The twin-block appliance for correction of class II division 1 malocclusion

Dental Update ◽  
2021 ◽  
Vol 48 (7) ◽  
pp. 579-583
Author(s):  
Erfan Salloum ◽  
Declan T Millett ◽  
Grant T McIntyre

The twin-block appliance is a widely used functional appliance for the correction of Class II division 1 malocclusion in growing children and adolescents. This article outlines the indications and case assessment, the steps in clinical management and appliance design. Evidence regarding the mode of action, effects and prediction of treatment outcome of the twin-block appliance for Class II division 1 malocclusion are also presented. CPD/Clinical Relevance: The twin-block appliance is a widely used functional appliance in the UK for the correction of Class II division 1 malocclusion in growing children and adolescents.

2019 ◽  
Vol 90 (2) ◽  
pp. 202-208 ◽  
Author(s):  
Ciara Campbell ◽  
Declan Millett ◽  
Niamh Kelly ◽  
Marie Cooke ◽  
Michael Cronin

ABSTRACT Objective: To compare Phase 1 treatment, using the Frankel 2 (FR2) or the modified Twin Block (MTB), for Class II division 1 malocclusion in children and adolescents with respect to: treatment duration, number of appliance breakages, occlusal outcome, and patient and parent perspectives. Materials and Methods: Sixty participants with a Class II division 1 malocclusion were randomly assigned to either the FR2 or MTB appliance in a two-armed parallel randomized clinical trial with an allocation ratio of 1 to 1. Time to achieve a Class I incisor relationship was the primary outcome. The number of appliance breakages was recorded. The Peer Assessment Rating (PAR) index was used to evaluate pre- and post-treatment occlusal outcome on study models. Participants completed the child OHRQoL (oral health-related quality of life), Piers-Harris, Standard Continuum of Aesthetic Need (SCAN), and Oral Aesthetic Subjective Impact Score (OASIS) questionnaires pre- and post-treatment; parents completed a SCAN questionnaire. Results: Forty-two participants completed treatment (FR2: 20; MTB: 22). Multiple imputation was used to impute missing data for noncompleters. Mean treatment duration was similar for the two appliances (FR2: 376 days [SD 101]; MTB: 340 days [SD 102]; P = .41). There were no significant differences in mean number of appliance breakages (FR2: 0.3 SD 0.7; MTB: 0.4 SD 0.8; P = .67 or mean PAR score P = .48). Patient and parent perspectives did not differ between appliances (P > .05). Conclusions: Phase 1 treatment duration, number of appliance breakages, occlusal outcome, and patient and parent perspectives were similar in 11–14 year olds with Class II division 1 malocclusion treated using the FR2 or MTB appliance.


2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Nugroho Ahmad Riyadi

The aim of orthodontics treatment is normalization of teeth position in three planes, using various orthodontics appliance to reach the chepalometric standar and normal occlusion. Orthodontic treatment for dentoskeletal class II division 1 malocclusion in growing patients using myofunctional appliance may correct anteroposterior planes of mandibula. This study was a descriptive retrospective analytic study to look at the success of Orthodontic treatment for dentoskeletal class II division 1 in growing patients with myofunctional appliance using chepalometrics analysis Steiner value. The sample used in this study is chepalogram radiographic from patient with dentoskeletal class II division 1 malocclusion in growing patients before and after using myofunctional appliance in PPDGS orthodontics Clinic of Padjadjaran University. Statistic analysis were performed with pair t-test and Wilcoxon. Based on this study, it is concluded that orthodontic treatment with myofunctional appliance such as activator and twin block in growing patient with dentoskeletal class II division 1 malocclusion shows significant changes and compatibility with the normal criteria.


2010 ◽  
Vol 33 (4) ◽  
pp. 354-358 ◽  
Author(s):  
A. Jamilian ◽  
R. Showkatbakhsh ◽  
S. S. Amiri

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Mary-Eleni Zouloumi ◽  
Kleopatra Tsiouli ◽  
Simeon Psomiadis ◽  
Olga-Elpis Kolokitha ◽  
Nikolaos Topouzelis ◽  
...  

Abstract Objectives To assess the perceived facial changes in class II division 1, convex profile patients treated with functional followed by fixed orthodontic appliances. Subjects and methods The study sample consisted of 36 pairs of pre- and post-treatment photographs (frontal and profile, at rest) of 12 patients treated with activator, 12 with twin-block, and 12 controls with normal profiles, treated without functional appliances. All photographs were presented in pairs to 10 orthodontists, 10 patients, 10 parents, and 10 laypersons. Visual analog scale (VAS) ratings of changes in facial appearance were assessed. Results The patient groups were similar in sex distributions, age, and treatment duration. The different rater groups showed strong to excellent agreement. There were no significant differences among treatment groups (F = 0.91; P = 0.526; Wilks lambda = 0.93), raters (F = 1.68; P = 0.054; Wilks lambda = 0.83), and when testing the combined effect of treatment and rater on the results (F = 0.72; P = 0.866; Wilks lambda = 0.85). The raters detected slightly more positive changes in the activator and twin-block groups, compared to the control group, regarding the lower face and the lips, but these findings did not reach significance. Furthermore, their magnitude hardly exceeded 1/20th of the total VAS length. Limitations Retrospective study design. Conclusions The perceived facial changes of convex profile patients treated with functional, followed by fixed orthodontic appliances, did not differ from those observed in normal profile patients, when full-face frontal and profile photos were simultaneously assessed. Consequently, professionals should be skeptical regarding the improvement of a patient’s facial appearance when this treatment option is used.


2014 ◽  
Vol 38 (4) ◽  
pp. 380-384 ◽  
Author(s):  
E A Satygo ◽  
A V Silin ◽  
G O Ramirez-Yañez

Objective: A study was designed to determine changes in the amplitude of the EMG muscular activity of the Masseter and Temporalis muscles at clench in children with a Class II, division 1 malocclusion treated with the pre-orthodontic Trainer functional appliance, for 12 months. Study Design: 36 Class II, division 1 malocclusion patients (mean age 7.6 ± 1.3 years) composed the treated group and wore the functional appliance; 22 children with a similar age and malocclusion composed the untreated controls; and, 20 children with no dental malocclusion participated as normal controls. Electromyographic (EMG) muscular activity of the Temporalis and Masseter muscles were recorded before and after treatment. Results: Subjects in the treated group reported a bilateral significant increase in the muscular electrical activity in the both tested muscles (p < 0.001). After treatment, they recorded values similar to those measured in normal controls, whereas the untreated controls remained on lower values. Conclusion: These results confirm that treatment with the pre-orthodontic Trainer functional appliance significantly increases the EMG muscular activity in the Temporalis and Masseter muscles at clench in patients with Class II, division 1 malocclusion.


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