Abstract

(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.

Highlights

  • Several functional/orthopedic devices aimed at encouraging mandibular growth by the forward positioning of the mandible are available for the resolution of Class II division 1 malocclusion [1]

  • All subjects treated by functional therapy at the peak in mandibular growth, as assessed by means of the cervical vertebral maturation method [13] (CS3–CS4 at the start of treatment (T1) and CS4–CS5 at the end of functional therapy (T2)), were included in this study

  • The outcomes of this research showed that the Co–Go–Me angle is the single significant predictor for the amount of advancement of the chin after twin-block treatment for Class II malocclusion

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Summary

Introduction

Several functional/orthopedic devices aimed at encouraging mandibular growth by the forward positioning of the mandible are available for the resolution of Class II division 1 malocclusion [1]. The twin block consists of two plates, upper and lower, which guide the mandible anteriorly by using interlocking occlusal bite blocks. The independent plates simplify language and eating with the device in place, improving patient compliance and treatment efficacy [2]. The nature of the variations that induce Class II resolution with functional appliances is not yet clear. Some authors suppose that the effects of functional therapy are limited to the dentoalveolar structures [3,4]. Other authors assume that this kind of device, applied during skeletal development, may modify maxilla–mandibular relationships [5,6]

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