scholarly journals Comparison of the effects of rapid maxillary expansion versus Twin Block appliance on mandibular growth in skeletal Class II patients

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.

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.


2021 ◽  
Vol 16 (Supp. 1) ◽  
pp. 87-94
Author(s):  
Hilda Fitria Lubis ◽  
Nurhayati Harahap ◽  
Ananda Permata Sari

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.


2007 ◽  
Vol 77 (5) ◽  
pp. 870-874 ◽  
Author(s):  
Roberto M. A. Lima Filho ◽  
Antonio C. O. Ruellas

Abstract Objective: To evaluate a 10-year follow-up of anteroposterior and vertical maxillary changes in skeletal Class II patients treated with slow and rapid maxillary expansion methods. Materials and Methods: The sample consisted of 70 patients divided into two groups: (1) treated with a cervical headgear with expansion of the inner bow (CHG) and (2) using a Haas-type rapid maxillary expansion appliance in conjunction with cervical headgear (RME-CHG). The CHG group consisted of 40 patients (18 males and 22 females; average age 10.6 years at pretreatment [T1], 13.6 years at posttreatment [T2], and 23.6 years at postretention [T3]). The RME-CHG group consisted of 30 patients (14 males and 16 females; average age 10.4 years at T1, 14.0 years at T2, and 24.6 years at T3). The profiles of SNA and SN-PP angles showed no significant differences in either group at T1, T2, and T3 phases. Results: For the entire sample, the profile analysis between the phases showed reduction in the SNA angle from T1–T2 and an increase from T2–T3. The SN-PP angle showed an increase from T1–T2 and a decrease from T2–T3. Treatment of skeletal Class II patients with slow and rapid maxillary expansions was efficient and stable over the long-term. Conclusions: The profiles of SNA and SN-PP at T1, T2, and T3 achieved with slow and rapid maxillary expansions were clinically equivalent.


2013 ◽  
Vol 3 (1) ◽  
pp. 40-43
Author(s):  
Shashank Sharad Gaikwad ◽  
Manish Suresh Sonawane ◽  
Girish Ramchandra Karandikar ◽  
Priyanka Anil Pawar ◽  
Shaili Sanjay Shah

ABSTRACT Functional appliances have been used for many years in the treatment of class II malocclusions. They redirect the growth of mandible bringing about a skeletal change in a growing patient. In case of any remaining dental discrepancy, a fixed appliance is obligatory. This patient was an 11-year-old growing female with a convex profile, receding chin, lower lip trap, class II skeletal and dental relationship, a large overjet and overbite and a high maxillary labial frenum attachment. Treatment started with the Twin-block appliance with an expansion screw to achieve transverse correction, promote growth of the mandible and improve her profile. This was followed by fixed appliance mechanotherapy to align and level the dentition, close spaces and retract the maxillary anteriors. Frenectomy was carried out after space closure. How to cite this article Sonawane MS, Karandikar GR, Gaikwad SS, Pawar PA, Shah SS. Two-Phase Treatment of a Growing Patient with a Skeletal Class II. J Contemp Dent 2013;3(1):40-43.


2007 ◽  
Vol 77 (4) ◽  
pp. 625-631 ◽  
Author(s):  
Roberto M. A. Lima Filho ◽  
Antonio Carlosde Oliveira Ruellas

Abstract Objective: To evaluate anteroposterior and vertical mandibular changes in skeletal Class II patients treated with slow or rapid maxillary expansions at 10-year follow-up. Materials and Methods: The sample consisted of 70 patients divided into two groups, treated with (1) a cervical headgear (CHG) with expansion of the inner bow or (2) a Haas-type rapid maxillary expansion (RME) appliance in conjunction with CHG (RME-CHG). The CHG group consisted of 40 patients (18 males and 22 females, with an average age of 10.6 years at pretreatment [T1], 13.6 years at posttreatment [T2], and 23.6 years at postretention [T3]), and the RME-CHG group consisted of 30 patients (14 males and 16 females with an average age of 10.4 years at T1, 14.0 years at T2, and 24.6 years at T3). Results: The profiles of SNB, B-Hor, and Pog-Hor showed significant increases for all treatment phases in both groups. The SN-Go-Gn angle showed no significant decrease from T1 to T2 and a significant decrease from T2 to T3. Conclusions: For the entire sample (CHG + RME-CHG) the profile analysis between the phases showed mean increases in B-Ver and Pog-Ver for both phases.


2019 ◽  
Vol 56 (2) ◽  
pp. 341-345 ◽  
Author(s):  
Luminita Ligia Vaida ◽  
Raluca Dima ◽  
Emilia Albinita Cuc ◽  
Bianca Maria Negrutiu ◽  
Abel Emanuel Moca ◽  
...  

The aim of this study was to evaluate the efficiency in using intermaxillary elastics to stimulate mandibular growth and advancement in orthodontic patients diagnosed with skeletal Class II malocclusion as well as to compare the use of these Class II elastics in two different therapeutic approaches. The sample consisted of 60 orthodontic patients aged 10-15 years, 34 girls and 26 boys. The sample was divided into two equal groups (each consisting of 30 patients). Patients belonging to the first group (Group 1) were subjected to 1/4�� - 6.0 oz elastics and were advised to change the elastic every 24 hours. Patients belonging to the second group (Group 2) were subjected to 1/4�- 4.5 oz elastics but with a recommendation to change the elastics every 12 hours. In order to evaluate the effectiveness of these two types of Class II elastics on mandibular growth and advancement, the value of the SNB angle at the beginning of the treatment (T1) was compared with the value of the SNB angle after 5 months of wearing intermaxillary elastics (T2). All patients showed statistically significant increased values of the SNB angle during the orthodontic treatment (p[0.001). Patients in Group 2 showed a significantly higher statistical increase (p[0.05) than patients in Group 1.


2021 ◽  
Vol 10 (34) ◽  
pp. 2954-2959
Author(s):  
Shilpa Venkatesh Pharande

The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.


2016 ◽  
Vol 50 (1) ◽  
pp. 31-41
Author(s):  
Prashantha Govinakovi Shivamurthy ◽  
Alireza Jafari ◽  
Ashutosh Shetty ◽  
Sadashiva Shetty Kandavara

2013 ◽  
Vol 18 (4) ◽  
pp. 70-81
Author(s):  
Osama Hasan Alali

INTRODUCTION: This article demonstrates the description and use of a new appliance for Class II correction. MATERIAL AND METHODS: A case report of a 10-year 5 month-old girl who presented with a skeletally-based Class II division 1 malocclusion (ANB = 6.5º) on a slightly low-angle pattern, with ML-NSL angle of 30º and ML-NL angle of 22.5º. Overjet was increased (7 mm) and associated with a deep bite. RESULTS: Overjet and overbite reduction was undertaken with the new appliance, Fixed Lingual Mandibular Growth Modificator (FLMGM). CONCLUSION: FLMGM may be effective in stimulating the growth of the mandible and correcting skeletal Class II malocclusions. Clinicians can benefit from the unique clinical advantages that FLMGM provides, such as easy handling and full integration with bracketed appliance at any phase.


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