol 11 (SPL3) ◽  
pp. 100-106
Author(s):  
Jagadheeswari Ramamoorthy ◽  
Remmiya Mary Varghese ◽  
Geo Mani

A Removable functional appliance is composed of polished acrylic shields and stainless steel wires prescribed for patients with more pronounced class II malocclusion or open bite. These appliances work comfortably with a patient’s inherent growth to produce the desired Skeletal or Dental development. It can be achieved by dentoalveolar effects, alteration of soft tissue and utilisation of greater Mandibular growth potential. The commonly used Removable functional appliances are Twin Block appliance, Activator, Bionator, Frankel appliance, etc. This study aims to assess the frequency of the usage of removable functional appliances in a hospital based set up. The data of patients undergoing Removable functional appliance therapy was retrieved from the case sheets of the patients.The collected data was tabulated in Excel and statistically analysed with the help of SPSS software. From the results obtained, Twin block appliance was the most prevalent Removable functional appliance with a frequency of 60.6%. Frankel appliance and Activator each had a frequency of 9.1%. Twin block appliances were mostly preferred for males than females whereas Activator is preferred mostly for females. Based on the age, Twin block appliance was preferred for the age group 10-15 years, Frankel appliance for 5-10 years, Activator and Other appliances for 10-15 years. Therefore, within the limits of this study, we observed that Twin block appliance was the most preferred Removable functional appliance used in the management of Class II malocclusion and the most common age group receiving appliance therapy is 10-15 years.


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