Treatment of a growing male having a recessive mandible with removable myofunctional appliance therapy followed by fixed orthodontic treatment: A case report (original) (raw)
Related papers
International Journal of Science and Research , 2024
Class II malocclusion is one of the most common orthodontic problems and it affects one-third of patients seeking orthodontic treatment. It can be due to prognathic maxilla, retrognathic mandible or both. Twin Block is a well-accepted patient friendly functional appliance for the treatment of growing patients with Class II malocclusion due to mandibular retrognathism. It works by guiding the mandible forward through the inclined plane on the bite block. It alters the neuromuscular environment and promotes favourable growth of the mandible by condylar adaptation. This case report describes the comprehensive management of a 11-year-old female patient diagnosed with a severe Class II skeletal discrepancy and Class II div I malocclusion with retrognathic mandible. Treatment was carried out in 2 stages. Stage I included twin block for mandibular advancement, reducing the overjet, achieve Class I molar relationships and gain anchorage at the start of treatment to simplify the fixed appliance stage. Stage II treatment included preadjusted edgewise appliance therapy for the aligning and levelling of the dentition. The post-treatment results were highly satisfactory, showing improvement in dental, skeletal and soft tissue profile.
International Journal of Applied Dental Sciences, 2021
A 12 year old boy presented with class II skeletal and dental relationship due to prognathic maxilla and retrognathic mandible with excessive overjet and 100% deepbite. He was treated with 2 phase treatment by phase 1 growth modification therapy using twinblock appliance with combination pull headgear to improve his profile followed by phase II fixed mechanotheraphy to settle his occlusion. Pretreatment, postfunctional and posttreatment records are shown and treatment stability after 2 years are also shown.
The Angle Orthodontist, 2010
Objective: To evaluate the treatment effects of twin-block and Mandibular Protraction Appliance-IV (MPA-IV) in the treatment of Class II division 1 malocclusion. Methods: Fifty North Indian girls with Class II division 1 malocclusion, in the age range of 9-13 years, were chosen. The subjects were divided among a control group (n 5 10), a twin-block group (n 5 25), and an MPA group (n 5 15). Pre-follow-up and post-follow-up lateral cephalograms of control subjects and pretreatment and posttreatment lateral cephalograms of the treatment subjects were traced manually and subjected to a pitchfork analysis. Results: Neither twin-block nor MPA-IV significantly restricted the forward growth of maxilla. Mandibular growth and improvement in the sagittal skeletal relation were significantly greater in the twin-block subjects. Distal movement of the maxillary dentition and mesial movement of the mandibular dentition were more prominent in the MPA-IV subjects. Molar correction and overjet reductions were significantly greater in the treatment subjects (P , .001). Conclusion: Twin-block and MPA-IV were effective in correcting the molar relationships and reducing the overjet in Class II division 1 malocclusion subjects. However, twin-block contributed more skeletal effects than MPA-IV for the correction of Class II malocclusion. (Angle Orthod. 2010;80:485-491.
Orthodontic Journal of Nepal
Mandibular defiiency in a Class II malocclusion is a frequently encountered condition that can be managed with myofunctional appliance in a growing child. An 11-year-old patient presented with a complaint of forwardly placed upper front teeth. The patient had a convex facial profie, acute naso-labial angle, deep mento-labial sulcus with lip trap. Clinically the patient showed positive VTO. The clinical fidings and cephalometric analysis indicated skeletal Class II jaw bases owing to prognathic maxilla and retrognathic mandible with Angle’s Class II division 1 malocclusion. CVMIshowed that the patient was in his growth phase. The treatment was done with a standard twin block appliance for 9 months followed by fied orthodontic treatment. The post functional phase showed correction of skeletal class II jaw base and marked improvement in the facial profie from convex to straight. It was later followed by fixed orthodontic treatment in the second phase upon completion of which bonded lin...
Medicina (Kaunas, Lithuania), 2005
Class II Division 1 malocclusion is the most frequent problem in the orthodontic practice. During the last ten years treatment with Twin-block functional appliance has gained popularity. The aim of the present study was to analyze the skeletal and dentoalveolar changes in Class II Division 1 malocclusions cases treated with Twin-block appliance. Cephalometric analysis of skeletal and dentoalveolar facial structures of 34 Class II Division 1 patients treated with Twin-block appliance was performed using the same reference system before and after treatment. Longitudinal growth records of persons with excellent occlusion-Bolton standards have been used for the control in order to assess natural growth. Mandibular length as measured from point Articulare to point Pogonion increased by 4.6 mm in the Twin-block group compare with 2.2 mm in the control Bolton standards group. Skeletal and dentoalveolar relationship between maxillary and mandibular bases improved significantly: ANB angle re...
