Abstract
This study was aimed at proposing a three-dimensional (3D) evaluation method for the soft tissue effects of Twin Block (TB) functional appliance therapy by using cone beam computed tomography (CBCT) images. In this retrospective study, a total of 60 pre- and posttreatment (T0 and T1) CBCT images of Class II patients with mandibular retrognathia treated with a TB appliance were used. Volumetric and linear soft tissue changes were evaluated quantitatively with 3D measurements and qualitatively with color mapping visual. Linear (NV-A and NV-Pog) and angular (SNA, SNB, and ANB) skeletal changes were also measured on 3D images. The Wilcoxon signed-rank test was used to compare statistical differences, and the scores of male and female participant differences were observed with the Mann–Whitney U test. In this study, a decrease was observed in SNA (p < 0.05), ANB (p < 0.01), and NV-Pog (p < 0.05) while an increase in SNB (p < 0.01) was found. However, decrease in NV-A distance was not statistically significant (p > 0.05). As a result of the evaluation of soft tissue changes, while the anterior reposition of the lower lip, soft tissue pogonion, and soft tissue gnathion was found to be significant (p < 0.01, p < 0.01, and p < 0.05, respectively), the upper lip and subnasale repositions were not statistically significant (p > 0.05). 3D soft tissue changes after TB therapy can be evaluated quantitatively and qualitatively by using CBCT images. Anterior repositioning of the mandible with functional therapy also provides improvement in soft tissue profile, especially in the lower facial region.
Highlights
One of the most important expectations of orthodontic patients with skeletal malocclusion is improvement in facial aesthetic appearance
There are different treatment options depending on the characteristics of the case [3, 4], Twin Block (TB) is the most popular functional appliance frequently preferred in the treatment of patients with skeletal Class II malocclusion caused by mandibular retrognathia during the growth and development period [5, 6]
When we examine the anteroposterior alteration of the mandible and maxilla, there was a significant decrease in NV-Pog distance (p < 0:05) while the decrease in NV-A distance was not significant (p > 0:05)
Summary
One of the most important expectations of orthodontic patients with skeletal malocclusion is improvement in facial aesthetic appearance. There are different treatment options depending on the characteristics of the case [3, 4], Twin Block (TB) is the most popular functional appliance frequently preferred in the treatment of patients with skeletal Class II malocclusion caused by mandibular retrognathia during the growth and development period [5, 6]. This appliance was developed by William J. Previous studies have shown that the TB appliance improves the facial profile aesthetically [8]
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