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Class II Division 1 Adolescent Treatment with Twin Block and Fixed Orthodontic Appliances: 3-Dimensional Changes of the Temporomandibular Joint
1Postgraduate Orthodontic Program, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, Ariz, USA
2Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
3Department of Orthodontics, School of Dentistry, University of Wonkwang, Iksan, Korea
4Division of Orthodontics, The Dental University Hospital, Tokyo, Japan
5Department of Orthodontics, Seoul National University Gwan-ak Dental Hospital, Seoul, Korea
6Department of Orthodontics, School of Dentistry, University of Wonkwang, Wonkwang Dental Research Institute, Iksan, Korea
*Corresponding Author(s): Jong-Moon Chae E-mail: jongmoon@wku.ac.kr
Introduction: Skeletal Class II division 1 malocclusions with a retrognathic mandible can be treated with Twin Block and fixed orthodontic appliances in growing adolescent patients. Objective: The aim of this case report was to show successful treatment results following step-by-step procedures determined by visualizing the changes of the temporomandibular joint (TMJ) area using cone-beam computed tomography (CBCT) images. Case report: A 10-year, 8-month-old female adolescent with skeletal Class II division 1 (ANB, 6.2°), severe overjet (8.4 mm), and overbite (7.8 mm) was treated with Twin Block and fixed orthodontic appliances. After wearing an active plate for 4 months, a Twin Block appliance for 9 months, a retainer with an inclined plane for 13 months, and fixed orthodontic treatment for 17 months, her skeletal Class II was corrected. After 39 months of posttreatment retention, good treatment results were maintained with favorable occlusion and facial balance. Acceptable 3-dimensional changes of the TMJ area were identified using cone-beam computed tomography images. Conclusion: A female adolescent patient with skeletal Class II division 1 malocclusion, severe overjet and overbite, and mandibular retrusion was treated using Twin Block and fixed orthodontic appliances. Acceptable 3-dimensional changes in the TMJ area and 2-dimensional growth of the mandible were identified using CBCT and cephalometric images.
Twin Block appliance; Temporomandibular joint; Cone-beam computed tomography
Jae Hyun Park,Youngjoo Lee,Kyosuke Mizutani,Mi-Young Lee,Jong-Moon Chae. Class II Division 1 Adolescent Treatment with Twin Block and Fixed Orthodontic Appliances: 3-Dimensional Changes of the Temporomandibular Joint. Journal of Clinical Pediatric Dentistry. 2022. 46(4);321-329.
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