2020
Treatment of Class II malocclusion with myofunctional appliances has been proven beneficial in growing patients. Twin block appliance, introduced by Clark in 1978 is most widely used myofunctional appliance. In this case report, 11 year old female patient with Class II malocclusion treated with two phase therapy. Phase I therapy involved treatment with twin block appliance to correct mandibular retrusion. Phase II involved fixed mechanotherapy to correct minor displacement and settle occlusion. Diagnosis, treatment planning, results and three year follow up are demonstrated in this case report.
The Saudi dental journal, 2018
The orthodontic management of patients with Class III malocclusion poses numerous prognostic and treatment challenges to the clinician. Various removable, orthopaedic, myofunctional and fixed appliances have been recommended for the correction of Class III malocclusion. The Reverse Twin Block (RTB) is a simple and well tolerated appliance which has often been used for the early management of such cases in mixed dentition. Cases reporting use of RTB in permanent dentition are however, limited. This article presents an insight into the encouraging results of reverse twin block (RTB) appliance used in conjunction with fixed mechanotherapy for the successful treatment of a 12-year-old patient presenting with skeletal Class III malocclusion and a concave facial profile. The RTB appliance helped establish a favourable environment for unrestricted maxillary growth, at the same time redirecting the mandibular growth to a clockwise direction and correcting the incisal relationship. The favou...
Treatment of a class II malocclusion patient with twin block appliance: a case report
International Journal of Scientific Reports, 2022
Class II malocclusions in growing patients is commonly encountered and respond well to functional appliances, provided the clinical and cephalometric findings are favourable. In case of class II hypodivergent malocclusion, the hypodivergent pattern is established early and become prominent with progression of time. These patients have significantly smaller mandibular plane angles and smaller gonial angles. This case report describes the treatment planning of a patient of age 14 years with class II malocclusion showing hypodivergent growth pattern and moderate crowding. Treatment was started with twin block functional appliance and non-extraction approach was planned. As the patient was in his peak growth spurt stage, the functional appliance therapy use at this stage was started to take advantage of that. Fixed orthodontic appliances were placed after completion of functional appliance therapy. The treatment resulted in achievement of class I molar relation bilaterally, normal overj...
Dentoskeletal effects of class II malocclusion treatment with the modified Twin Block appliance
Journal of Clinical and Experimental Dentistry, 2019
BackgroundThe purpose of this study was to prospectively assess the dentoskeletal effect of a modified Twin Block appliance for treatment of class II malocclusions.Material and MethodsLateral cephalograms of 25 Class II malocclusion patients were compared to evaluate skeletal, dentoalveolar and soft tissue changes pre- and post-treatment with a modified Twin Block appliance. A total of 33 angular and linear variables were used for analysis. The differences were calculated at the start and end of treatment. The paired T test was performed to compare the cephalometric measurements before and after treatment.ResultsCompared the pre- and post- treatment measurements, there was a significant increase in SNB (P<0.001), CO-Gn (P<0.001), ANS-Me (P=0.001), Mandibular base (P<0.001), Lower 1 to NB (°) (P=0.004), Lower 1 to NB (mm) (P<0.001), and Z-angle (P=0.001) following functional therapy with modified Twin Block appliance. On the other hand, a significant decrease was observed in ANB (P<0.001), NA-Pog (P<0.001), overjet (P<0.001), and overbite (P=0.007), Upper 1 to palatal plane (P=0.007), UL-E-line (P<0.001), LL-E-line (P=0.001), and H-angle (P=0.002) after treatment with modified Twin Block appliance.ConclusionsThe modified Twin-Block improves facial esthetics in Class II malocclusion by a combination of changes in skeletal as well as dentoalveolar structures. The increase of mandibular unit length was observed to be due to a true mandibular growth not just a repositioning of the mandible. The modified appliance, however, did not show any superior effects in terms of less dental compensation compared to the conventional Twin–Block appliance. Key words:Dentoskeletal effect, Modified Twin Block, Class II malocclusion.
Dental Journal (Majalah Kedokteran Gigi), 2017
Background: The analysis of cephalometric radiographs provides information about facial skeletal structures, jaw bone-base relationships, incisive-axial inclination relationships, soft tissue morphology, growth direction and pattern, malocclusion classification and the limitations of orthodontic treatments. In class II malocclusion, the mesiobuccal cusp of the permanent maxillary first molar rests between the first mandibular molar and the second premolar. A twin block appliance is recommended to treat Class II dentoskeletal malocclusion with retrognathic mandible characteristics. Purpose: The aim of this study was to analyze the dentoalveolar alterations in class II dentoskeletal malocclusion with retrognathic mandible characteristics after orthodontic treatment with twin block appliance based on a Steiner analysis. Methods: This research constitutes a retrospective study using secondary data derived from the lateral cephalometric radiographs of patients with Class II malocclusion ...