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Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
Twin block  2   /certified fixed orthodontic courses by Indian   dental academy
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Twin block 2 /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in

continuing dental education , training dentists

in all aspects of dentistry and offering a wide

range of dental certified courses in different

formats.

Indian dental academy provides dental crown &

Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit

www.indiandentalacademy.com ,or call
0091-9248678078

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  • 1. TWIN BLOCK INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com 1
  • 2. Twin block technique www.indiandentalacademy.com 2
  • 3. Twin block technique      Treatment of Class II div I. Treatment in mixed dentition. Twin block traction technique. Treatment of ant. open bite Treatment of Class II div II. www.indiandentalacademy.com 3
  • 4. Twin block technique     Treatment of Class III. Magnetic twin block Twin block for TMJ therapy. Fixed twin block. www.indiandentalacademy.com 4
  • 5. Treatment of Class II Div I Deep Bite Bite registration-Project Bite Gauge.  On an average-5-10 mm (70% protrusive path) .  Reactivation of appliance.  www.indiandentalacademy.com 5
  • 6. Treatment of Class II Div I Deep Bite Appliance design -inclined planes must be clear of the lower molars .  www.indiandentalacademy.com 6
  • 7. Treatment of Class II Div I Deep Bite  1. 2. Temporary fixation of twin block. Appliance may be fixed using cement on the tooth bearing areas. Bonded directly on clasps-esp. on deciduous molars www.indiandentalacademy.com 7
  • 8. Treatment of Class II Div I Deep Bite www.indiandentalacademy.com 8
  • 9. Treatment of Class II Div I Deep Bite Management of deep bite-this is achieved by trimming the occlusal block, so as to encourage eruption of the lower molars  Elastic separators Trimming occlusodistally www.indiandentalacademy.com 9
  • 10. Treatment of Class II Div I Deep Bite Trimming -1-2 mm /visit Molars erupt 6-9 months Triangular wedge shaped area Eruption of the pre molar www.indiandentalacademy.com 10
  • 11. Treatment of Class II Div I Deep Bite www.indiandentalacademy.com 11
  • 12. Treatment of Class II Div I Deep Bite  Intergingival height-used to establish correct vertical dimension. www.indiandentalacademy.com 12
  • 13. Treatment of Class II Div I Deep Bite   Comfort zone-17-19 mm. This is used as a guide to establish the correct vertical dimension during treatment. www.indiandentalacademy.com 13
  • 14. Treatment of Class II Div I Deep Bite Reactivation of twin block-In case of larger overjet. -Full correction not achieved with initial activation. -Growth is less favourable. -In adult treatment. -In TMJ therapy -Restricted protrusive pathway. www.indiandentalacademy.com  14
  • 15. Treatment of Class II Div I Deep Bite www.indiandentalacademy.com 15
  • 16. Treatment of Class II Div I Deep Bite   Extending the ant. incline of upper twin block Preformed inclined wedges may be used. www.indiandentalacademy.com 16
  • 17. Treatment in Mixed Dentition  Skeletal discrepancies are not delayed until the permanent dentition. 1. Prominent upper incisors. 2. Early treatment of crowding. www.indiandentalacademy.com 17
  • 18. Treatment in Mixed Dentition  Bite registration-same… Appliance design-modified to meet the requirement of mixed dentition - limited by decd. teeth - unfavourable contour  www.indiandentalacademy.com 18
  • 19. Treatment in Mixed Dentition www.indiandentalacademy.com 19
  • 20. Treatment in Mixed Dentition  1. 2.   C –clasps are commonly used – Temporary fixation. Grind retention groove. Ball end clasps Synthetic crown contours www.indiandentalacademy.com 20
  • 21. Treatment in Mixed Dentition www.indiandentalacademy.com 21
