scholarly journals Dentoskeletal effects of Twin Block appliance in patients with Class II malocclusion

2021 ◽  
Author(s):  
Mahamad Irfanulla Khan ◽  
Praveen Kumar Neela ◽  
Nayeem Unnisa ◽  
Ajit Kumar Jaiswal ◽  
Nadeem Ahmed ◽  
...  
Keyword(s):  
Class Ii ◽  
Post Treatment ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Mandibular Growth ◽  
Twin Block ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Pre Treatment ◽  
Class Ii Division 1

Background and aim. Class II malocclusions are most commonly seen in orthodontic practice and in the recent times Twin Block appliance has been the most popular and widely used among removable functional appliances for the correction of Class II malocclusion in growing patients. The aim of this retrospective study was to evaluate the dentoskeletal effects produced by the Twin Block appliance for the correction of Class II division 1 malocclusion with retrognathic mandible. Methods. Pre-treatment (T1) and post-treatment (T2) lateral cephalograms of 30 patients treated with Twin Block appliance (mean age  =  10.8 ± 1.2 years) for the correction of class II division 1 malocclusion were compared with the 30 untreated class II control patients (mean age 11.2 ± 0.8 years) who did not undergo any treatment during this period. Both the groups were evaluated for the dentoskeletal changes using 24 angular and linear cephalometric measurements. The differences between the pre and post-treatment were calculated using a paired t-test. Results. The cephalometric analysis revealed that the Twin Block appliance stimulated mandibular growth and statistically significant differences were found between the two groups. Twin Block patients showed a statistically very high significant (p<0.001) increase in mandibular length (6.02 mm) compared with the control group (0.3 mm). ‘Headgear effect’ on the maxilla, increase in lower anterior facial height, significant reduction of overjet, overbite and Class I molar relationship was achieved in the Twin Block group. However, no significant changes appeared in the control group. Conclusion: The results of the present study conclude that the Twin Block appliance is effective in the treatment of Class II malocclusion and this is due to a combination of skeletal and dentoalveolar changes in both the arches.

scholarly journals Dentoskeletal effects produced by a Jasper Jumper with an anterior bite plane

2016 ◽  
Vol 86 (5) ◽  
pp. 775-781 ◽  
Author(s):  
Turi Bassarelli ◽  
Lorenzo Franchi ◽  
Efisio Defraia ◽  
Birte Melsen
Keyword(s):  
Matched Control ◽  
Class Ii ◽  
Control Group ◽  
Comprehensive Treatment ◽  
Class Ii Malocclusion ◽  
Significant Movement ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Student’S T ◽  
Class Ii Division 1

ABSTRACT Objective:  The aim of this retrospective study was to evaluate the dentoskeletal effects produced by a modified Jasper Jumper with an anterior bite plane for the correction of Class II division 1 malocclusion. Materials and Methods:  A sample of 32 growing patients (mean age  =  11.9 ± 1.4 years) with Class II division 1 malocclusion and increased overbite were treated with a modified Jasper Jumper (JJ) and anterior bite plane protocol and compared with a matched control group of 30 subjects with untreated Class II malocclusion (mean age 12.2 ± 0.8 years). Lateral cephalograms were taken before treatment (T1) and at the end of comprehensive treatment (T2). Mean treatment duration was 2.1 ± 0.4 years. The T1–T2 changes in the two groups were compared with Student’s t-tests for independent samples. Results:  The JJ group was successfully treated to a Class I occlusal relationship with a significant reduction in overjet (–3.9 mm, P &lt; .001) and overbite (–3.1 mm, P &lt; .001). The JJ group exhibited a significant increase in mandibular length and a significant improvement in maxillomandibular sagittal skeletal relationships. The lower incisors were significantly proclined, while the lower first molars demonstrated significant movement in a mesial direction. Conclusions:  Use of a modified JJ appliance and anterior bite plane is an effective protocol for the treatment of Class II malocclusion with increased overbite and greater skeletal (75%) than dentoalveolar (25%) effects mainly at the mandibular level.

scholarly journals Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages

2016 ◽  
Vol 21 (3) ◽  
pp. 73-84 ◽  
Author(s):  
Aisha Khoja ◽  
Mubassar Fida ◽  
Attiya Shaikh
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Post Treatment ◽  
Twin Block ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Maturation Stages ◽  
Cervical Vertebral Maturation ◽  
Treatment Observation ◽  
Class Ii Division 1

