Use of a Modified Twin Block Appliance following Partial Maxillectomy: Case Report

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.

2017 ◽  
Vol 2017 ◽  
pp. 1-19 ◽  
Author(s):  
Giuseppe Perinetti ◽  
Luca Contardo

Current evidence on the reliability of growth indicators in the identification of the pubertal growth spurt and efficiency of functional treatment for skeletal Class II malocclusion, the timing of which relies on such indicators, is highly controversial. Regarding growth indicators, the hand and wrist (including the sole middle phalanx of the third finger) maturation method and the standing height recording appear to be most reliable. Other methods are subjected to controversies or were showed to be unreliable. Main sources of controversies include use of single stages instead of ossification events and diagnostic reliability conjecturally based on correlation analyses. Regarding evidence on the efficiency of functional treatment, when treated during the pubertal growth spurt, more favorable response is seen in skeletal Class II patients even though large individual responsiveness remains. Main sources of controversies include design of clinical trials, definition of Class II malocclusion, and lack of inclusion of skeletal maturity among the prognostic factors. While no growth indicator may be considered to have a full diagnostic reliability in the identification of the pubertal growth spurt, their use may still be recommended for increasing efficiency of functional treatment for skeletal Class II malocclusion.


2020 ◽  
Vol 67 (3) ◽  
pp. 159-164
Author(s):  
Tina Pajevic ◽  
Jovana Juloski ◽  
Marija Zivkovic

Introduction. Orthodontic treatment of Class II Division 1 (II/1) malocclusions in adults can be challenging since skeletal effects are limited. Possible treatment options are orthodontic camouflage or orthognatic surgery, in severe cases. The aim of this paper was to present a successful management of Class II malocclusion in an adult patient using temporary anchorage devices (TADs). Case report. After detailed clinical examination, study models and cephalometric analysis, a 26 years old patient was diagnosed with Class II malocclusion, an overjet of 12 mm, congenitally missing tooth 41 and midline shifted to the right in upper dental arch. In prior orthodontic treatment, patient had upper premolars extracted. Posterior teeth in upper left quadrant were shifted mesially. The camouflage treatment was considered, using temporary anchorage devices (TADs) to distalize posterior teeth on the left side, and gain space for incisor retraction and midline correction in upper dental arch. Results. Using TADs as additional anchorage in anterior region and coil spring for molar distalization, the space was made for tooth 23, midline correction and incisor retraction. After 40 months, a satisfactory result was achieved, overjet and midline correction, class I canines occlusion and class II molar occlusion. Conclusion. Class II/1 malocclusion in adults can be successfully treated using TADs. The success depends on the severity of malocclusion and patient cooperation.


2021 ◽  
Vol 11 (1) ◽  
pp. 143-146
Author(s):  
Ramida Shadlinskaya ◽  
Zaur Novruzov

Aims: Evaluation of the effectiveness of orthodontic treatment of Class II malocclusion with the Twin-block appliance in children withβ-thalassemia major. Methods: The study was conducted with 49 patients with Class II malocclusion aged 10-14 years. The control group included 23 healthy patients. The main group included 26 patients with β-thalassemia major. Patients had received orthodontic treatment with a Twin-block appliance. The duration of orthodontic treatment was 1.5–2 years. Results: In both groups, a statistically significant increase in the SNB angle was observed. Subsequently, the ANB angle was normalized. The effective length of the maxilla growing and mandibular length increasing was observed. Overjet distance is decreased due to favorable torque changes. Pretreatment assessment revealed that overbite was smaller in children with β-thalassemia major. As the effect of orthodontic treatment, statistically, significant changes were observed on both overjet and overbite distances (p <0.001). Conclusions: Orthodontic treatment of β-thalassemia major of patients with Twin-block appliance in mixed dentition stage is effective in improving inter arch relationships and the orofacial functions.


2016 ◽  
Vol 1 (1) ◽  
pp. 27
Author(s):  
Setiarini Widiarsanti ◽  
Darmawan Sutantyo ◽  
Pinandi Sri Pudyani