  • 22. Twin block Traction Technique   1. 2. 3. In most cases ,full functional correction can be achieved with twin block alone. In minority of the casesSevere maxillary protrusion. To control vertical growth pattern. Adult treatment. www.indiandentalacademy.com 22
  • 23. Twin block Traction Technique The Concorde Facebow-Before the dev. of twin block ,author used extraoral traction with removable appliance as means of anchorage.  -A method was developed to combine extraoral and intermaxillary traction . www.indiandentalacademy.com 23
  • 24. Twin block Traction Technique www.indiandentalacademy.com 24
  • 25. Twin block Traction Technique    The labial hook is positioned extraorally 1cm clear of the lips. Traction component are worn only at night. Careful selection of case is very essential www.indiandentalacademy.com 25
  • 26. Twin block Traction Technique   Concorde facebow helped in restricting maxillary growth, at the same time encouraged mandibular growth in combination with the functional appliance. Patient comfort and acceptance was similar to the conventional facebow. www.indiandentalacademy.com 26
  • 27. Twin block Traction Technique www.indiandentalacademy.com 27
  • 28. Twin block Traction Technique  Directional control of orthopedic force- www.indiandentalacademy.com 28
  • 29. Treatment of Ant. Open Bite     May be due to -skeletal. -soft tissue. Airway obstruction. Early treatment –helpful in controlling functional imbalance Prognosis-extent of skeletal/soft tissue - growth pattern www.indiandentalacademy.com 29
  • 30. Treatment of Ant. Open Bite  Pitfalls in Treatment – Necessary to be attentive to avoid overeruption of 2nd molars behind the appliance. www.indiandentalacademy.com 30
  • 31. Treatment of Ant. Open Bite Trimming of the upper twin block www.indiandentalacademy.com 31
  • 32. Treatment of Ant. Open Bite Bite registration-Sagittal activation-two step activation to be done in cases with increased jet. -Vertical activation-4mm interincisal clearance, so as to open bite beyond the free way space  www.indiandentalacademy.com 32
  • 33. Treatment of Ant. Open Bite Appliance design Vertical control-increase thickness of block. -occlusal rest on 2nd molars - no acrylic on ant. teeth.  www.indiandentalacademy.com 33
  • 34. Treatment of Ant. Open Bite Closing Ant. Open bite - Palatal spinner. - Tongue guard. - Labial bow.  www.indiandentalacademy.com 34
  • 35. Treatment of Ant. Open Bite www.indiandentalacademy.com 35
  • 36. Treatment of Ant. Open Bite Intra oral traction . -This may be used to accelerate bite closure-alternative to high pull headgear. -Idea was taken from Dr Mills, who used elastics to maintain occlusal contacts.  www.indiandentalacademy.com 36
  • 37. Treatment of Ant. Open Bite     Intrusive effect of the blocks is reinforced by vertical elastics. Elastics may be worn at night/full time. Additional advantage of increasing occlusal contact on the inclined planes. Magnets can also be used for the same purpose. www.indiandentalacademy.com 37
  • 38. Treatment of Ant. Open Bite www.indiandentalacademy.com 38
  • 39. Treatment of Class II Div II   Retroclined upper incisors are responsible holding the mandible. Twin block aims at unlocking the malocclusion by releasing the mandible from entrapped position. www.indiandentalacademy.com 39
  • 40. Treatment of Class II Div II Bite registration -Bite is taken with incisors in edge-edge.  -These pt. usually have a deep bite, so they require more vertical development. -However amount of sagittal advancement is limited www.indiandentalacademy.com 40
  • 41. Treatment of Class II Div II www.indiandentalacademy.com 41
  • 42. Treatment of Class II Div II www.indiandentalacademy.com 42
  • 43. Treatment of Class II Div II Appliance design Sagittal Dev.-formerly sagittal appliances were used (Witzig and Sphal 1987).  -Two sagittal screws are placed in the horizontal plane and angled along the line of buccal segment. www.indiandentalacademy.com 43
