scholarly journals Comparison of twin block appliance and Forsus Fatigue Resistant Device therapies on uvulo-glossopharyngeal dimensions: A retrospective study

2021 ◽  
Vol 11 ◽  
pp. 23-31
Author(s):  
Mehmet Ali Yavan ◽  
Merve Aycan ◽  
Dicle Aksoyler ◽  
Aysegul Essiz

Objectives: The aim of this study was to compare the effects of two different functional appliances on skeletal, dental, and uvulo-glossopharyngeal dimensions. Materials and Methods: Pre- and post-treatment lateral cephalograms of 50 adolescent Class II patients with a retrognathic mandible were obtained from an archive and divided into two groups according to functional therapy. Twenty-five patients (14 females, 11 males, mean age: 13.5 ± 2.8) who were treated with Forsus Fatigue Resistant Device (FFRD) and 25 patients (17 females, eight males, mean age: 12.5 ± 0.4) who had received functional therapy through the twin block (TWB) were enrolled. Skeletal, dentoalveolar, tongue, uvula, hyoid position, and oropharyngeal airway parameters were measured using the Dolphin software, and uvulo-glossopharyngeal area measurements were performed with the AutoCAD software. Results: The TWB group exhibited remarkable mandibular advancement compared to the FFRD group (P < 0.05). Both of the treatments proclined mandibular incisors, and tongue dimensions increased significantly in both groups (P < 0.05). While the hyoid point moved forward and the oropharyngeal area increased significantly in the TWB group, no significant changes were observed in the FFRD group. The comparison of the TWB and FFRD groups with regard to uvulo-glossopharyngeal dimensions showed no significant differences between the groups (P > 0.05). Conclusion: Changes in uvulo-glossopharyngeal dimensions did not significantly vary between the two different functional therapies.

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 236-242
Author(s):  
Ram Mohan Parvathy ◽  
Sandeep Shetty ◽  
Parveen Katheesa

Introduction and Aim: Various functional appliances are developed to remodel the glenoid fossa and, thereby change the position of the mandible and correct Class II malocclusion. Many diagnostic aids have already been used to evaluate the changes ,but Cone Beam computed tomography (CBCT), three -dimensional diagnostic tool is rarely used .So this study was conducted with an aim is to evaluate the changes seen in the temporomandibular joint (TMJ) after mandibular advancement in class II malocclusions with functional appliance therapy, using CBCT, and also to assess and compare the efficacy of Twin Block, Power Scope and Forsus Fatigue Device used for the correction of class II malocclusion.Materials and Methods: The retrospective study was performed using the 52 CBCT scans of 26 patients with class II malocclusion due to retrognathic mandible. The subjects were divided into three groups based on appliance (Twin Block, Power Scope and Forsus Fatigue Resistant Device) used for the treatment. The changes seen in TMJ after mandibular advancement and condylar response to functional therapy was evaluated using the six. Data obtained were subjected to one-way Anova analysis with Posthoc Tukey test. Software SPSS version 20 was used to analyse the data. The level of significance was set at p < 0.05.Results: In subjects treated with Twin Block, the condyle was displaced slightly downwards and anteriorly; and condylar height was reduced. The decrease in the anterior and superior joint spaces were also found. In subjects treated with PowerScope and Forsus Fatigue Resistant Device, there was an increase in condylar height and width with a decrease in anterior and superior joint space.Conclusion: All three appliances were found to bring about changes in TMJ structures, but amongst them the Twin block has proved to be more efficient.


2017 ◽  
Vol 07 (02) ◽  
pp. 008-018
Author(s):  
Kaushik Shetty ◽  
Saidath K. ◽  
Akhil Shetty ◽  
M. S. Ravi ◽  
Keerthan Shashidhar ◽  
...  

