Twin Force Bite Corrector Research Articles

Assessment of the condylar response of two differently anchored fixed functional appliances in class II malocclusion in young adult orthodontic patients: A randomized clinical trial.

Measuring the condylar volume changes after treatment with skeletally anchored type IV Herbst appliance vs. Twin Force Bite Corrector (TFBC) in class II malocclusion in young adult patients. Twenty class II malocclusion participants were randomly involved in our randomized clinical study. They are divided equally into two groups: group I (10 patients with an age range of 16 to 18 years and a mean age of (17.15 ± 0.62) (five males and five females) with a mean Angle formed between (A) point and (Nasion) point and (B) point, to determine anteroposterior relation between maxilla and mandible (ANB) of 6.20 (1.03) and a mean mandibular length of 106.1 (1.7), who were treated by a skeletally anchored type IV Herbst appliance, supported at the mandible by two mini-plates fixed bilaterally at the mandibular symphysis; group II (10 patients with an age range of 15 to 18 years and a mean age of (16.85 ± 0.33) (six males and four females) with a mean ANB of 6.80 (0.89) and a mean mandibular length of 107.3 (2.36), who were treated by a TFBC that was installed just mesial to the tube of the maxillary first permanent molar and distal to the bracket of the lower canine for 4 months. According to the Index of Orthognathic Functional Treatment Need (IOFTN) index, the participants in both groups have grade 4 (great need for treatment) as they have excessive overjet (6-9 mm). Cone-beam computed tomography (CBCT) was taken just before installing fixed functional appliances and after the removal. The condylar volume was measured using Dolphin software. Parametric measurements were performed by the independent t-test, while non-parametric variables (percent change) were compared by the Mann-Whitney U-test. On the right side, the Herbst group recorded a percent increase (median = 1.23%), while TFBC recorded a median percent decrease (-7.85%). This change is statistically significant (P = 0.008). The difference in the condylar volume was significantly higher with the mini-plate anchored Herbst appliance than with the dentally anchored TFBC group.

MANAGEMENT OF CLASS II MALOCCLUSION USING TWIN FORCE BITE CORRECTOR

Class II malocclusion is one of the most commonly occurring conditions, and the component mostly involved is mandibular retrognathism. The treatment modalities include both removable and fixed appliances. The advantage of fixed functional appliances is that it is not dependent on patient compliance. Various fixed functional appliances are available such as rigid, flexible, and hybrid. The present case series discusses a hybrid type of fixed functional appliance, i.e. Twin Force Bite Corrector appliance in three cases: A 15‑year‑old female patient with Class II malocclusion due to mandibular retrognathism, a 14‑year‑old male patient with Class II malocclusion due to mandibular retrognathism, and a 14‑year‑old female patient with Class II malocclusion due to mandibular retrognathism. The effects produced by this appliance are similar to the conventional fixed functional appliances such as Forsus, Herbst, and also it has a distinct advantage of quick chair-side fabrication and simple design.

Profile changes after class II treatment with twin force appliance in patients with different facial patterns

ABSTRACT Objective This study aimed to compare the soft tissue profile changes after treatment with the Twin Force Bite Corrector (TFBC) appliance in patients with different facial patterns. Material and Methods The sample consisted of 42 patients with Class II malocclusion treated orthodontically without extractions and the TFBC. Six patients with balanced facial patterns were excluded from the sample. The sample was then divided into 2 groups: Group 1 (hypodivergent pattern) consisted of 18 patients with a mean initial age of 17.91 years (SD = 7.13), mean final age of 20.45 years (SD = 7.18), and mean treatment time of 2.53 years (SD = 0.93). Group 2 (hyperdivergent pattern) consisted of 18 patients with a mean initial age of 15.87 years (SD = 5.64), mean final age of 18.63 years (SD = 5.79), and mean treatment time of 2.75 years (SD = 0.60).The initial and final lateral cephalograms of each patient were used to measure the soft tissue profile variables. Intergroup comparison was performed by independent t-tests Results There was no statistically significant difference between the soft tissue profile changes with treatment with the TFBC between the hypodivergent and hyperdivergent groups. Conclusion The treatment of the Class II malocclusion with the Twin Force appliance in patients with hypodivergent and hyperdivergent patterns promoted similar changes in the soft tissue profile.

