Early treatment outcomes of class II malocclusion with twin-block facial profile and cephalometric changes

Abstract

Esthetic improvement is highly valued by patients seeking orthodontic treatment. Subjects with a class II malocclusion are a good example of patients who seek treatment primarily for esthetic improvement. A young growing child with convex profile due to a small, retropositioned mandible, normal midface and lower tip trap is more suitable for functional appliance treatment. Functional appliances encourage adaptive skeletal growth by maintaining the mandible in a corrected forward position for a sufficient period of time to allow adaptive skeletal changes to occur in response to a functional stimulus. The aim of this article is to describe two cases of class II malocclusion in late mixed dentition period treated with twin-block. The cephalometric and facial profile changes have been discussed.

Soft tissue changes: a comparison between changes caused by the construction bite and by successful treatment with a modified Twin-block appliance

“…The skeletal and dental effects of the Twin-block and other functional appliances have been investigated using lateral cephalometry (6)(7)(8). Only mandibular changes greater than 2mm, however, have been deemed clinically significant (9).…”

Analisis Penggunaan Twin Block Pada Perawatan Maloklusi Dentoskeletal Kelas Ii Divisi 1 Disertai Retrognati Mandibula Berdasarkan Cervical Vertebral Maturation Stage

“…14,[17][18][19][20] Penelitian-penelitian lain menyatakan hal serupa, namun dengan menambahkan bahwa perawatan menunjukkan hasil yang baik jika dilakukan pada tahap awal gigi campuran atau pada tahap akhir gigi campuran. 21 Penelitian yang dilakukan oleh Singh dan Clark 22 meneliti efektivitas perawatan twin block berdasarkan waktu sebelum dan setelah pubertas.…”

“…Hal ini terjadi karena alat twin block berfungsi untuk menstimulasi pertumbuhan mandibula melalui pertumbuhan kartilago kondilus, sehingga pertumbuhan endokondral akan terjadi lebih pesat. 8,21,22 Hal yang sama juga terjadi pada variabel ukuran linear panjang badan mandibula dan tinggi ramus. Perubahan linear mandibula paling besar terlihat pada variabel panjang total mandibula.…”

“…Hal ini disebabkan adanya sinergi dari peningkatan panjang badan mandibula dan tinggi ramus secara simultan. 8 Hasil penelitian ini sejalan dengan penelitian Al-Anezi 17 , Singh dkk 21 , dan Fareen dkk 20 yang menyatakan bahwa alat twin block akan meningkatkan panjang mandibula secara keseluruhan sehingga sudut ANB akan berkurang. Bacetti dkk 8 dalam penelitiannya juga menyatakan bahwa perubahan skeletal yang paling tampak setelah perawatan twin block adalah perubahan skeletal pada mandibula.…”

Changes in soft tissue facial profile of class II skeletal malocclusion patients with retrognathic mandible treated with twin block appliance

“…This character often causes patient with Class II malocclusion to have a convex profile. 3 Male facial profiles with bi-maxillary protrusion and a female profile with retruded mandible were considered the least attractive. Whereas, straight facial profile was perceived to be highly attractive by both expert and nonexpert groups.…”