scholarly journals Development of a Prediction Model for Short-Term Success of Functional Treatment of Class II Malocclusion

2020 ◽  
Vol 17 (12) ◽  
pp. 4473
Author(s):  
Elisabetta Cretella Lombardo ◽  
Lorenzo Franchi ◽  
Giorgio Gastaldi ◽  
Veronica Giuntini ◽  
Roberta Lione ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Outcome Variable ◽  
P Value ◽  
Functional Therapy ◽  
Twin Block ◽  
Predictive Variables ◽  
Lateral Cephalograms ◽  
Patient Responsiveness ◽  
Forward Stepwise

(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.

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
Keyword(s):  
Retrospective Study ◽  
Class Ii ◽  
Post Treatment ◽  
Mandibular Advancement ◽  
Functional Therapy ◽  
Twin Block ◽  
Oropharyngeal Airway ◽  
Lateral Cephalograms ◽  
Functional Appliances ◽  
Forsus Fatigue Resistant Device

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.

scholarly journals Comparison of Activator-Headgear and Twin Block Treatment Approaches in Class II Division 1 Malocclusion

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Stjepan Spalj ◽  
Kate Mroz Tranesen ◽  
Kari Birkeland ◽  
Visnja Katic ◽  
Andrej Pavlic ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Skeletal Maturity ◽  
Normal Growth ◽  
Class Ii ◽  
Twin Block ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Functional Appliances ◽  
Growth Changes ◽  
Class Ii Division 1

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.

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 A New Geometric Intersection Point (Ms) to Determine the Spatial Position of Maxillary Sinus

2013 ◽  
Vol 01 (02) ◽  
pp. 100-105
Author(s):  
Sarabjeet Singh ◽  
Mukti Gautam ◽  
Rita Kashyap ◽  
Gurinderpal Sandhu ◽  
Divya Singla
Keyword(s):  
Maxillary Sinus ◽  
Class Ii ◽  
Intersection Point ◽  
Spatial Position ◽  
Class I ◽  
P Value ◽  
X Rays ◽  
Effective Measure ◽  
Anterior Cranial Base ◽  
Lateral Cephalograms

Abstract Introduction: Cephalometeric landmark detection, is a knowledge intensive activity to identify on standardized lateral x-rays of the skull, to perform measurements needed for medical diagnosis, treatment planning and evaluation. For computation of analysis of steps and for determination of underlying structures, provided landmarks should be correctly localized. Due to the complexity of human anatomy sensed in a cephalometric x-ray, the landmarks are localized and constructed. Maxillary sinus has an important role to play in the formation of facial contours. Objective: Our aim is to check the validity of new geometric intersection point Ms, evaluating cephalometerically the spatial position of maxillary sinus and to find any correlation between the spatial position of maxillary sinus and sagittal dysplasias. Study design: A single-institution prospective analysis. Subjects and methods: A total of 20 lateral cephalograms were used, of both sexes, ranging in age from 18-25 years. These radiographs were from subjects, classified into class I and class II on the bases of ANB and Ao-Bo. Maxillary sinus was carefully analyzed and measured in linear dimensions of length and width and its spatial position was calculated by using a new geometric intersection point Ms, created by the intersection of the linear measurements, in relation to the anterior cranial base. The spatial position of maxillary sinus was calculated from the position of the intersection point Ms. The length and height of maxillary sinus was measured and compared in both the groups. Results: The mean of maxillary sinus length (MSL) and height (MSH) was 43.2 ± SD 3.2mm and 41.2 ± SD 3.8mm, respectively for classI (p value=0.595) and 44.2 ± SD 4.9mm and 43.0 ± SD 3.4mm, respectively for class II (p value=0.283). The intersection point Ms depicting centre of maxillary sinus from x-axis (Ms-Msx) was same for both the groups. Mean for Ms-Msy, was 37.3 ± SD 5.7 for class I and 37.8 ± SD 1.9 for class II (p value=0.796). No statistical significance was found among the results in both the groups. Conclusion: The length and height of maxillary sinus was calculated and the centre of maxillary sinus was calculated by the intersection of the two. This new point can contribute in calculating the spatial position of sinus and be an effective measure to study the convexity and concavity of the midface. In the present study, the length and height of the sinus did not alter with the increased or decreased ANB and Ao-Bo. There was no significant spatial position change of maxillary sinus with variation in ANB and Ao-Bo (sagittal). Regarding vertical parameters, Ms may have significant correlation with the various malocclusions.

scholarly journals Evaluation of changes seen in TMJ after mandibular advancement in treatment of Class II malocclusions, with functional appliances, a CBCT study

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 236-242
Author(s):  
Ram Mohan Parvathy ◽  
Sandeep Shetty ◽  
Parveen Katheesa
Keyword(s):  
Three Dimensional ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
Functional Appliance ◽  
Functional Therapy ◽  
Twin Block ◽  
Functional Appliances ◽  
Level Of Significance ◽  
Forsus Fatigue Resistant Device

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.

scholarly journals Changes in soft tissue facial profile of class II skeletal malocclusion patients with retrognathic mandible treated with twin block appliance

2019 ◽  
Vol 31 (1) ◽  
pp. 32
Author(s):  
Ng Hui Lin ◽  
Eky Setiawan Soeria Soemantri ◽  
Gita Gayatri
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
Facial Soft Tissue ◽  
Profile Angle ◽  
Facial Profile ◽  
Twin Block ◽  
Skeletal Malocclusion ◽  
Soft Tissue Profile ◽  
Significant Difference ◽  
Soft Tissue Changes