Dentoskeletal and soft-tissue changes comparison between the Jasper Jumper and Twin Force Bite Corrector in Class II malocclusion patients: A retrospective study

This retrospective study aimed to compare the dentoskeletal and soft-tissue changes in Class II malocclusion patients treated with Jasper Jumper and Twin Force Bite Corrector associated with fixed orthodontic appliances. The sample comprised 60 subjects divided into 3 groups. Patients with Class II malocclusion, mandibular retrusion, slight or no crowding and with no previous orthodontic treatment were eligible. Group 1 comprised 20 patients treated with the Jasper Jumper (JJ), with an initial age of 12.39 years. Group 2 comprised 20 patients treated with the Twin Force (TF), with an initial age of 11.83 years. The control group consisted of 20 untreated Class II subjects with an initial age of 12.13 years. Intergroup pretreatment comparisons were performed with One-way analysis of variance and intergroup treatment changes were compared with the Analysis of Covariance, both followed by Tukey test. The TF group showed greater increase in mandibular length (6.23mm±4.64, P=0.004) than the control group (2.94mm±1.75). The mandibular incisors in the experimental groups presented significantly greater labial inclination and protrusion than the control (Md1.NB; JJ: 4.19°±2.09; TF: 4.46°±6.83; control: 1.13°±2.08, P=0.000/Md1-NB; JJ: 1.95mm±1.45; TF: 1.74mm±1.79; control: 0.31mm±0.81, P=0.000). In addition, the treated groups also showed significantly improvement of the dental relationships (Overjet; JJ: -4.05mm±4.64; TF: -3.80mm±2.12; control: 0.05mm±1.12, P=0.000/Overbite; JJ: -2.52mm±1.46; TF: -2.93mm±2.13; control: -0.63mm±1.35, P=0.000). The Jasper Jumper and Twin Force associated to fixed appliances were effective in correcting Class II malocclusion with a combination of skeletal and dentoalveolar changes. However, the TF seems to provide more skeletal effects with greater maxillary growth restriction and mandibular length increase when compared to the JJ.

ASSESSMENT OF THE CONDYLAR RESPONSE IN PREPUBERTAL AND POSTPUBERTAL PATIENTS TREATED BY TWIN FORCE BITE CORRECTOR APPLIANCE; A CBCT COMPARATIVE STUDY

ASSESSMENT OF THE CONDYLAR RESPONSE IN PREPUBERTAL AND POSTPUBERTAL PATIENTS TREATED BY TWIN FORCE BITE CORRECTOR APPLIANCE; A CBCT COMPARATIVE STUDY

Correction of Class II malocclusion with the twin force bite corrector – A case report

A class II intermaxillary dental relationship represents a posterior discrepancy of the lower teeth with regard to the upper teeth. In class II malocclusion the mesiobuccal groove of the lower first molar is posterior to the mesiobuccal cusp of the upper first molar. Various types of appliances are used for treatment of Class II malocclusion cases. Twin force bite corrector is used to correct Class II malocclusion due to retrognathic mandible. This article presents a case of class II malocclusion treatment with TFBC appliance. Keywords: Class II malocclusion, Functional appliances, Twin force bite corrector, TPA, TFBC

Class II young adult treatment with Twin Force Bite corrector: 10-year follow-up

One of the most preferred compliance free fixed functional appliances in nongrowing patients is Twin Force Bite corrector (TFBC). The aim of this case report is to evaluate the effectiveness of TFBC in the treatment of an adult Class II case. A 16-year 1-month-old boy having skeletal and dental Class II relationship was selected. Roth 0.018 × 0.025 inch slots brackets were attached; a fixed lingual arch in the mandibular dental arch and a Nance appliance in the maxillary dental arch were used to increase anchorage. The TFBC therapy used for sagittal activation and stimulation of forward mandibular growth lasted for 3 months. The post-TFBC treatment lasted 6 months and the total treatment time was 9 months. Treatment of a young adult Class II malocclusion with TFBC resulted in a Class I molar occlusion, an ideal overjet, overbite, and incisor angulation in a short time and maintained in the 10-year follow-up.

Fixed or removable function appliances for Class II malocclusions.

Data sourcesEmbase, Cochrane Central Register of Controlled Trials, Medline (Pubmed), Web of Science, Google Scholar, Scopus, LILACS database and bibliographies of clinical trials encountered during search. There was no restriction on language or date during search.Study selectionRandomised Controlled Trials (RCTs) and Controlled Clinical Trials (CCT) in patients with Class II malocclusions that compared at least one fixed functional appliance with at least one removable functional appliance (RFA) in children below 16 years of age. Primary outcomes were clinical and lateral cephalometric measurements and the duration of treatment. Secondary outcomes included patient experiences of treatment, quality of life measures and harms arising during treatment as well as costs of both treatments.Data extraction and synthesisThe titles and abstracts of all studies identified through the search were assessed independently and in duplicate by two review authors. Disagreements about included studies were resolved through discussion with the third author. Heterogeneity was assessed using customised forms and risk of bias using a Cochrane Collaboration tool. A meta-analysis was planned for studies at low risk of bias with similar comparisons reporting the same outcome.ResultsTwo RCTs and two CCTs that met the inclusion/exclusion criteria were included in the final analysis. Risk of bias assessment indicated three trials were at high risk while one was unclear. Consequently, the included trials were deemed to be inappropriate for meta-analysis (MA).Two studies with 282 participants evaluated Twin Block with fixed Herbst appliance and reported significant improvements in anterior-posterior skeletal discrepancy, mandibular length and reduction of overjet with both appliances. While one study reported significantly shorter treatment duration in Herbst appliance, the other study did not find any difference. Herbst appliance had better compliance, less dropouts but more emergency visits.One trial that compared activator appliance with Twin Force Bite Corrector found significantly shorter time with the fixed appliance. However, effective length and sagittal positioning of the mandible was not different between the groups.One trial comparing activator with Forsus FRZ reported enhanced mandibular growth and restrained maxillary growth with both the appliances. While activator appliance was associated with increased posterior facial height, Forsus significantly rotated the occlusal plane.ConclusionsLimited available evidence indicates that both fixed and removable functional appliances are effective in reducing overjet in growing children. However, there is insufficient evidence to differentiate between the two types with respect to biological (skeletal and dental) effects or patient experiences.