  • 44. Treatment of Class II Div II  Can be used for both upper and lower arches. www.indiandentalacademy.com 44
  • 45. Treatment of Class II Div II  Combined transverse and sagittal development www.indiandentalacademy.com 45
  • 46. Treatment of Class III  Functional correction of Class III malocclusion can be achieved by simply reversing the angulation of the inclined planes. www.indiandentalacademy.com 46
  • 47. Treatment of Class III  Bite registration- -Differs from Class II malocclusion. -2mm interincisal clearance in full retruded position. www.indiandentalacademy.com 47
  • 48. Treatment of Class III Appliance design-sagittal design is usually made. -combination of transverse and sagittal.  www.indiandentalacademy.com 48
  • 49. Treatment of Class III One important point-position of the condyles.  www.indiandentalacademy.com 49
  • 50. Treatment of Class III  Another modification-lip pads may be used to support the upper lip clear of the incisors. www.indiandentalacademy.com 50
  • 51. Treatment of Class III   Reverse pull facial mask As an additional component to advance the maxilla by elastic traction www.indiandentalacademy.com 51
  • 52. Treatment of Class III www.indiandentalacademy.com 52
  • 53. Magnetic Twin Block    Used to accelerate correction of the arch relationship. Two types-samarium cobalt. -neodynium boron. Vardimon et al 1989-90-carried out various animal experiments in mandibular advancement www.indiandentalacademy.com 53
  • 54. Magnetic Twin Block   Author modified the twin block by addition of attracting magnets . Magnets are placed on to the inclined planes. www.indiandentalacademy.com 54
  • 55. Magnetic Twin Block Attracting magnets -Increase activation - Increase frequency -Increased force of contact  Repelling magnets -Less mechanical activation. -Additional stimulus.  www.indiandentalacademy.com 55
  • 56. TMJ Therapy Case history & diagnosis-Full case history –cause and effect relationship of occlusal disharmony and mandibular displacement to pain .  - Radiographic examination of the TMJ. www.indiandentalacademy.com 56
  • 57. TMJ Therapy  - Timing of the clickEarly opening click-22mm Midopening click-22-35mm Late opening click-35mm www.indiandentalacademy.com 57
  • 58. TMJ Therapy Goals of TMJ therapy-relieve pain by distal displacement -restrain muscles to healthy pattern. -recapture disc by advancing mandible. -move teeth causing occlusal imbalance. -increase the vertical dimension.  www.indiandentalacademy.com 58
  • 59. TMJ Therapy Stages of treatmentI-sagittal development-  www.indiandentalacademy.com 59
  • 60. TMJ Therapy  II Functional repositioning Pain relieved immediately Muscles are restrained Disc is recaptured www.indiandentalacademy.com 60
  • 61. TMJ Therapy  III Vertical development Trimming the upper blocks Vertical traction Twin block biofinisher www.indiandentalacademy.com 61
  • 62. TMJ Therapy  Twin block biofinisher- www.indiandentalacademy.com 62
  • 63. TMJ Therapy www.indiandentalacademy.com 63
  • 64. Fixed Twin Blocks   1. 2. 3. Increase control by the operator Limited indicationsGrowth status of the pt. Pt. cooperation. One phase treatment is planned. www.indiandentalacademy.com 64
  • 65. Fixed Twin Blocks  1. 2. 3. Three distinct phasesFirst –arch development. Second –orthopaedic treatment with fixed functional twin block system. Third – detailed orthodontic treatment www.indiandentalacademy.com 65
  • 66. Fixed Twin Blocks Functional componentsTwin Block Transpalatal Arch www.indiandentalacademy.com 66
  • 67. Fixed Twin Blocks  Twin block lingual arch www.indiandentalacademy.com 67
  • 68. Fixed Twin Blocks  Twin Block Hyrax Appliance www.indiandentalacademy.com 68
  • 69. www.indiandentalacademy.com 69
  • 70. Fixed Twin Blocks Clinical Management & Maintenance -appliance is tried in mouth –bite is checked -Once cemented-if correct forward posture is not achieved a- lower appliance may be removed and trimmed b- provision of Class II elastics  www.indiandentalacademy.com 70