Introduction: The soft tissue aspect in orthodontics treatment has gained attention in the last few years. The soft tissue profile is said to reflect the underlying skeletal profile, which causes a convex profile in patients with class II skeletal malocclusion. This research was aimed to determine the changes in the soft tissue facial profile of class II skeletal malocclusion patients with retrognathic mandible after twin block treatment. Methods: The type of research used in this study was retrospective descriptive research with paired t-test. The population was children aged 10-13 years old with class II skeletal malocclusion that were treated with twin block appliance in the Faculty of Dentistry Universitas Padjadjaran, Indonesia. The results of soft tissue changes before and after twin block treatment were compared. Results: There was an insignificant increase in soft tissue profile angle and Holdaway’s soft tissue angle after twin block treatment (p > 0.05). Whereas, Holdaway’s H-angle was decreasing and Merrifield’s Z-angle was increasing after twin block treatment, with statistically significant difference (p < 0.05). Conclusion: There was a decrease of H-angle, indicates a reduction in facial convexity and improvement of the facial profile after twin block treatment, but no difference in soft tissue profile angle and Holdaway’s soft tissue angle after twin block treatment. Keywords: Facial soft tissue profile, class II skeletal malocclusion, retrognathic mandible, twin block appliance

scholarly journals Twin block appliance: Effect on pharyngeal airway

2018 ◽  
Vol 7 (4) ◽  
pp. 147-152
Author(s):  
Vivek Bikram Thapa ◽  
Amrita Shrestha ◽  
Prabesh Sherchan ◽  
Prakash Poudel ◽  
Luna Joshi
Keyword(s):  
Soft Palate ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Twin Block ◽  
Skeletal Class ◽  
Pharyngeal Airway ◽  
Skeletal Class Ii ◽  
Obstructive Sleep ◽  
Lateral Cephalograms ◽  
Mandibular Retrusion

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.

scholarly journals Comparison of dentoskeletal and soft tissue effects of Class II malocclusion treatment with Jones Jig appliance and with maxillary first premolar extractions

2019 ◽  
Vol 24 (2) ◽  
pp. 56-65
Author(s):  
Daniela Cubas Pupulim ◽  
José Fernando Castanha Henriques ◽  
Guilherme Janson ◽  
Fernanda Pinelli Henriques ◽  
Karina Maria Salvatore Freitas ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Treatment Time ◽  
Class Ii ◽  
Treatment Protocols ◽  
Soft Tissue Profile ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Treatment Changes ◽  
Group 2 ◽  
Cephalometric Changes

Abstract Objective: The aim of this study was to compare the cephalometric changes in Class II division 1 malocclusion patients treated with Jones Jig appliance or with maxillary first premolar extractions. Methods: The sample consisted of 88 lateral cephalograms of 44 patients, divided into two groups. Group 1 consisted of 21 patients treated with Jones Jig appliance, with a mean initial age of 12.88 ± 1.23 years and final mean age of 17.18 ± 1.37 years, and a mean treatment time of 4.29 years. Group 2 comprised 23 patients treated with maxillary first premolar extractions, with a mean initial age of 13.59 ± 1.91 years and mean final age of 16.39 ± 1.97 years, and a mean treatment time of 2.8 years. Intergroup treatment changes were compared with t and Mann-Whitney tests. Results: Class II correction in G2 (maxillary first premolar extractions) presented significantly greater maxillary retrusion, reduction of anteroposterior apical base discrepancy, smaller increase in the lower anterior face height and significantly greater overjet reduction than G1 (Jones Jig). Conclusions: Treatment with maxillary first premolar extractions produced greater overjet reduction, but the two treatment protocols produced similar changes in the soft tissue profile.

scholarly journals Effect of Clark's twin-block appliance (CTB) and non-extraction fixed mechano-therapy on the pharyngeal dimensions of growing children

2015 ◽  
Vol 20 (6) ◽  
pp. 82-88 ◽  
Author(s):  
Batool Ali ◽  
Attiya Shaikh ◽  
Mubassar Fida
Keyword(s):  
Upper Airway ◽  
Mandibular Advancement ◽  
Rank Test ◽  
P Value ◽  
Severe Respiratory Distress ◽  
Fixed Appliance ◽  
Twin Block ◽  
Lateral Cephalograms ◽  
The Mean ◽  
Pre Treatment

Abstract Introduction: Narrow airway dimensions due to mandibular deficiency can predispose an individual to severe respiratory distress. Hence, treatment with mandibular advancement devices at an early age might help improving the pharyngeal passage and reduce the risk of respiratory difficulties. Therefore, the aim of the current study was to evaluate the mean changes in the pharyngeal dimensions of children with mandibular deficiency treated with Clark's twin-block appliance (CTB) followed by fixed orthodontic treatment. Methods: Orthodontic records of 42 children with mandibular deficiency were selected. Records comprised three lateral cephalograms taken at the start of CTB treatment, after CTB removal and at the end of fixed appliance treatment, and were compared with 32 controls from the Bolton-Brush study. Friedman test was used to compare pre-treatment, mid-treatment and post-treatment pharyngeal dimensions. Wilcoxon signed rank test was used to compare the airway between pre-treatment and post follow-up controls. Mann-Whitney U test was applied to compare the mean changes in pharyngeal dimensions between treatment group and controls from T2 to T0. Post-hoc Dunnet T3 test was used for multiple comparisons of treatment outcomes after CTB and fixed appliances, taking a p-value of ≤ 0.05 as statistically significant. Results: Superior pharyngeal space (p < 0.001) and upper airway thickness (p = 0.035) were significantly increased after CTB, and the change in superior pharyngeal space remained stable after fixed mechano-therapy. Conclusion: CTB can have a positive effect in improving pharyngeal space and the resultant increase in airway remains stable on an average of two and a half years.

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