Abstract
This systematic review aims to assess skeletal, dental and soft tissue treatment effects of the conventional Twin-block appliance compared to control in Class II malocclusion till date. The electronic databases of Medline, PubMed and Cochrane library were systematically searched until September 2019. The human studies that had used the conventional Twin block appliance with a control group evaluated by a Lateral Cephalogram were included. A total of 321 articles were examined. 10 articles were selected. Majority studies reported a significant improvement in the mandible and in the vertical height, maxillary restrictive effect was less consistently reported. A restrictive maxillary molar effect and an advancement in the mandibular molar has been suggested. Retroclination of the maxillary incisors and proclination of mandibular incisor inclination has been reported. There is some evidence to suggest a retrusive upper lip effect and a protrusive lower lip effect. Increase in Nasolabial angle and some decrease in the mentolabial sulcus to be expected. In conclusion the conventional Twin Block appliance have shown desirable skeletal, dental and soft tissue effects. However certain inevitable side effects are also seen mainly its effect on lower anterior proclination.
Highlights
The Twin block was developed by Dr William J
The aim of this review is to assess the possible skeletal, dental and soft tissue treatment effects of the conventional Twin-block appliance compared to controls in Class II malocclusion individuals till date
Restrictive maxillary effects of Twin block were reported by a few studies,[7,12,15] whereas most studies reported no restrictive maxillary effect.[8,9,11,13,14,16]
Summary
The Twin block was developed by Dr William J. Clark in 1977.1 Even though it’s a removable appliance requiring patient compliance, it’s still one of the most widely used functional correctors. Twin-block appliance consists of upper and lower acrylic bite blocks with interlocking occlusal inclined planes at 70o angle, which functions to bring the mandible in its desired forward and downward position.[2] It’s mainly indicated in actively growing Class II division I malocclusions.[1,3]. Multiple authors have reported variable results with variable intensities till-date.[4,5] A recent systematic review reporting all the treatment effects of Twin Block was lacking. The aim of this review is to assess the possible skeletal, dental and soft tissue treatment effects of the conventional Twin-block appliance compared to controls in Class II malocclusion individuals till date
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