Soft Tissue Esthetic Changes Following a Modified Twin Block Appliance Therapy: A Prospective Study

Abstract

Aim Achieving a satisfactory facial esthetics is of utmost importance in the practice of orthodontics. Cl II div 1 patients often suffer from numerous adverse facial characteristics which may impair their social well-being. The objective of the current study was to evaluate the esthetic changes in such patients by using a modified twin block appliance. Materials and methods Seventy adolescent patients with mandibular deficiency consecutively underwent treatment with a modified twin block appliance for a mean period of 13 months. Soft tissue analyzes of Burstone and Mcnamara were applied to evaluate the changes before and after the treatment. The esthetic changes before and after the therapy were compared using parametric paired t tests analysis. p values less than 0.05 were considered significant. Results Facial convexity, lip incompetence, upper lip protrusion, and columellar inclination significantly decreased ( p < 0.05) while Merrifield's Z -angle nasolabial angle, lower lip length, and mentolabial angle significantly increased ( p < 0.05). Vertical facial height ratio, lower lip protrusion, upper lip length as well as nasal projection and inclination, did not change significantly ( p > 0.05) Conclusion Our findings indicated that a modified form of the twin block appliance can be substantially effective in the improvement of several aspects of patients’ facial balance with minimum untoward effects. Clinical significance Adolescents suffering from mandibular deficiency can gain substantial facial balance with the twin block appliance. The whole face attractiveness, however, is another subject and should not be conflicted with the facial balance. How to cite this article Shahamfar M, Atashi MHA, Azima N. Soft Tissue Esthetic Changes Following a Modified Twin Block Appliance Therapy: A Prospective Study. Int J Clin Pediatr Dent 2020;13(3):255–260.

Evaluation of modified clear Twin Block aligner in treating adolescents with skeletal class II malocclusion: A two‐centre cephalometric study

“…Teeth alignment can promote arches coordination As for soft tissue changes, protrusive profile and lip aesthetic were improved after CTB and TB treatment, as evidenced by the decrease of S Vert-Ss and S Vert-Ls, as well as the increase of S Vert-Li, S Vert-Si and S Vert-Pog'. Those findings were in accordance with previous studies, 38,39 and the improvement of profile and lip aesthetics might be the result of mandibular advancement and overjet reduction. Mandibular advancement not only promoted the forward movement of chin and lower lip, but also reduced overjet.…”

Comparison of Twin Block appliance and Herbst appliance in the treatment of Class II malocclusion among children: a meta-analysis

“…The comparison effect of Herbst and Twin-Block on U1 to SN needs further elaboration. In orthodontics, attaining pleasing facial aesthetics is crucial, especially since patients with Class II malocclusion frequently exhibit several unfavorable facial traits that can negatively impact their social well-being [ 34 ]. This meta-analysis analyzed soft-tissue profile changes after Class II Twin-block treatment and found improvements in posterior facial height, and convexity angle among children receiving the Twin-block appliance.…”

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