ABSTRACT Objectives: To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB) in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Methods: Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1) were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05) . Results: When compared with controls, there was a significant reduction in ANB angle (p < 0.001), which was due to a change in SNB angle in CS-2 and CS-3 (p < 0.001), and in SNA (p < 0.001) and SNB (p = 0.016) angles in the CS-4 group. There was significant increase in the GoGn-SN angle in CS-2 (p = 0.007) and CS-4 (p = 0.024), and increase in Co-Gn and Go-Gn amongst all cervical stages (p < 0.05). There was significant decrease in U1-SN and increase in IMPA amongst all cervical stages (p < 0.05). There was significant retraction of the upper lip in CS-3 (p = 0.001), protrusion of the lower lip in CS-2 (p = 0.005), increase in nasolabial angle in CS-4 (p = 0.006) and Z-angle in CS-3 (p = 0.016), reduction in H-angle in CS-2 (p = 0.013) and CS-3 (p = 0.002) groups. When pre- and post-treatment mean differences were compared between different cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . Conclusions: The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and dentoalveolar structures. The favorable mandibular growth occurs during any of the cervical vertebral maturation stages, with more pronounced effect during CS-3 stage.

scholarly journals Alveolar and symphysis regions of patients with skeletal class II division 1 anomalies with different vertical growth patterns

2012 ◽  
Vol 06 (02) ◽  
pp. 123-132 ◽  
Author(s):  
Elcin Esenlik ◽  
Fidan Alakus Sabuncuoglu
Keyword(s):  
Normal Subjects ◽  
Class Ii ◽  
Growth Patterns ◽  
Control Group ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Main Factor ◽  
Class Ii Division 1

ABSTRACTObjectives: The aim of this study was to investigate the alveolar and symphysis region properties in hyper-, hypo-, and normodivergent Class II division 1 anomaliesMethods: Pretreatment lateral cephalograms of 111 young adult female patients with skeletal Class II division 1 anomalies were compared to those of 54 Class I normal subjects (control group). Class II cases were divided into hyperdivergent (n = 58), hypodivergent (n = 19), and normodivergent groups (n = 34). The heights and widths of the symphysis and alveolus and the depth of maxillary palate were measured on the lateral cephalogramsResults: Mean symphysis width was wider in the hypodivergent Class II group than in the other groups, while mean symphysis height was similar among all groups. Maxillary palatal depth, upper incisor angle, upper and lower molar alveolar heights, and Id–Id′ width were also similar among groupsConclusion: Symphysis width is the main factor in the differential diagnosis of Class II division 1 anomaly rather than symphysis height and hypodivergent Class II Division 1 anomaly is more suitable for mandibular incisors movements. (Eur J Dent 2012;6:123-132)

scholarly journals Facial esthetic outcome of functional followed by fixed orthodontic treatment of class II division 1 patients

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Mary-Eleni Zouloumi ◽  
Kleopatra Tsiouli ◽  
Simeon Psomiadis ◽  
Olga-Elpis Kolokitha ◽  
Nikolaos Topouzelis ◽  
...  
Keyword(s):  
Class Ii ◽  
Control Group ◽  
Orthodontic Appliances ◽  
Facial Appearance ◽  
Twin Block ◽  
Fixed Orthodontic Appliances ◽  
Division 1 ◽  
Wilks Lambda ◽  
Facial Changes ◽  
Class Ii Division 1

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.

scholarly journals Upper Airway Dimensions in Class II Malocclusion

2007 ◽  
Vol 77 (6) ◽  
pp. 1046-1053 ◽  
Author(s):  
Mirja Kirjavainen ◽  
Turkka Kirjavainen
Keyword(s):  
Treatment Time ◽  
Upper Airway ◽  
Class Ii ◽  
Class I ◽  
Class Ii Malocclusion ◽  
Cross Sectional ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Upper Airway Structure ◽  
Class Ii Division 1

Abstract Objective: To study the effects of cervical headgear treatment of Class II division 1 malocclusion on upper airway structures in children. Materials and Methods: Forty children aged 9.1 (7.2–11.5) years with Class II division 1 malocclusion were treated using a cervical headgear as the only treatment appliance. The headgear consisted of a long outer bow bent 15° upward and a large inner bow expanded 10 mm larger than the intermolar distance. Lateral cephalograms were taken before and after the treatment. Upper airway structures were estimated from the cephalograms. The results were compared to cross-sectional data of 80 age-matched controls with a Class I molar relationship. Results: A Class I molar relationship was achieved in all treated children. The mean treatment time was 1.6 (0.3–3.1) years. The Class II malocclusion was accompanied by a similar or wider nasopharyngeal space than in the controls but narrower oro- and hypopharyngeal spaces. The retropalatal area was widened by the treatment (P &lt; .05), whereas the rest of the oropharynx and hypopharynx remained narrower than in the controls. Before the treatment, the mandibular plane was in a more horizontal position than in the controls, but during the treatment, it rotated to a position similar to that of the controls. Conclusion: Class II division 1 malocclusion is associated with a narrower upper airway structure even without retrognathia. Headgear treatment is associated with an increase in the retropalatal airway space.

