Effects Of Twin Block Appliance Research Articles

Cone Beam Computed Tomograghic Evaluation of the Effects of Twin Block Appliance Used For Correction of Skeletal Class II Growing Patients.

Cone Beam Computed Tomograghic Evaluation of the Effects of Twin Block Appliance Used For Correction of Skeletal Class II Growing Patients.

Skeletal, Dental and Soft Tissue Effects of Twin Block Appliance in Different Facial Divergence Cases

IntroductionClass II malocclusions refer to a discrepancy in the sagittal plane associated with either backward or upward rotation of the jaw. A backwardly positioned mandible is usually managed using a Twin block appliance which contains a bite plane to direct the occlusal forces in a more favorable direction. Our aim was to evaluate skeletal, dental, and soft tissue changes using twin-block appliance therapy in different facial divergence patients. MethodsA cephalometric study was conducted among two groups with 15 patients in each group. Group 1 have a Frankfort Mandibular plane Angle (FMA) of 18-25 degree while Group 2 have an FMA of 28 to 33 degree with Class II Division I malocclusion. All of them were treated with twin block appliances with modifications done according to FMA. Cephalometric analysis was done using Dolphin software (Dolphin Imaging 11.95) to evaluate skeletal, dental, and soft tissue changes after twin block therapy. ResultsAnalysis of variance and paired t-test were used to evaluate pre and post-treatment changes in cephalograms. The position of the mandible, maxillomandibular relation, and mandibular length was changed by 3.99 degrees, 5.23 degrees, and 4.04mm respectively in horizontal growers, while by 2.9 degrees, 1.74 degrees, and 1.07mm respectively in vertical growers. An increment in FMA by 4.59 degrees in horizontal growers with good vertical control and a little increment in FMA by 1.07 degrees in vertical growers were seen. Conclusions The twin block appliance is effective in skeletal, dental, and soft tissue correction in patients with different facial divergences.

Effects of twin-block appliance on upper airway parameters in OSA children with class II malocclusion and mandibular retrognathia: a CBCT study.

Correction of class II mandibular retrognathic skeletal malocclusion with twin-block appliance resulted in a significant increase in upper airway volume, MCA, anteroposterior and lateral distances of the MCA at the level of the oropharynx, MCA at the level of the hypopharynx and upper airway length, and a significant decrease in AHI, but it had no effect on nasopharynx parameters. • CBCT imaging has been shown to be an effective and precise diagnostic tool for analyzing the upper airways and craniofacial structures. • Twin block appliance may be an effective treatment modality in children with OSA. • Minimal cross-sectional area of upper ways may be the most relevant potential parameter when explaining how the upper airway anatomy plays role of in the pathogenesis of pediatric OSA. • Twin block appliance induced favorable changes in upper airway morphology (oropharynx area mainly) and respiratory parameters in OSA children with class II malocclusion.

A Comparative Evaluation of the Dentoskeletal Treatment Effects Using Twin Block Appliance and Myobrace System on Class II Division I Malocclusion.

The study aimed to evaluate the dentoskeletal effects of twin block appliance and myobrace system in treating skeletal Class II Division I malocclusions in growing children taking into account the effects of normal growth in an untreated control group. Twenty subjects with Class II Division I malocclusion considered as study group were allocated randomly to two treatment groups of 10 each, consecutively treated with twin block appliances (mean age 10.850 ± 1.37 years) and myobrace system (mean age 10.40 ± 1.89 years). Ten children (mean age 10.60 ± 1.77 years) with untreated Class II Division I malocclusion were considered as a control group to eliminate possible growth effects. At the start of the treatment and end of the observation period of 18–24 months, lateral cephalograms were taken. All the angular and linear parameters measured were subjected to statistical analysis. Twin block group subjects produced more measurable and statistically significant skeletal and dentoalveolar changes at the end of the observation period, demonstrated by correction of full cuspal Class II molar relationship to Class I molar relationship and yielding mandibular growth in increments greater in magnitude than the myobrace system. Meanwhile, the myobrace system-induced favorable dentoalveolar changes by a significant reduction of overjet. The retrognathic profile, however, improved in both the intervention groups as the upper lip protrusion, mentalis strain, and the lower lip curl were eliminated in striking contrast to the untreated control group. The study demonstrates that with appropriate patient selection both myobrace system and twin block appliances can be used in conjunction with the fixed appliance therapy to achieve more stable Class II corrections.How to cite this article: Johnson JS, Satyaprasad S, Sharath Chandra H, et al. A Comparative Evaluation of the Dentoskeletal Treatment Effects Using Twin Block Appliance and Myobrace System on Class II Division I Malocclusion. Int J Clin Pediatr Dent 2021;14(S-1):S10–S17.

Dentoskeletal effects of Twin Block appliance in patients with Class II malocclusion.

