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

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.

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.


2018 ◽  
Vol 7 (4) ◽  
pp. 147-152
Author(s):  
Vivek Bikram Thapa ◽  
Amrita Shrestha ◽  
Prabesh Sherchan ◽  
Prakash Poudel ◽  
Luna Joshi

Background: Mandibular retrusion is the main cause of Skeletal Class II malocclusion characterized by skeletal retrusion of mandible with skeletal or dentoalveolar protrusion of maxillary. Objectives: This study was conducted to evaluate effect of treatment with twin-block appliances on pharyngeal dimensions. Methodology: This study was conducted in in the Department of Orthodontics & Dentofacial Orthopedics in Kathmandu Medical College. Twenty patients of age group 7 to 14 years with skeletal class II malocclusion with mandibular retrusion were selected. Variables evaluated were depth of nasopharynx; height of nasopharynx; depth of oropharynx; depth of hypopharynx; soft palate length; soft palate thickness and soft palate inclination. The lateral cephalograms were obtained for all subjects before the start of treatment and after a follow-up period of approximately three months in treatment. Results: Results showed that depth of nasopharynx increased by 1 mm, height of nasopharynx increased by 0.78 mm, depth of nasopharynx increased by 1.97 mm, depth of hypopharynx increased by 0.79 mm, soft palate length decreased by 4 mm, soft palate thickness increased by 2 mm and soft palate inclination decreased by 7.01 mm. The results for depth of pharynx and soft palate thickness were statistically significant. Conclusion: This study concluded that the use of twin block appliance for class II patients corrects sagittal dimension of oropharynx and hypopharynx. Early intervention for mandibular retrognathism in class II malocclusion helps enlarge the airway dimensions and decrease potential risk of obstructive sleep apnea syndrome for growing patients in the future.


2011 ◽  
Vol 12 (1) ◽  
pp. 14-18 ◽  
Author(s):  
G Anil Kumar ◽  
Amit Maheshwari

ABSTRACT Aim The aims of this study were to evaluate the dental changes brought about by activator and activator headgear combination (ACHG) and to determine whether we can achieve control over the lower incisor proclination which is a side effect of using functional appliances; or not, while treating cases of skeletal class II malocclusions. Methods Lateral cephalograms of 45 skeletal class II division 1 patients were selected for the study. Fifteen of them were successfully treated with an Andresen activator and the other 15 with an activator headgear combination. Fifteen class II subjects who had declined treatment served as the control group. Cephalometric landmarks were marked by one author to avoid interobserver variability. Results The results revealed that both the activator and the activator headgear combination significantly (p < 0.001) affected dental variables measured. The mandibular incisor proclination was effectively controlled in the activator headgear combination group. Conclusion An activator headgear combination would offer itself as a better option compared with activator alone in the treatment of skeletal class II malocclusions especially in cases with proclined mandibular incisors. Clinical significance When one of the treatment goals is to achieve a greater control over mandibular incisor proclination in the treatment of Skeletal Class II malocclusions, employing a combination of activator and headgear may substantially improve clinical outcomes. How to cite this article Lall R, Kumar GA, Maheshwari A Kumar M. A Retrospective Cephalometric Evaluation of Dental Changes with Activator and Activator Headgear Combination in the Treatment of Skeletal Class II Malocclusion. J Contemp Dent Pract 2011;12(1):14-18.


Author(s):  
Mahamad Irfanulla Khan ◽  
Praveen Kumar Neela ◽  
Nayeem Unnisa ◽  
Ajit Kumar Jaiswal ◽  
Nadeem Ahmed ◽  
...  

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.


