scholarly journals Dental and skeletal changes in mild to moderate Class II malocclusions treated by either a Twin-block or Xbow appliance followed by full fixed orthodontic treatment

2015 ◽  
Vol 85 (6) ◽  
pp. 997-1002 ◽  
Author(s):  
Sayeh Ehsani ◽  
Brian Nebbe ◽  
David Normando ◽  
Manuel O Lagravere ◽  
Carlos Flores-Mir

ABSTRACT Objective:  To compare the short-term skeletal and dental effects of two-phase orthodontic treatment including either a Twin-block or an XBow appliance. Materials and Methods:  This was a retrospective clinical trial of 50 consecutive Class II cases treated in a private practice with either a Twin-block (25) or XBow (25) appliance followed by full fixed orthodontic treatment. To factor out growth, an untreated Class II control group (25) was considered. Results:  A MANOVA of treatment/observation changes followed by univariate pairwise comparisons showed that the maxilla moved forward less in the treatment groups than in the control group. As for mandibular changes, the corpus length increase was larger in the Twin-block group by 3.9 mm. Dentally, mesial movement of mandibular molars was greater in both treatment groups. Although no distalization of maxillary molars was found in either treatment group, restriction of mesial movement of these teeth was seen in both treatment groups. Both treatment groups demonstrated increased mandibular incisor proclination with larger increases for the XBow group by 3.3°. The Wits value was decreased by 1.6 mm more in the Twin-block group. No sex-related differences were observed. Conclusions:  Class II correction using an XBow or Twin-block followed by fixed appliances occurs through a relatively similar combination of dental and skeletal effects. An increase in mandibular incisor inclination for the XBow group and an increased corpus length for the Twin-block group were notable exceptions. No overall treatment length differences were seen.

2017 ◽  
Vol 87 (6) ◽  
pp. 824-833 ◽  
Author(s):  
Osama Eissa ◽  
Mahmoud El-Shennawy ◽  
Safaa Gaballah ◽  
Ghada El-Meehy ◽  
Tarek El Bialy

ABSTRACT Objective: To evaluate the skeletal, dental, and soft tissue effects of the Forsus Fatigue Resistant Device (FRD) used with miniscrew anchorage and compare them with those of the conventional Forsus FRD. Materials and Methods: This study was carried out on 38 patients. These patients were randomly allocated into three groups. The 14 patients in group 1 (aged 12.76 ± 1.0 years) were treated with the FRD appliance. In group 2, the 15 patients (aged 12.52 ± 1.12 years) received treatment with FRD using miniscrew anchorage, and the 9 patients in group 3 (aged 12.82 ± 0.9 years) received no treatment as a control group. Linear and angular measurements were made on lateral cephalograms before and immediately after Forsus treatment. Data were analyzed statistically using paired t-, ANOVA, and Tukey tests. Results: Class I molar relationship and overjet correction were achieved in both treatment groups. Although mandibular growth was statistically nonsignificant, there was a significant headgear effect on the maxilla. Mandibular incisor proclination, maxillary incisor retroclination, and distalization of maxillary molars were significant in both treatment groups. However, no significant differences were found between the treatment groups. Conclusions: Class II correction was mainly dentoalveolar in both treatment groups. Use of miniscrews with Forsus did not enhance mandibular forward growth nor prevent labial tipping of the mandibular incisors.


2021 ◽  
Vol 11 (1) ◽  
pp. 143-146
Author(s):  
Ramida Shadlinskaya ◽  
Zaur Novruzov

Aims: Evaluation of the effectiveness of orthodontic treatment of Class II malocclusion with the Twin-block appliance in children withβ-thalassemia major. Methods: The study was conducted with 49 patients with Class II malocclusion aged 10-14 years. The control group included 23 healthy patients. The main group included 26 patients with β-thalassemia major. Patients had received orthodontic treatment with a Twin-block appliance. The duration of orthodontic treatment was 1.5–2 years. Results: In both groups, a statistically significant increase in the SNB angle was observed. Subsequently, the ANB angle was normalized. The effective length of the maxilla growing and mandibular length increasing was observed. Overjet distance is decreased due to favorable torque changes. Pretreatment assessment revealed that overbite was smaller in children with β-thalassemia major. As the effect of orthodontic treatment, statistically, significant changes were observed on both overjet and overbite distances (p <0.001). Conclusions: Orthodontic treatment of β-thalassemia major of patients with Twin-block appliance in mixed dentition stage is effective in improving inter arch relationships and the orofacial functions.


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.


