International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 17 , ISSUE 1 ( January, 2024 ) > List of Articles

ORIGINAL RESEARCH

Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study

Bhakti Halapanavar, MN Padmini, Sonali Deshmukh, Afshan S Waremani, Aniket Kasodekar

Keywords : Children, Functional therapy, Growth, PowerScope™, Skeletal, Twin block

Citation Information : Halapanavar B, Padmini M, Deshmukh S, Waremani AS, Kasodekar A. Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study. Int J Clin Pediatr Dent 2024; 17 (1):7-14.

DOI: 10.5005/jp-journals-10005-2727

License: CC BY-NC 4.0

Published Online: 14-03-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim: This current study evaluated and compared the skeletal changes in the head of the condyle, glenoid fossa, and articular space between the twin block appliance and PowerScope™ a fixed functional appliance. Materials and methods: This study was a pilot, randomized, single-blinded, assessing the skeletal changes in the components of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT). The study was conducted in 20 subjects in the age range of 11–14 years with class II division 1 malocclusion. These subjects were distributed randomly between two groups with an allocation ratio of 1:1 (group I—twin block and group I—PowerScope™). Follow-ups of both groups were done till desirable skeletal correction was attained (clinical edge-to-edge incisor relation). Results: Condylar parameters such as position, height, and length were evaluated bilaterally in the CBCT scans. After using both devices, there was an increase in all condylar qualities; however, the twin block appliance showed a more noticeable difference, which has been determined to be statistically significant. In the twin block group, there was an average decrease of 0.56 mm in the anterior articular space and an increase of 1.2 and 2.64 mm in the middle and posterior articular spaces, respectively. In the PowerScope™ group, there was an average decrease of 0.23 mm in the anterior articular space and an increase of 2.55 and 1.85 mm in the middle and posterior articular spaces, respectively. In the case of the twin block device, the change in glenoid fossa angle was observed to be 6.1 mm on both sides and a mean difference of 1.25 mm on the right-side and 1.75 mm on the left-side was observed in the case of PowerScope™. The difference was established to be significant with a p < 0.05 in all cases. Conclusion: Condylar attributes increased after the application of both devices but the difference was more pronounced in the case of twin block appliances. The difference in articular space (middle and posterior) between the twin block group and PowerScope™ group, was not significant statistically. In the present study, the remodeling in the glenoid fossa was greater in the twin block group compared to the PowerScope™ group.


HTML PDF Share
  1. Siara-Oldsa NJ, Pangrazio-Kulbershb V, Bergerc J, et al. Long-term dentoskeletal changes with the bionator, herbst, twin block, and MARA functional appliances. Angle Orthod 2010;80(1):18–29. DOI: 10.2319/020109-11.1
  2. Rabie AB, Zhao Z, Shen G, et al. Osteogenesis in the glenoid fossa in response to mandibular advancement. Am J Orthod Dentofacial Orthop 2001;119(4):390–400. DOI: 10.1067/mod.2001.112875
  3. Rabie AB, Xiong H, Hagg U. Forward mandibular positioning enhances condylar adaptation in adult rats. Eur J Orthod 2004;26(4):353–358. DOI: 10.1093/ejo/26.4.353
  4. O'Brien K, Wright J, Conboy F, et al. Effectiveness of early orthodontic treatment with the Twin-block appliance: a multicenter, randomized, controlled trial. Part 1: dental and skeletal effects. Am J Orthod Dentofacial Orthop 2003;124(3):234–243. DOI: 10.1016/S0889540603003524
  5. Cacciatore G, Ghislanzoni LT, Alvetroc L, et al. Treatment and post-treatment effects induced by the Forsus appliance - a controlled clinical study. Angle Orthod 2014;84(6):1010–1017. DOI: 10.2319/112613-867.1
  6. Papadopoulos MA. Orthodontic Treatment of Class II Malocclusion in Non-compliant Patient. China: Elsevier Publishing; 2000. p. 10–12.
  7. Kinzinger G, Ostheimer J, Förster F, et al. Development of a new fixed functional appliance for treatment of skeletal class II malocclusion – first report. J Orofac Orthop 2002;63(5):384–399. DOI: 10.1007/s00056-002-0118-1
  8. Hilgers ML, Scarfe WC, Scheetz JP, et al. Accuracy of linear temporomandibular joint measurements with cone-beam computed tomography and digital cephalometric radiography. Am J Orthod Dentofacial Orthop 2005;128(6):803–811. DOI: 10.1016/j.ajodo.2005.08.034
  9. LeCornu M, Cevidanes LH, Zhu H, et al. Three-dimensional treatment outcomes in class II patients treated with the Herbst appliance: a pilot study. Am J Orthod Dentofacial Orthop 2013;144(6):818–830. DOI: 10.1016/j.ajodo.2013.07.014
  10. Baumgaertel S, Palomo JM, Palomo L, et al. Reliability and accuracy of cone-beam computed tomography dental measurements. Am J Orthod Dentofacial Orthop 2009;136(1):19–25. DOI: 10.1016/j.ajodo.2007.09.016
  11. Wadhawan N, Kumar S, Kharbanda OP, et al. Temporomandibular joint adaptations following two-phase therapy: an MRI study. Orthod Craniofac Res 2008;11(4):235–250. DOI: 10.1111/j.1601-6343.2008.00436.x
  12. Konik M, Pancherz H, Hansen K. The mechanism of class II correction in late Herbst treatment. Am J Orthod Dentofacial Orthop 1997;112(1):87–91. DOI: 10.1016/s0889-5406(97)70278-6
  13. McNamara JA Jr. Components of class II malocclusion in children 8-10 years of age. Angle Orthod 1981;51(3):177–202. DOI: 10.1043/0003-3219(1981)051<0177:COCIMI>2.0.CO;2
  14. Baccetti T, Franchi L, Toth LR, et al. Treatment timing for twin block therapy. Am J Orthod Dentofacial Orthop 2000;118(2):159–170. DOI: 10.1067/mod.2000.105571
  15. Ruf S, Pancherz H. Temporomandibular joint growth adaptation in Herbst treatment: a prospective magnetic resonance imaging and cephalometric roentgenographic study. Eur J Orthod 1998;20(4):375–386. DOI: 10.1093/ejo/20.4.375
  16. Ruf S, Baltromejus S, Pancherz H. Effective condylar growth and chin position changes in activator treatment: a cephalometric roentgenographic study. Angle Orthod 2001;71(1):4–11. DOI: 10.1043/0003-3219(2001)071<0004:ECGACP>2.0.CO;2
  17. Arici S, Akan H, Yakubov K, et al. Effects of fixed functional appliance treatment on the temporomandibular joint. Am J Orthod DentofacialOrthop 2008;133(6):809–814. DOI: 10.1016/j.ajodo.2006.07.035
  18. Zymperdikas VF, Koretsi V, Papageorgiou SN, et al. Treatment effects of fixed functional appliances in patients with class II malocclusion: a systematic review and meta-analysis. Eur J Orthod 2016;38(2):113–126. DOI: 10.1093/ejo/cjv034
  19. Servello DF, Fallis DW, Alvetro L. Analysis of class II patients, successfully treated with the straight-wire and Forsus appliances, based on cervical vertebral maturation status. Angle Orthod 2015;85(1):80–86. DOI: 10.2319/102513-780.1
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.