scholarly journals Immediate Skeletal and Dentoalveolar Effects of the Crown- or Banded Type Herbst Appliance on Class II division 1 Malocclusion

2008 ◽  
Vol 78 (2) ◽  
pp. 361-369 ◽  
Author(s):  
Gregory A. Barnett ◽  
Duncan W. Higgins ◽  
Paul W. Major ◽  
Carlos Flores-Mir
Keyword(s):  
Clinical Trials ◽  
Selection Criteria ◽  
Normal Growth ◽  
Class Ii ◽  
Control Group ◽  
Herbst Appliance ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Growth Changes ◽  
Class Ii Division 1

Abstract Objective: To evaluate the relative skeletal and dental changes produced by the crown- or banded-type Herbst appliance in growing Class II division 1 malocclusion cases. Materials and Methods: Several electronic databases were searched with the help of a health sciences librarian, without language limitation. Abstracts that appeared to fulfill the initial selection criteria (Herbst use and clinical trial) were selected by consensus, and their original articles were then retrieved. Clinical trials were selected that used lateral cephalograms to assess immediate skeletal and dental changes from the use of either crown or banded Herbst appliances. Clinical trials that employed other simultaneous potentially growth-modifying appliances or surgery were excluded. A comparable untreated Class II division 1 malocclusion control group was required to factor out normal growth changes. References from the selected articles were also hand searched. Results: Only three articles meet the selection criteria. Proclination and anterior movement of the lower incisors, overjet reduction, and improvement of first molar relationship thorough mesial movement of the first molars, reduction of ANB angle, and an increase in the mandibular plane angle were reported. There were mixed findings as to mandibular sagittal length and position and increases in lower face height, both anteriorly and posteriorly. No statistically significant changes were noted in the sagittal length or position of the skeletal maxilla. Conclusions: Dental changes have more impact than skeletal changes in the correction of Class II division 1 malocclusions with the crown or banded Herbst appliance.

scholarly journals Treatment effects of myofunctional appliances in different jaw rotations in Class II division 1 malocclusion

2015 ◽  
Vol 5 ◽  
pp. 70-76
Author(s):  
Kyumi V. Shethiya ◽  
Gauri S. Vichare ◽  
Ravindranath B. Sable
Keyword(s):  
Class Ii ◽  
High Angle ◽  
Forward Movement ◽  
Myofunctional Therapy ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Pre Treatment ◽  
One Year ◽  
Lower Incisors ◽  
Class Ii Division 1

Aim This retrospective study was conducted to determine skeletal, dentoalveolar changes in children treated with Twin Block or activator for the treatment of Class II Division 1 malocclusion with different jaw rotations. Materials and Methods Standardized lateral cephalograms of 32 patients (18 boys, 14 girls) between the ages of 11 and 14 years were chosen and divided into two groups, high angle (FMA >27) and low angle (FMA <20). Cephalograms were taken at T1 (pre-treatment) and T2 (after one year of myofunctional therapy).These were manually traced and analysed. Results The results showed statistically significant increase in SNB angle, VRP-Pog due to forward movement of the mandible. The overjet reduced significantly due to retroclination of upper incisors and proclination of lower incisors in both groups. Conclusion It was concluded that both high angle and low angle groups responded equally well to myofunctional therapy showing significant skeletal and dentoalveolar changes.

scholarly journals Dentoskeletal effects of Class II malocclusion treatment with the Twin Block appliance in a Brazilian sample: A prospective study

2014 ◽  
Vol 19 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Luciano Zilio Saikoski ◽  
Rodrigo Hermont Cançado ◽  
Fabrício Pinelli Valarelli ◽  
Karina Maria Salvatore de Freitas
Keyword(s):  
Class Ii ◽  
Growth Potential ◽  
Control Group ◽  
Class Ii Malocclusion ◽  
Twin Block ◽  
Brazilian Sample ◽  
Anterior Teeth ◽  
Skeletal Class Ii ◽  
Lateral Cephalograms ◽  
Intergroup Comparison