Stability of Class II fixed functional appliance therapy--a systematic review and meta-analysis.

To systematically search for scientific evidence concerning the stability of treatment (Tx) results achieved by means of Class II fixed functional appliance therapy and to assess possible differences between appliances. An electronic search of databases and orthodontic journals was carried out (until December 2013), with supplemental hand searching. In addition to the names of all identified appliances, the term fixed functional was used in combination with each of the following search terms: long-term, post-Tx, relapse, retention, stability. To be included in the review, the articles had to contain clear data on: Class II Tx with a fixed functional appliance (>5 patients), post-Tx period ≥ 1 year, assessment of ANB angle, Wits appraisal, molar relationship, soft-tissue profile convexity excluding the nose, overjet and/or overbite. The literature search revealed 20 scientific investigations which corresponded to only two of the 76 identified appliances (Herbst and Twin Force Bite Corrector). As only one publication was found for the Twin Force Bite Corrector, a meta-analysis could only be performed for Herbst Tx. The data were extracted, pooled and weighted according to the number of patients in each study. The mean values for post-Tx relapse (percentages relative to the Tx changes) were: ANB angle 0.2 degrees (12.4 per cent), Wits appraisal 0.5mm (19.5 per cent), sagittal molar relationship 1.2mm/0.1 cusp widths (21.8 per cent /6.5 per cent); soft-tissue profile convexity excluding nose less than 0.1 degrees (1.0 per cent), overjet 1.8mm (26.2 per cent), overbite Class II:1 1.4mm (44.7 per cent), overbite Class II:2 1.0mm (22.2 per cent). The scientific evidence concerning the stability of Tx results is inexistent for most fixed functional appliances for Class II correction except for Herbst appliance Tx. Even if the evidence level of most included studies is rather low, good dentoskeletal stability without clinically relevant changes was found for most variables.

Four years stability evaluation of the changes obtained by twin force bite corrector appliance

Four years stability evaluation of the changes obtained by twin force bite corrector appliance

Treatment effects of a Twin-Force Bite Corrector versus an Activator in comparison with an untreated Class II sample: a preliminary report

Abstract Objectives: The present study aimed to compare the treatment outcomes of a fixed-functional appliance (Twin-Force Bite Corrector - TFBC) and a conventional removable functional appliance (Activator) in the treatment of skeletal Class II malocclusions. Methods: The TFBC and Activator Groups each included 10 young adults possessing a skeletal Class II malocclusion, and the treatment outcomes of both groups were quantified and compared, using lateral cephalometric radiographs, with an untreated skeletal Class II Control Group. Results: A skeletal Class I relationship and a marked reduction in overjet were achieved in both treatment groups; however, the duration of treatment was significantly shorter in the TFBC Group (0.45 years) when compared with the Activator Group (1.37 years) (p < 0.001). Effective length and sagittal positioning of the mandible underwent significant changes in the TFBC and Activator Groups. Vertical facial dimensions increased in each group; however, these increases were significantly greater in the Activator Group when compared to the TFBC and Control Groups (p < 0.05). Dentoalveolar changes also contributed to the reduction in overjet. Conclusions: Although both appliances succeeded in eliminating the Class II relationship and improving the overjet and overbite, the short treatment time in the TFBC Group raises questions regarding the long-term stability of the results.