Abstract Aims: To assess the changes in the oropharyngeal airway (OAW) dimensions in individuals with retrognathic mandible treated with Forsus FRD and Twin Block appliance to correct the skeletal Class II mal relationship. Methodology: 40 individuals, with Class II skeletal pattern were selected as per inclusion criteria. Pre-treatment lateral cephalograms and hand wrist radiographs were obtained and analyzed. Group 1 with 20 individuals were treated with Forsus FRD and Group 2 with 20 individuals were treated with conventional Twin Block Appliance. Post treatment records were taken after the Class I molar relationship had been obtained. Pre and post treatment cephalograms were compared and analyzed. The data obtained was statistically evaluated using paired t test and unpaired t test. Results: On comparison of pre-treatment and post-treatment cephalograms, increase in Oropharyngeal Airway (OAW) measurements, such as Superior posterior airway space (SPAS), Middle airway space (MAS) and Inferior airway space (IAS) was very highly significant. Conclusion: Our results suggest the existence of a relationship between functional-orthopaedic treatment and increases in OAW dimensions in skeletal Class II growing subjects.


Author(s):  
Elisabetta Cretella Lombardo ◽  
Lorenzo Franchi ◽  
Giorgio Gastaldi ◽  
Veronica Giuntini ◽  
Roberta Lione ◽  
...  

(1) Background: The nature of the changes that contribute to Class II correction with functional appliances is still controversial. A broad variation in treatment responses has been reported. The purpose of this study was to find cephalometric predictors for individual patient responsiveness to twin-block treatment in patients with Class II Division 1 malocclusion; (2) Methods: The study was performed on a sample of 39 pubertal patients (21 females, 18 males) treated with the twin block appliance. Lateral cephalograms were available at the start of the treatment (T1) and at the end of functional therapy (T2). The outcome variable was the T2–T1 change in the sagittal position of the soft tissue pogonion with respect to the vertical line perpendicular to the Frankfort plane and passing through point subnasale. The predictive variables were age, gender at T1, and all the cephalometric parameters measured T1. Forward stepwise linear regression with p value to enter 0.05 and p value to leave 0.10 was applied; (3) Results: The only significant predictive variable that was selected was the Co–Go–Me angle (p = 0.000); (4) Conclusions: A greater advancement of the soft tissue chin on the profile is expected with smaller pretreatment values of Co–Go–Me angle.


2013 ◽  
Vol 2 (1) ◽  
pp. 1-11
Author(s):  
Morteza Oshagh ◽  
Mahtab Memarpour ◽  
Hooman Zarif Najafi ◽  
Somayeh Heidary

Background: Functional appliances such as Bionator have been used to treat Class II malocclusion. The purpose of this study was to compare the skeletal, dental and soft tissue effects of Bionator appliances with Multi-P (a newly developed appliance) in the treatment of Class II malocclusion. Subjects and methods: 45 class II children were chosen and randomly assigned to either the Bionator or Multi-P treatment group. After excluding 13 patients from the study, 21 patients in Bionator and 11 patients in Multi-P group have participated in the study. Lateral cephalograms were analyzed at the beginning (To) and at the end of treatment (T1) to evaluate the changes in both groups. The paired t.test and Leven’s test were enrolled for statistical analysis.Results: Reduction of ANB angle was detected in both treatment groups. The Bionator group underwent insignificant greater mandibular advancement as measured by the SNB angle. (p= 0.737) The mandibular plane angle increased insignificantly in both groups. (p> 0.05) The inclination of upper incisors decreased significantly in Multi-P group. (p= 0.042)Conclusion: Both appliances are effective therapeutic means for class II treatment associated with mandibular deficiency and may lead to normalization of the dentoskeletal parameters at the end of the treatment.


2015 ◽  
Vol 85 (5) ◽  
pp. 784-789 ◽  
Author(s):  
Veronica Giuntini ◽  
Andrea Vangelisti ◽  
Caterina Masucci ◽  
Efisio Defraia ◽  
James A. McNamara Jr ◽  
...  