2020 ◽  
pp. 1-3
Author(s):  
Pasupureddi Keerthana ◽  
Prasad Chitra

Objective: To evaluate dentoskeletal, soft tissue and airway changes in Class II malocclusion patients treated with AdvanSync2 Class II corrector in conjunction with fixed appliances. Methods: Forty-five subjects with skeletal and dental Class II malocclusion requiring fixed functional therapy were included. Pre-treatment cephalograms served as control group (Group 1), post treatment cephalograms of patients treated using AdvanSync2, as experimental group (Group 2). Changes in skeletal, dental, soft tissue profile and airway were analyzed on lateral cephalograms using 21 variables from multiple cephalometric analysis. Results were tabulated and data was analyzed using Wilcoxon signed rank test for linear parameters and paired student t test for angular parameters. Results: Maxillary skeletal and dental effects included restriction of growth, upper incisor retrusion and retroclination at p<0.001. Mandibular incisors proclined during treatment. Forward mandibular relocation was noted, though not statistically significant. Upper and lower lip repositioning was achieved, establishing lip competency. Changes in Z angle and nasolabial angle were positive, reducing facial convexity. Significant airway dimensional improvements were noted. Conclusion: AdvanSync2 Class II corrector was effective in treating skeletal Class II malocclusions with mandibular retrognathism. It produced its effects mainly through maxillary restriction and mandibular dentoalveolar changes which furthermore helped in achieving good soft tissue profiles in patients. Positive airway changes were also noted.


Author(s):  
Maria Dolores Austro-Martinez ◽  
Ana I. Nicolas-Silvente ◽  
Eugenio Velasco-Ortega ◽  
Alvaro Jimenez-Guerra ◽  
Jose A. Alarcon

One of the goals of functional-appliance devices is to modify the vertical growth pattern, solving several kinds of malocclusion. This study aimed to evaluate Class II malocclusion treatment’s stability with Austro Repositioner, followed by fixed appliances, and assess its capacity to modify vertical dimensions in brachyfacial patients. A test group of 30 patients (16 boys and 14 girls, mean 11.9 years old) with Class II malocclusion due to mandibular retrognathism and brachyfacial pattern treated with Austro Repositioner and fixed appliance were compared to a matched untreated Class II control group of 30 patients (17 boys and 13 girls, mean age 11.7 years old). Lateral cephalograms were taken at T1 (initial records), T2 (end of treatment), and T3 (one year after treatment). Statistical comparisons were performed with a paired-sample t-test and two-sample t-tests. Significant improvements in the skeletal Class II relationship were observed in the treated group. The ANB angle decreased (4.75°), the SNB angle increased (3.92°), and the total mandibular length (Co-Pg) increased (8.18 mm) (p < 0.001). Vertical dimensions were also significantly modified, the FMA angle increased (3.94°), LAFH-distance increased (3.15 mm), and overbite decreased (3.35 mm). These changes remained stable one year after treatment. The Austro Repositioner was adequate for treating the skeletal Class II malocclusion resulting from the mandible retrusion in brachyfacial patients.


2012 ◽  
Vol 06 (02) ◽  
pp. 123-132 ◽  
Author(s):  
Elcin Esenlik ◽  
Fidan Alakus Sabuncuoglu

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)


2018 ◽  
Vol 89 (3) ◽  
pp. 391-403 ◽  
Author(s):  
Sherif A. Elkordy ◽  
Amr M. Abouelezz ◽  
Mona M. S. Fayed ◽  
Mai H. Aboulfotouh ◽  
Yehya A. Mostafa

ABSTRACT Objectives: To evaluate the use of direct miniplate anchorage in conjunction with the Forsus Fatigue Resistant Device (FFRD) in treatment of skeletal Class II malocclusion. Materials and Methods: Forty-eight females with skeletal Class II were randomly allocated to the Forsus plus miniplates (FMP) group (16 patients, age 12.5 ± 0.9 years), Forsus alone (FFRD; 16 patients, age 12.1 ± 0.9 years), or the untreated control group (16 subjects, age 12.1 ± 0.9 years). After leveling and alignment, miniplates were inserted in the mandibular symphysis in the FMP group. The FFRD was inserted directly on the miniplates in the FMP group and onto the mandibular archwires in the FFRD group. The appliances were removed after reaching an edge-to-edge incisor relationship. Results: Data from 46 subjects were analyzed. The effective mandibular length significantly increased in the FMP group only (4.05 ± 0.78). The mandibular incisors showed a significant proclination in the FFRD group (9.17 ± 2.42) and a nonsignificant retroclination in the FMP group (−1.49 ± 4.70). The failure rate of the miniplates was reported to be 13.3%. Conclusions: The use of miniplates with the FFRD was successful in increasing the effective mandibular length in Class II malocclusion subjects in the short term. The miniplate-anchored FFRD eliminated the unfavorable mandibular incisor proclination in contrast to the conventional FFRD.


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