Comparison Of Soft Tissue Treatment Changes between Twin Force Bite Corrector and Forsus Fatigue Resistance Appliance

Comparison Of Soft Tissue Treatment Changes between Twin Force Bite Corrector and Forsus Fatigue Resistance Appliance

Ratings of profile attractiveness after functional mandibular advancement

Considerations involving orthodontic treatment and facial esthetics have directed the investigation of the optimal treatment, especially in the correction of Class II, division 1 malocclusions, both esthetically and functionally. The aim of this study is to determine whether the use of a Twin force bite corrector in combination with Edgewise mechanics yields a more esthetic facial profile than Edgewise treatment alone. Methods: The present retrospective study compared matched two groups of adolescent patients, (total n=20) The first, treated with functional orthopedic therapy using a TFBC in combination with preangulated Edgewise appliances, (n=10). The second, matched group (n=10) was treated using standard Edgewise mechanics alone. A panel of ten orthodontic graduate evaluators investigated silhouettes of lateral photographs of perceived post treatment facial esthetics of Egyptian adolescents with Class II, division 1 malocclusions treated by one of the two methods. They scored each silhouette's attractiveness on a 100% visual analogue scale (modified VAS). Independent samples t test at 0.05 level of significance was used to compare the VAS scores. Results: the evaluators showed wide range of agreement among the two treated groups in selecting the most attractive profiles. The evaluation of pre/post treatment for each group and randomized post treatment of both goups for facial attractiveness showed insignificant difference statisticaly. Conclusion: TFBC treatment in combination with Edgewise mechanics has measurable benefits.

Mechanism of Class II correction in prepubertal and postpubertal patients with Twin Force Bite Corrector

To compare the dentoskeletal effects and treatment efficiency of the Twin Force Bite Corrector (TFBC) appliance in Class II correction of patients treated before or after the pubertal growth spurt. Forty-one normodivergent Class II patients treated with the TFBC appliance were divided into two groups based on their cervical vertebral maturation stage (CVMS). Group 1 (G1) consisted of 23 patients (mean age 12.44 ± 1.59 years) where treatment was initiated before the pubertal growth spurt (CVMS I and II), while group 2 (G2) consisted of 18 patients (mean age 13.76 ± 1.44 years) where treatment was started after the pubertal growth spurt (CVMS III to V). Dentoskeletal measurements were made on lateral cephalograms taken before (T1) and after orthodontic treatment (T2). During treatment, G1 had significantly greater skeletal correction than G2, with more dentoalveolar effects being observed in G2 than G1. However, on comparing both groups at the end of treatment (T2) when growth is complete, no differences in the parameters measured were observed. Overall, treatment time was significantly longer for G1 (3.67 ± 1.45 years) compared to G2 (2.75 ± 1.07 years). There is no difference in overall dentoskeletal effects obtained at the end of treatment by the TFBC appliance in normodivergent prepubertal vs postpubertal patients. However, treatment efficiency based on treatment timing is significantly greater for the postpubertal group.

Prospective study of dentoskeletal changes in Class II division malocclusion treatment with twin force bite corrector

To evaluate the dentoskeletal changes of Class II malocclusion treatment with the Twin Force Bite Corrector (TFBC). The sample comprised 86 lateral cephalograms obtained from 43 subjects with Class II division 1 malocclusion; the subjects were divided into two groups. The experimental group comprised 23 patients with a mean initial age of 12.11 years who were treated with the TFBC for a mean period of 2.19 years. The control group included 40 lateral cephalograms from 20 Class II nontreated patients, with an initial mean age of 12.55 years and a mean observation period of 2.19 years. The lateral cephalograms were evaluated before and after orthodontic treatment in group 1 and in the beginning and end of the observation period in group 2. t-Tests were used to compare the initial and final cephalometric characteristics of the groups as well as the amount of change. The experimental group presented greater maxillary growth restriction and mandibular retrusion than the control group, as well as greater maxillomandibular relationship improvement and greater labial tipping of the mandibular incisors. The results also showed a greater decrease in overbite and overjet in the experimental group, and there were no statistically significant differences in the craniofacial growth pattern between groups. The TFBC promotes restriction of anterior maxillary displacement without significant changes in mandibular length and position and improvement of maxillomandibular relationship without changes in facial growth and significant buccal tipping of mandibular incisors. Class II correction with the TFBC occurred primarily as a result of dentoalveolar changes.

Correction of Class II molar relation using intermaxillary compression spring

Intermaxillary compression spring is a kind of non-compliance appliance used for correction of Class II molar relation. In these case reports, Class II molar relations were corrected by intermaxillary compression springs such as Twin Force Bite Corrector and Forsus. The effects of intermaxillary compression spring were lingual tipping and extrusion of upper incisors, distal tipping of upper molars, labial tipping of lower molars, and mesial movement of lower molars, thus causing backward rotation of the occlusal plane and slight backward rotation of the mandible. These effects are similar to the effects of Class II elastics. Therefore, intermaxillary compression spring should be used with the same precautions of Class II elastics. In these case reports, Class I molar relation and normal overjet and overbite were achieved without patient compliance using intermaxillary compression springs.