Background and aimClass II malocclusions are most commonly seen in orthodontic practice and in the recent times Twin Block appliance has been the most popular and widely used among removable functional appliances for the correction of Class II malocclusion in growing patients. The aim of this retrospective study was to evaluate the dentoskeletal effects produced by the Twin Block appliance for the correction of Class II division 1 malocclusion with retrognathic mandible.MethodsPre-treatment (T1) and post-treatment (T2) lateral cephalograms of 30 patients treated with Twin Block appliance (mean age = 10.8 ± 1.2 years) for the correction of class II division 1 malocclusion were compared with the 30 untreated class II control patients (mean age 11.2 ± 0.8 years) who did not undergo any treatment during this period. Both the groups were evaluated for the dentoskeletal changes using 24 angular and linear cephalometric measurements. The differences between the pre and post-treatment were calculated using a paired t-test.ResultsThe cephalometric analysis revealed that the Twin Block appliance stimulated mandibular growth and statistically significant differences were found between the two groups. Twin Block patients showed a statistically very high significant (p<0.001) increase in mandibular length (6.02 mm) compared with the control group (0.3 mm). “Headgear effect” on the maxilla, increase in lower anterior facial height, significant reduction of overjet, overbite and Class I molar relationship were achieved in the Twin Block group. However, no significant changes appeared in the control group.ConclusionThe results of the present study conclude that the Twin Block appliance is effective in the treatment of Class II malocclusion and this is due to a combination of skeletal and dentoalveolar changes in both the arches.

Class II Malocclusion and Traumatized Incisors in Adolescent with Twin Block and Fixed Appliance

This case report presents the outcome of atypical extraction and effect of Twin Block appliance on a growing adolescent. A 12-year-old boy who had complained about protrusive upper lips after being involved in a traffic accident. Tooth 11 was replanted at a local dental clinic, while tooth 21 was lost. In extra-oral examination, this patient had convex profile, obtuse nasolabial angle, and receded chin position. In intra-oral examination, bilateral Class II molar and canine relation were shown, the overjet was 11 mm between tooth 11 and 41; 7 mm between tooth 22 and 31; the overbite was 6 mm. Cephalometric analysis showed skeletal Class II jaw relationship with mandibular retrusion, and average mandible plane angle. The cervical vertebrae maturation stage was in late stage II to stage III. In the first stage of treatment, he received partial fixed orthodontic appliance to increase the overjet; then, Twin Block was used to facilitate mandibular growth. In the second stage, full-mouth fixed edgewise appliance was bonded and teeth 11 and 42 were extracted due to poor prognosis. After treatment, a harmonious profile was achieved. With proper case selection, good patient cooperation and appropriate appliance construction, distinct result with Twin Block appliance can be achieved. Early treatment using Twin Block appliance is effective in reduction of anterior-posterior discrepancy and severity of malocclusion.

A Systematic Review of Skeletal, Dental and Soft Tissue Treatment Effects of Twin Block Appliance

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.

Effect of Twin Block Appliance on a Growing Patient – A Case Report

Twin block appliance is very effective in a growing patient. The successful use of this appliance in the treatment of skeletal Class II malocclusion is based upon factors such as; age of patient, compliance of the patient and other case selection criteria. This case report includes a 14-year-old boy who was treated with twin block appliance. If treated timely, growth modification and orthopedic effects with this appliance can be achieved in a growing individual.

Immediate Effect of Twin Block Appliance on the Airway on a Sample of Patients with Class II division 1 Malocclusion on Skeletal II Base

Immediate Effect of Twin Block Appliance on the Airway on a Sample of Patients with Class II division 1 Malocclusion on Skeletal II Base

Effects of twin block appliance on obstructive sleep apnea in children: a preliminary study

Oral appliances are increasingly advocated as a treatment option for obstructive sleep apnea (OSA). However, it is not clear how the different designs influence treatment efficacy in children. The aim of this study was to investigate the effects of twin block (TB) appliance on children with OSA and mandibular retrognathia. A total of 46 children (31 males, 15 females, aged 9.7 ± 1.5years, BMI: 18.1 ± 1.04kg/m(2)) diagnosed with mandibular retrognathia and OSA by polysomnography (PSG) and with no obesity or adenotonsillar hypertrophy were recruited for the study. Patients in the treatment group were instructed to wear the twin block oral appliance full time for an average of 10.8months. The efficacy of treatment was determined by monitoring the PSG and cephalometric changes before and after appliance removal. Data were analyzed using paired t test. Results showed an improvement in patient's facial profile after treatment with the TB appliance. The average AHI index decreased from 14.08 ± 4.25 to 3.39 ± 1.86 (p < 0.01), and the lowest SaO2 increased from 77.78 ± 3.38 to 93.63 ± 2.66 (p < 0.01). Cephalometric measurements showed a significant increase in the superior posterior airway space, middle airway space, SNB angle and facial convexity which indicate an enhancement in mandibular growth, and reduction in the soft palate length. This preliminary study suggests that twin block appliance may improve the patient's facial profile and OSA symptoms in a group of carefully selected children presented with both OSA and mandibular retrognathia symptoms.