Abstract
Purpose: The purpose of this study was to compare the outcomes of the treatment with the twin block and modified twin block appliances in growing patients with Class 2 malocclusion. Materials and Methods: A cephalometric analysis was performed in 51 patients. The twin block sample consisted of 23 patients, 10-girls and 13-boys (mean age 10.46±0.71 years at the start of treatment, T1, and 12.84±0.78 years at the end of active treatment, T2). The modified twin block sample consisted of 28 patients, 18 girls and 15 boys (mean age 11.78±0.91 years at T1, and 13.32±0.56 years at T2). The twin block activators were used during the day, except for eating time, and the modified ones were used only at night. Duration of the treatment was 16-20 months. The changes from T2 to T1 and the differences between the groups were compared with the analysis of variance. Results: SNB angle in the twin block group showed 1.25±1.39 degrees change and in the modified twin block group, it exhibited 3.69±1.01 degrees change. Overjet in the group with twin block decreased 4.58±1.59 mm, and in the group with modified twin block it decreased 4.43±1.41 mm. In the modified twin block group, there was more retrusion of upper incisors in comparison with the twin block group. Accordingly, under the effect of modified twin block, retrusion of the upper lip was observed. Conclusion: Through modifying the twin block appliance, it is possible to ensure the comfort of the patients by reducing the daily usage, to reposition the mandibula forward and to correct overjet and sagittal dento-skeletal relationships without increasing facial height and to improve positions of upper incisors and lips.
Highlights
Distal bite malocclusion is one of the most common orthodontic problems, affecting approximately 10% of the population
The purpose of this study was to compare the outcomes of the treatment with the twin block and modified twin block appliances in growing patients with Class 2 malocclusion
The modified twin block sample consisted of 28 patients, 18 girls and 15 boys
Summary
Distal bite malocclusion is one of the most common orthodontic problems, affecting approximately 10% of the population. Maxillo-mandibular relation, soft tissue thickness, tension of masticatory and facial muscles change because of distal malocclusions, aesthetics, pronunciation and chewing disfunction occurs, and 75% of the distal bite patients exhibit a retrusive chin position [1, 2]. The decision as to which is the most effective method to use in the treatment of growing patients with distal bite malocclusions has long been the source of considerable debate in the orthodontic literature. The goal of orthodontic treatment is to restore functions and aesthetics. For this purpose, it is necessary to create an individual balance between skeletal and soft tissues [3, 4]. In the treatment of distal malocclusions, as a result of forward repositioning of the mandible, tension in the intraarticular ligaments and adaptive changes in the articular cartilage occur accelerating the growth of the mandible [5,6,7,8]
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