  • 71. Fixed Twin Blocks    Appointment should be after 3-4 weeks. Support phase-anterior inclined plane is constructed. -standard lower appliance Comprehensive fixed appliance phase. www.indiandentalacademy.com 71
  • 72. Fixed Twin Blocks  1. 2. 3. Some disadvantagesBlocks may become loose. Control of vertical dimension is limited. Compromised oral hygiene. www.indiandentalacademy.com 72
  • 73. 7th IOS PG conventionDr Pradip Shetey    The mandibular -first molar and adams clasp is fabricated on it. A hook is fabricated and soldered on to the adams clasp. In the maxillary arch, the elastics are engaged onto the U loop of the labial bow. A Class II elastic force in the range of 70 to 80 gms per side www.indiandentalacademy.com 73
  • 74. 7th IOS PG conventionDr Pradip Shetey 1. Posture the mandible forward even during sleep. 2.Encourages mandibular growth by stimulating the retrodiscal pad of the TM joint . (Petrovic 1977) 3.Uprights the proclined maxillary incisors in a class II div I malocclusion www.indiandentalacademy.com 74
  • 75. 7th IOS PG conventionDr Pradip Shetey 4.. Reduces the treatment time 5. Only a simple modification is required to engage the classs II elastics in comparison to the use of concorde face bow or magnets. 6. Good patient comfort and acceptance. 7. Can be used 24 hours www.indiandentalacademy.com 75
  • 76. Other Modifications www.indiandentalacademy.com 76
  • 77. Other Modifications www.indiandentalacademy.com 77
  • 78. Recent Studies www.indiandentalacademy.com 78
  • 79. The Effect of Twin blocks -David Ian et.al. AJO1998      Prospective controlled study. Sample size -36 -19 males -17 females Mean age of 12.4yrs and 0.9 yrs. Control group-27 -13 males -14 females Mean age of 12.1 yrs. www.indiandentalacademy.com 79
  • 80. The Effect of Twin blocks -David Ian et.al. AJO1998 Skeletal – -a mean forward growth /repositioning of mandible of 2.4mm. -increase in SNB. -no significant maxillary restraint. -Increase in lower ant. face height  www.indiandentalacademy.com 80
  • 81. The Effect of Twin blocks -David Ian et.al. AJO1998 Dental-overjet reduction -10.8 retroclination -7.9 proclination  -buccal segment correction. www.indiandentalacademy.com 81
  • 82. The Effect of Twin blocks -David Ian et.al. AJO1998     Very effective in reducing overjet. This mainly due to dentoalveolar effects. Significant increase in the SNB. Attempt to modify . www.indiandentalacademy.com 82
  • 83. Treatment Effects of the Twin Block Appliance: A Ceph. study   -- Christine Mills & McCulloch -AJO 1998 Clinical prospective study Purpose was to evaluate cephalometrically the treatment effects of the Twin Block appliance. www.indiandentalacademy.com 83
  • 84. Treatment Effects of the Twin Block Appliance: A Ceph. study Sample size -28 -11 boys -17 girls  Mean age was 9yrs 1 month.  The criteria for selection-skeletal class II with positive VTO. -ANB-more than 5 -full cusp Class II & end on or greater.  www.indiandentalacademy.com 84
  • 85. Treatment Effects of the Twin Block Appliance: A Ceph. study   Active treatment 6-15 months. Control group included 28 untreated persons with class II malocclusion obtained from Burlington Growth Centre at the University of Toronto. www.indiandentalacademy.com 85
  • 86. Treatment Effects of the Twin Block Appliance: A Ceph. study  - Appliance was slightly modified - Acrylic labial bow. - Elastic hooks. 31 Cephalometric variables were used 13 showed a significant differences. www.indiandentalacademy.com 86
  • 87. Treatment Effects of the Twin Block Appliance: A Ceph. study     ResultsMandibular unit length (Co-Gn)-6.5mm increase as compared to 2.3mm. Increase in the SNB by 1.9 as compared to 0.3 Headgear effect was also observed-0.9 decrease in the SNA . www.indiandentalacademy.com 87