OBJECTIVE: The aim of this study was to assess the dentoskeletal effects of Class II malocclusion treatment performed with the Twin Block appliance. METHODS: The experimental group comprised 20 individuals with initial mean age of 11.76 years and was treated for a period of 1.13 years. The control group comprised 25 individuals with initial mean age of 11.39 years and a follow-up period of 1.07 years. Lateral cephalograms were taken at treatment onset and completion to assess treatment outcomes. Intergroup comparison was performed by means of the chi-square and independent t tests. RESULTS: The Twin Block appliance did not show significant effects on the maxillary component. The mandibular component showed a statistically significant increase in the effective mandibular length (Co-Gn) and significant improvement in the maxillomandibular relationship. The maxillary and mandibular dentoalveolar components presented a significant inclination of anterior teeth in both arches. The maxillary incisors were lingually tipped and retruded, while the mandibular incisors were labially tipped and protruded. CONCLUSIONS: The Twin Block appliance has great effectiveness for correction of skeletal Class II malocclusion in individuals with growth potential. Most changes are of dentoalveolar nature with a large component of tooth inclination associated with a significant skeletal effect on the mandible.

scholarly journals A prospective controlled evaluation of Class II division 1 malocclusions treated with fixed lingual mandibular growth modificator

2013 ◽  
Vol 84 (3) ◽  
pp. 527-533 ◽  
Author(s):  
Osama H. Alali
Keyword(s):  
Class Ii ◽  
Growth Spurt ◽  
Control Group ◽  
Lower Incisor ◽  
Mandibular Growth ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Controlled Evaluation ◽  
Treatment Observation ◽  
Observation Period

ABSTRACT Objective: To assess the net dentofacial effects of the fixed lingual mandibular growth modificator (FLMGM). Materials and Methods: The study sample comprised 38 patients with Class II/1 malocclusion and retrognathic mandible. All were in the pubertal growth spurt. Whereas FLMGM was applied to the treatment group (n  =  21, mean age  =  13.2 years), no treatment was performed on the control group (n  =  17, mean age  =  12.5 years). Skeletal and dentoalveolar changes were assessed on digital lateral cephalograms obtained at the beginning and end of the treatment/observation period of 8 months. Paired and independent t-tests were used to assess the differences within and between groups. Results: Maxillary growth was not affected by FLMGM treatment, which resulted in a significant overjet reduction of 4.1 mm, an increase in total mandibular length (Co-Gn) of 2.3 mm, chin advancement of 1.6°, and upper incisor retroclination of 4.0°. A reduction of 2.4° in ANB was largely due to an increase of 1.8° in SNB. Favorably, the lower incisors were obviously retroclined by 4.5°. The changes in the vertical skeletal relationships were negligible. Conclusion: FLMGM was effective in treating growing Class II/1 patients and produced favorable dentofacial effects, with the matched untreated sample showing minimal changes. Lower incisor retroclination was a benefit of FLMGM treatment.

scholarly journals Determination of the structural characteristics in youngsters from Ceará with Class II, division 1 malocclusion

2012 ◽  
Vol 17 (4) ◽  
pp. 140-147
Author(s):  
Keila Maria de Sousa Castelo ◽  
Fausto Silva Bramante
Keyword(s):  
Structural Characteristics ◽  
Class Ii ◽  
Northeastern Brazil ◽  
Control Group ◽  
Gender Dimorphism ◽  
Dimensional Changes ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Class Ii Division 1

OBJECTIVE: To determine the structural characteristics of Caucasian youths from Ceará State, Northeastern Brazil, presenting with Class II, Division 1 malocclusion and to investigate whether there is gender dimorphism based on the cephalometric variables assessed. METHODS: By means of lateral cephalograms, it was possible to determine the cephalometric characteristics of Class II, Division 1 malocclusion in a sample of 50 Caucasian youths from Ceará State, Brazil, of both genders (25 male and 25 female), aged between 9 and 14 years, who had not received previous orthodontic treatment. Sixteen cephalometric measures were evaluated and a comparison was made between the experimental group (Class II) and the control group (Class I), a sample comprising 50 Caucasian children from the Brazilian State of Ceará, of both genders (22 male and 28 female), aged 9 to 13 years, obtained from research conducted at the Study Center of the Federal University of Ceará (UCCB), Department of Orthodontics. CONCLUSIONS: Overall, the maxilla exhibited adequate positioning. The mandible showed a clear predominance of retrusion and dimensional changes in the sagittal direction. The facial vertical dimensions were increased. The maxillary incisors were well-positioned in their apical bases and with slight lingual inclination. The mandibular incisors were labially inclined and protruded. The study identified the presence of gender dimorphism in the following measures: P-Nperp, Co-A, Wits and ALFH.

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