scholarly journals Skeletal Class II Malocclusion Treatment with Combined Twin Block and Lip Bumper Appliances: A Case Report

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.

2021 ◽  
pp. 030157422110221
Author(s):  
Aravinthrajkumar Govindaraj ◽  
Ashwin Mathew George

Patients with a skeletal class II malocclusion are usually associated with a prognathic maxilla with orthognathic mandible or a retrognathic mandible with orthognathic maxilla or a combination of both. Patients with severe prognathic maxilla are usually associated with increased overjet which results in a lower lip trap. The lip trap should be managed the earliest as it will lead to further proclination of the upper anterior teeth and also hinder the normal growth of the mandible. To overcome the limitations of a conventional lip bumper, we arrived at an idea of fixed lip bumper supported using mini-implants.


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.


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 ◽  
Vol 54 (3) ◽  
pp. 240-247
Author(s):  
Snigdha Pattanaik

PK, a 12-year-old female patient, was diagnosed with skeletal Class II due to retrognathic mandible, average growth pattern, Angle’s Class II, Division I malocclusion with Class II canine relation, mild upper anterior spacing, upper anterior proclination, uprighted lower anterior, lingually tipped 35, increased overjet and overbite, scissor bite Irt 24, 25, acute nasolabial angle, tongue thrust habit, incompetent lips, and lower lip trap. The nonextraction approach to orthodontic treatment was involved. The skeletal malocclusion was corrected using the twin-block appliance, followed by upper and lower pre-adjusted edgewise appliances (0.022 × 0.028 slot) with the MBT prescription.


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.


1982 ◽  
Vol 9 (1) ◽  
pp. 3-31 ◽  
Author(s):  
N. M. Bass

An orthopaedic appliance system has been developed with the specific therapeutic intention of removing those factors responsible for the initiation or maintenance of the skeletal Class II malocclusion. This is accomplished by means of restraint and redirection of forward maxillary growth and induction of mandibular growth. Concurrently, adverse soft tissue influences are eliminated or ameliorated. Clinical and experimental evidence gives support to this concept and case histories show the clinical mode of use of the appliance system. An initial 10–12 month orthopaedic phase is followed by a second phase of similar duration, utilizing full Edgewise therapy to perfect the occlusion. The second phase is much reduced in complexity and is generally confined to alignment and final detailing as the essential corrections have been achieved in the orthopaedic phase. It is considered that this combined approach to Skeletal II treatment is more physiologic than conventional treatment and results in a better harmony of dental and facial features.


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