2020 ◽  
Vol 25 (2) ◽  
pp. 25-31
Author(s):  
Anderson Jaña Rosa ◽  
Rizomar Ramos do Nascimento ◽  
José Nelson Mucha ◽  
Oswaldo de Vasconcellos Vilella

ABSTRACT Objective: Evaluate dental and skeletal changes resulting from the exclusive use of the cervical headgear for 15 ± 4 months in the treatment of patients with Class II division 1 malocclusion. Methods: Differences between the beginning (T1) and immediately after the end of the therapy (T2) with the cervical headgear in growing patients (Experimental Group, EG, n = 23) were examined and compared, during compatible periods, with those presented by a group of untreated individuals (Control Group, CG, n =22) with similar malocclusions and chronological age. The cephalometric variables evaluated were: ANB, GoGn.SN, AO-BO, S'-ANS, S'-A, S'-B, S'-Pog and S'-U6 (maxillary first molar). The Shapiro-Wilk and Levene tests were used to evaluate the results. Results: Significant differences were found relative to the ANB, S'-U6, AO-BO, S'-ANS, S'-A, S'-B and S'-Pog variables between T1 and T2 when comparing both groups. No statistically significant variation was found regarding the GoGn.SN angle. Conclusions: The use of cervical headgear promoted distal movement of the maxillary first molars and restricted the anterior displacement of the maxilla, without significantly affecting the GoGn.SN angle.


2018 ◽  
Vol 88 (5) ◽  
pp. 530-537
Author(s):  
E. Erin Bilbo ◽  
Steven D. Marshall ◽  
Karin A. Southard ◽  
Verrasathpurush Allareddy ◽  
Nathan Holton ◽  
...  

ABSTRACT Objectives: The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group. Materials and Methods: Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models. Results: Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = −1.925°, P &lt; .0001; FH-NA = −3.042°, P &lt; .0001; linear measurement A-point to Vertical Reference = −3.859 mm, P &lt; .0001) and reduction of the ANB angle (−1.767°, P &lt; .0001), with no effect on mandibular horizontal growth or maxillary and mandibular vertical skeletal changes. A-point horizontal restriction and forward mandibular horizontal growth accompanied the study group correction to Class I molar, and these changes were stable long term. Conclusions: One phase treatment for Class II malocclusion with high-pull headgear followed by fixed orthodontic appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.


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.


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.


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.


2007 ◽  
Vol 77 (4) ◽  
pp. 694-700 ◽  
Author(s):  
Aslihan Uzel ◽  
Ilter Uzel ◽  
M. Serdar Toroglu

Abstract Objective: To evaluate the relative effects of Class II elastics applied directly with utility arches (UAs) or with the Reciprocal Mini–Chin Cup (RMCC) appliance. Materials and Methods: Thirty patients with Class II division 1 malocclusion were included. Fifteen of them were treated with the RMCC appliance and the other 15 treated with Class II elastics on UAs. Lateral cephalograms of an additional 15 untreated persons having the same characteristics as the treatment groups were used as a control group. Results: The mean control period was 10 months. Class I molar and canine relationships were achieved in a mean treatment time of 4.6 months with the RMCC appliance and in 8.5 months with the elastics on UAs. The amount of overjet reduction was 4.7 mm in the RMCC group (87.87% dental) and 5.2 mm in the UA group (80.76% dental). The molar correction was 4.5 mm in the RMCC group (87.36% dental) and 2.0 mm in the UA group (51.47% dental). The anterior lower facial height increased in both of the treatment groups. Conclusions: The RMCC appliance is a valuable alternative for Class II elastic use in Class II cases in which the upper molars need to be moved to the distal more than the upper incisors.


2007 ◽  
Vol 77 (5) ◽  
pp. 907-914 ◽  
Author(s):  
Gregory Stylianos Antonarakis ◽  
Stavros Kiliaridis

Abstract Objective: To evaluate the anteroposterior short-term skeletal and dental effects on Class II malocclusion in growing patients following treatment with functional appliances (activators or twin block), extraoral traction, or combination appliances (appliances with both functional and extraoral traction components), based on published data. Materials and Methods: A literature search was carried out identifying a total of nine prospective clinical trials. The data provided in the publications underwent meta-analysis using the random effects model with regard to SNA, SNB, ANB, and overjet. Results: All appliance groups showed an improvement in sagittal intermaxillary relationships (decrease in ANB) when compared to untreated subjects. Activators and twin block appliances accomplish this mainly by acting on the mandible (increases in SNB) while twin block appliances also seem to act on the maxilla (decrease in SNA). Extraoral traction appliances achieve this by acting on the maxilla (decreases in SNA). Combination appliances mainly act on the mandible (increase in SNB). Activators, twin block, and combination appliances also reveal a decrease in overjet, which is not the case in the singular use of extraoral traction. Conclusions: Intermaxillary changes being present in all appliance groups, anteroposterior treatment response following the use of functional appliances and/or extraoral traction in growing class II malocclusion patients is most evident in one of the two jaws (mandible for activators and combination appliances and maxilla for extraoral traction) except for the twin block group, which shows changes on both jaws.


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