ABSTRACT Objective:  To compare the dentoskeletal changes produced by the Twin-block appliance (TB) followed by fixed appliances vs the Forsus Fatigue Resistant Device (FRD) in combination with fixed appliances in growing patients having Class II division 1 malocclusion. Materials and Methods:  Twenty-eight Class II patients (19 females and 9 males; mean age, 12.4 years) treated consecutively with the TB followed by fixed appliances were compared with a group of 36 patients (16 females and 20 males; mean age, 12.3 years) treated consecutively with the FRD in combination with fixed appliances and with a sample of 27 subjects having untreated Class II malocclusion (13 females and 14 males; mean age, 12.2 years). Mean observation interval was 2.3 years in all groups. Cephalometric changes were compared among the three groups by means of ANOVA and Tukey's post hoc tests. Results:  The FRD produced a significant restraint of the maxilla compared with the TB and control samples (SNA, −1.1° and −1.8°, respectively). The TB sample exhibited significantly greater mandibular advancement and greater increments in total mandibular length than either the FRD or control groups (SNB, 1.9° and 1.5°, respectively; and Co-Gn, 2.0 mm and 3.4 mm, respectively). The FRD produced a significantly greater amount of proclination of the mandibular incisors than what occurred with the TB or the control samples (2.9° and 5.6°, respectively). Conclusion:  The TB appliance produced greater skeletal effects in terms of mandibular advancement and growth stimulation while the Forsus caused significant proclination of the mandibular incisors.


2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Stjepan Spalj ◽  
Kate Mroz Tranesen ◽  
Kari Birkeland ◽  
Visnja Katic ◽  
Andrej Pavlic ◽  
...  

The purpose was to compare the treatment effects of functional appliances activator-headgear (AH) and Twin Block (TB) on skeletal, dental, and soft-tissue structures in class II division 1 malocclusion with normal growth changes in untreated subjects. The sample included 50 subjects (56% females) aged 8–13 years with class II division 1 malocclusion treated with either AH (n=25) or TB (n=25) appliances. Pre- and posttreatment lateral cephalograms were evaluated and compared to 50 untreated class II division 1 cases matched by age, gender, ANB angle, and skeletal maturity. A paired sample, independent samples tests and discriminant analysis were performed for intra- and intergroup analysis. Treatment with both appliances resulted in significant reduction of skeletal and soft-tissue facial convexity, the overjet, and the prominence of the upper lip in comparison to untreated individuals (p<0.001). Retroclination of maxillary incisors and proclination of mandibular incisors were seen, the latter being significantly more evident in the TB group (p<0.05). Increase of effective mandibular length was more pronounced in the TB group. In conclusion, both AH and TB appliances contributed successfully to the correction of class II division 1 malocclusion when compared to the untreated subjects with predominantly dentoalveolar changes.


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 ◽  
Vol 10 (1) ◽  
pp. 55-64
Author(s):  
Raksha Rajput ◽  
Suchita Daokar

Introduction: Class II div 1 malocclusion is most commonly presented with retruded mandible. This backward placement of mandible pushes the tongue posteriorly and inturn impairs the position of hyoid bone and total tongue area. Correction of retruded mandible with functional appliances is also considered to have positive effect on hyoid bone position and tongue area. Aim and Objectives: The objective of this study was to evaluate and compare the effects of Twin Block and Forsus on the hyoid bone position and tongue area in the treatment of Class II division 1 malocclusion. Materials & Method: A 2-arm parallel, randomized controlled trial was designed consisting of 24 Class II division 1 malocclusion patients indicated for treatment with functional appliances. 24 patients were randomized and equally divided among Twin Block (Group A) and Forsus (Group B) group. Pre- and post functional lateral cephalograms of both groups were traced and statistically analysed using paired t-test and T test of Equality of Means. ‘p’ value of less than 0.05 was considered as statistically significant. Result: A significantly upward and forward movement of hyoid bone was found with both the appliances. Tongue area also improved with Twin Block and Forsus group. On intergroup comparison insignificant results were observed between both the appliances indicating similar effect on tongue area and hyoid bone position. Conclusion: Twin Block has more skeletal effect than Forsus, still both Twin Block and Forsus are effective in improving tongue area and forward and upward displacement of hyoid bone position while correcting Class II malocclusion.


2016 ◽  
Vol 21 (3) ◽  
pp. 73-84 ◽  
Author(s):  
Aisha Khoja ◽  
Mubassar Fida ◽  
Attiya Shaikh

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.


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