Perawatan ortodontik interseptif efektif untuk mengurangi keparahan maloklusi disertai dengan kebiasaan buruk. Pemilihan waktu perawatan sangat penting agar perawatan dapat berhasil. Periode percepatan pertumbuhan berkisar antara 10-12 tahun untuk perempuan dan 12-14 tahun untuk laki-laki. Aktivator dengan skrup ekspansi digunakan untuk menstimulasi pertumbuhan mandibula, untuk mendapatkan ruang dari ekspansi pada kedua lengkung rahang dan untuk menghentikan kebiasaan buruk. Tujuan dari studi kasus ini adalah untuk memaparkan tata laksana perawatan dengan aktivator pada masa percepatan pertumbuhan. Pasien seorang laki-laki berusia 12 tahun datang dengan keluhan utama gigi atas maju dan kurang menarik. Kebiasaan buruk pasien adalah bernafas melalui mulut. Pemeriksaan objektif menunjukkan hubungan klas I pada kedua sisi, pola skeletal klas II, jarak inter P1 atas 35,7 mm dan jarak inter P1 bawah 30,3 mm. Maloklusi Angle Klas I tipe dentoskeletal dengan tipe skeletal kelas II dan incisivus maksila protrusif, overjet: 9,5 mm, overbite: 6,2 mm, palatal bite, scissorbite, malposisi gigi individual, kebiasaan buruk bernafas melalui mulut dan pergeseran midline RA kekanan sebesar 1,6 mm. Setelah 4 bulan perawatan, kebiasaan buruk telah berhenti, overjet menjadi 5 mm, overbite menjadi 3,2 mm, jarak inter P1 atas 36,5 mm dan jarak inter P1 bawah 31,6 mm. Aktivator dengan skrup ekspansi efektif untuk mencegah terjadinya disharmoni rahang dengan modifikasi pertumbuhan dan perkembangan rahang serta untuk menghentikan kebiasaan buruk dalam waktu singkat. Beberapa hal tersebut dapat dicapai dengan ketepatan pemilihan waktu perawatan yaitu dalam periode percepatan pertumbuhan. ABSTRACT: Interceptive Orthodontic Treatment Using Activator in Growth Spurt Period. Interceptive orthodontic treatment is effective to reduce the severity of malocclusion with oral bad habits. Time treatment is an important thing to make the treatment become successful. Growth spurt period in range 10-12 years old for female and 12-14 years old for male. Activator with an expansion screw was used to stimulate the mandibula growth, to create space by expanding both arches and to stop the bad habit. A 12 years old male patient with a chief complaint of protruded maxillary teeth and unpleasant appearance. The oral bad habit of patient was mouth breathing. Objective examination showed class I molar relationship on both sides, skeletal class II pattern, inter upper premolars was 35,7 mm and inter lower premolars was 30,3 mm. Angle malocclusion class I with skeletal class II and protruded incisive maxilla, overjet 9,5 mm, overbite 6,2 mm, mouth breathing bad habit, upper midline shifting 1,6 mm to the right side. After 4 months of treatment the oral bad habit was stop, overjet 5 mm, overbite 3,2 mm, inter upper premolars 36,5 mm and inter lower premolars 31,6 mm. Activator with an expansion screw was effectively prevent the skeletal disharmony by modification of growth and development of jaw, and stop the oral bad habit in short period of time. Those can be achieved by the right time choosing in growth spurt period for the treatment.


2021 ◽  
pp. 030157422110572
Author(s):  
Ankit Kumar Shahi ◽  
Payal Sharma ◽  
Achint Juneja ◽  
Divya Shetty ◽  
Rishibha Bhardwaj ◽  
...  

Objectives: To evaluate the treatment outcomes between Twin Block and AdvanSync2® appliances by comparing the skeletal, dentoalveolar, and soft tissue changes. Materials and Methods: Radiographic data of 20 patients were retrospectively analyzed. Data were selected from patients in their skeletal growth spurt as evaluated by the cervical vertebral maturation method (CVMI 2, 3, and 4), with class II malocclusion characterized with retrognathic mandible (ANB > 4°, SNB < 77°, FMA = 25 ± 5°, overjet > 5 mm). There were 10 patients in each group that underwent orthodontic correction for class II malocclusion: either using Twin Block or AdvanSync2®. Independent t test and Paired t test and chi-square tests were used for the data analysis. The level of statistical significance was set at P value ≤.05. Results: The chronological and skeletal age were similar in both the groups. Records were taken for the functional treatment with mean treatment span of 8 ± 1 month. Changes in SNB (group I = 1.59°, group II = 3.11°) ( P < .01), Co-Gn (group I = 2.89 mm, group II = 5.34 mm), and U1-L1° (group I = −1.51°, group II = 2.97°) showed statistically different outcome between the groups, when the pre-post data were studied. Rest of the variables—cranial base, maxillary skeletal, mandibular skeletal, intermaxillary, vertical skeletal, maxillary dentoalveolar, mandibular dentoalveolar, and soft tissue—showed similar outcome ( P > .05). Conclusion: Both appliances lead to desirable outcomes in the correction of class II malocclusion. AdvanSync2® resulted in inducing more of changes in SNB and effective mandibular length as compared to Twin Block. Overjet and molar relation improved significantly with both the appliances. Both the appliances resulted in similar skeletal, dentoalveolar, and soft tissue changes.


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 ◽  
Vol 13 (52) ◽  
pp. 10-24
Author(s):  
Luciana Quintanilha Pires Fernandes ◽  
Jonas Capelli Junior ◽  
José Augusto Mendes Miguel

Rapid maxillary expansion (RME) is an orthodontic treatment alternative that aims to increase the transverse direction of the maxilla by separating the median palatine suture (MPS). miniscrew-assisted rapid palatal expansion (MARPE) aims to enhance the orthopedic effects of RME through skeletal anchorage. Thus, the aim of this article is to provide a guide for MARPE planning in cone beam computed tomography (CBCT) and for installation of the expander device with this technique. In addition, a case report of a Caucasian male patient, 16 years and 3 months old with Class II malocclusion, division 1 right subdivision, posterior crossbite of the right side and atresic upper arch in the post-pubertal growth spurt phase will be presented. The patient was treated with MARPE for a period of 5 weeks, when overcorrection of crossbite, correction of maxillary atresia, opening of MPS and creation of a transient diastema between the upper incisors were achieved, evidencing the success of the MARPE technique in a post-pubertal growth spurt patient.


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