  • 88. Treatment Effects of the Twin Block Appliance: A Ceph. study    Same was observed dentally-1mm distalization on upper molars in contrast to 0.3 mm forward migration. Lower incisors tipped 5.2 as compared to 1.4. Lower molars moved mesially 1.4 as compared to 0.2 mm mesial movement. www.indiandentalacademy.com 88
  • 89. Treatment Effects of the Twin Block Appliance: A Ceph. study    Overall reduction of overjet by 5.6mm Nearly 2/3 of it could be accounted for by the forward growth of mandible. Further follow up studies are underway to assess the long term stability . www.indiandentalacademy.com 89
  • 90. Posttreatment changes after successful correction of class II malocclusion with Twin Block    -AJO 2000 Sample size -26 sample-11 males -15 females Control group was again selected and matched for age, sex, vertical facial type. 24 out of 28 control which were used earlier. www.indiandentalacademy.com 90
  • 91. Posttreatment changes after successful correction of class II malocclusion with Twin Block     31 variables were used-25 showed statistically significant difference. Results – There was a overall increase of 6.5mm over 36 months (2mm per year). Control group showed -6.7mm over 34 months(2.4mm) www.indiandentalacademy.com 91
  • 92. Posttreatment changes after successful correction of class II malocclusion with Twin Block    The Twin Block group showed some relapse in dental changes Upper incisors uprighting 1.5 and labial proclination of 0.8 –overjet reduction of 1mm. Less mesial migration of lower molars as compared to the control group. www.indiandentalacademy.com 92
  • 93. Cephalometric evaluation of Twin Block in treatment of class II Div I malocclusion with matched normative data   -M.J.Trenouth AJO 2000 Aim-to compare ceph. changes in a group of successfully treated pt. matched for age, sex, and treatment time from published normative data. Sample -30 pts. 14 -males 16-females www.indiandentalacademy.com 93
  • 94. Cephalometric evaluation of Twin Block in treatment of class II Div I malocclusion with matched normative data Results-reduction of overjet by 7mm -significant reduction in upper incisor angulation -no significant change in lower incisor angulation.  www.indiandentalacademy.com 94
  • 95. Cephalometric evaluation of Twin Block in treatment of class II Div I malocclusion with matched normative data  Statistically significant reduction in ANB angle-mainly due to increase in SNB. www.indiandentalacademy.com 95
  • 96. Treatment timing for Twin Block therapy AJO 2000 TizianoBaccetti -Lorenzo Franchi -Linda Toth - James Mcnamara    Cephalometric study conducted to evaluate skeletal and dental changes induced by twin block with two different groups ,treated at different skeletal maturity stages. Group 1-21 –mean age 9yrs 11 months Group 2-15 –mean age 12yrs 11 months www.indiandentalacademy.com 96
  • 97. Treatment timing for Twin Block therapy AJO 2000 TizianoBaccetti -Lorenzo Franchi -Linda Toth - James Mcnamara    Group 1-peak in the growth was not achieved Group 2-during or slightly after onset of pubertal growth spurt. Results –group 2 produced more favourable results. www.indiandentalacademy.com 97
  • 98. Treatment timing for Twin Block therapy AJO 2000 TizianoBaccetti -Lorenzo Franchi -Linda Toth - James Mcnamara   Greater skeletal contribution to molar correction Lager increments in total mandibular length. www.indiandentalacademy.com 98
  • 99. Advantages of Twin Block Appliance       Comfort Esthetics Function Pt .compliance Facial appearance. Speech www.indiandentalacademy.com 99
  • 100. Advantages of Twin Block Appliance       Clinical management. Arch dev. Vertical control Facial asymmetry Safety and efficiency Age of treatment. www.indiandentalacademy.com 100
  • 101. Advantages of Twin Block Appliance   Integration with fixed appliance Treatment of temporomandibular joint dysfunction. www.indiandentalacademy.com 101
  • 102. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com 102

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