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Three-dimensional skeletal, dentoalveolar and temporomandibular joint changes produced by Twin Block functional appliance

Dreidimensionale skelettale, dentoalveoläre und temporomandibuläre Gelenkveränderungen nach Behandlung mit der Twin-Block-Apparatur

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Abstract

Introduction

The aim of this study was to three-dimensionally analyze the net skeletal, dental, and temporomandibular joint (TMJ) treatment changes using Twin Block functional therapy in comparison to untreated subjects.

Materials and methods

The study (Twin Block) group comprised 22 female patients with skeletal Class II malocclusion due to mandibular retrusion. A total of 18 skeletal Class II untreated female subjects were included as controls. Skeletal, dental, and TMJ changes were evaluated using pre- and posttreatment/observational by cone beam computed tomography (CBCT) images. The treatment changes were compared with the growth changes observed in the control group using independent t‑tests.

Results

Compared to the changes induced by normal growth, the effective mandibular length, ramus, and corpus lengths increased by 3.19, 3.47, and 2.69 mm (P < 0.001 for all), respectively. The maxillary and mandibular incisors inclination and position were significantly reduced and increased, respectively (P < 0.001). The maxillary first molars were significantly moved distally and intruded by 1 and 0.36 mm, respectively, while the lower first molars moved mesially and intruded by 2.18 and 0.59 mm, respectively. There was a significant change in the condylar dimensions: increase in length, width, and height by 1.28, 0.88, 1.59 on the right and by 1.60, 0.53, and 1.10 mm on the left sides, respectively. There was significant forward positioning of the right and left condyle by 1.5 and 1.3 mm, respectively.

Conclusions

Treatment with the Twin Block functional appliance results in significant skeletal, dentoalveolar, and condylar changes in both dimensions and positions.

Zusammenfassung

Einleitung

Ziel der Studie war die Untersuchung skelettaler, dentaler und temporomandibulärer Veränderungen nach einer Twin-Block-Therapie im Vergleich mit einer unbehandelten Kontrollgruppe.

Material und Methoden

Die Interventionsgruppe (Twin Block) umfasste 22 Patientinnen mit skelettaler Klasse-II-Malokklusion und Unterkieferrücklage. 18 unbehandelte Klasse-II-Patientinnen dienten als Kontrollgruppe. Skelettale, dentale und temporomandibuläre Veränderungen wurden anhand von DVT-Aufnahmen evaluiert, die vor und nach Behandlung bzw. während der Behandlung angefertigt worden waren. Mittels t‑Tests für unabhängige Stichproben wurden die behandlungs- bzw. die wachstumsbedingten Veränderungen in der Interventions- und der Kontrollgruppe miteinander verglichen.

Ergebnisse

Im Vergleich mit den Veränderungen, die sich wachstumsbedingt ergeben haben, erhöhten sich die effektive Unterkieferlänge sowie die Längen von Ramus und Corpus mandibulae um 3,19, 3,47 bzw. 2,69 mm (p < 0,001 für alle). Inklination und Position der Oberkieferinzisivi verringerten sich signifikant (p < 0,001), Inklination und Position der Unterkieferinzisivi erhöhten sich dagegen signifikant (p < 0,001). Die ersten Molaren im Oberkiefer wurden signifikant um 1,0 bzw. 0,36 mm distalisiert und intrudiert, während die unteren ersten Molaren um 2,18 bzw. 0,59 mm mesialiert und intrudiert wurden. Es gab signifikante Veränderungen an den Kondylen: Länge, Breite und Höhe vergrößerten sich um 1,28, 0,88 bzw. 1,59 auf der rechten und um 1,60, 0,53 bzw. 1,10 mm auf der linken Seite. Auf beiden Seiten kam es zu einer signifikanten Vorverlagerung der Kondylen um 1,5 (rechts) bzw. 1,3 mm (links).

Schlussfolgerungen

Die Behandlung mit einem Twin-Block-Funktionsgerät führte zu signifikanten skelettalen, dentoalveolären und temporomandibulären Veränderungen.

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Authors and Affiliations

  1. Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Minia University, Minia, Egypt

    Hanem Younes Elfeky

  2. Department of Orthodontics and Dentofacial Orthopedics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt

    Mona Salah Fayed,  Sanaa Abou Zeid Soliman &  Dalia Mohamed El Boghdadi

  3. Department of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Jazan University, Jazan, Saudi Arabia

    Maged Sultan Alhammadi

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  1. Hanem Younes Elfeky
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  2. Mona Salah Fayed
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  3. Maged Sultan Alhammadi
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  4. Sanaa Abou Zeid Soliman
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  5. Dalia Mohamed El Boghdadi
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Correspondence to Maged Sultan Alhammadi.

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Conflict of interest

H.Y. Elfeky, M.S. Fayed, M.S. Alhammadi, S.A.Z. Soliman and D.M. El Boghdadi declare that they have no competing interests.

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Elfeky, H.Y., Fayed, M.S., Alhammadi, M.S. et al. Three-dimensional skeletal, dentoalveolar and temporomandibular joint changes produced by Twin Block functional appliance. J Orofac Orthop 79, 245–258 (2018). https://doi.org/10.1007/s00056-018-0137-1

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  • DOI: https://doi.org/10.1007/s00056-018-0137-1

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