Sawant Hitesh R, Jawdekar Ashwin M, Gangurde Parag V, Dhone Swati A
Department of Orthodontics and Dentofacial Orthopedics, Bharati Vidyapeeth (Deemed to be University), Dental College and Hospital, Navi, Mumbai, Maharashtra, India.
Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth (Deemed to be University), Dental College and Hospital, Navi, Mumbai, Maharashtra, India.
Int J Clin Pediatr Dent. 2024 Oct;17(10):1181-1188. doi: 10.5005/jp-journals-10005-2970.
An 11-year-old female patient with developing class II division 1 malocclusion having retrognathic mandible and crowding in the lower arch, horizontal growth pattern, with convex profile, hyperactive mentalis muscle, positive visual treatment objective (VTO) in cervical vertebral maturation indicator (CVMI) stage 4 was planned to be treated using modification of conventional twin block appliance. Though a wide variety of myofunctional appliances like activator, Bionator, and Frankel appliances can be delivered to the patient, twin block appliance being a mechanofunctional appliance is routinely preferred by operators due to simplicity of its design and construction in comparison to other appliances. One of the biggest challenges in management of growing patients with skeletal class II malocclusion is the compliance of patients in wearing the myofunctional appliances. Also, the wire framework of most of these functional appliances evokes stigma in young children due to peer pressure. An appliance that eliminates this wire framework can help to increase the duration of wear. Since twin block appliance is the most preferred myofunctional appliance by most of the operators, an attempt was made to make it more convenient to the patient by simplifying its design, especially in regards to the elimination of delta clasps and labial bow framework. Delta clasps were replaced by composite buttons bonded to buccal surface of mandibular first premolar and maxillary first molar. Labial bow framework was eliminated by inducing full coverage of teeth using Essix thermoformed sheets. It was observed that the elimination of the wire framework indeed helped increase the compliance of the patient. Thus, exercises combined with myofunctional appliance therapy helped correct the developing class II division 1 malocclusion prior to fixed mechanotherapy. In conclusion, thorough planning and meticulous execution of E-twin block therapy can achieve correction of developing class II division 1 malocclusion.
Sawant HR, Jawdekar AM, Gangurde PV, Esthetic Twin Block Approach for Correction of Developing Class II Division 1 Malocclusion of an 11-year-old Female Patient: A Case Report. Int J Clin Pediatr Dent 2024;17(10):1181-1188.
一名11岁女性患者，患有正在发展的安氏II类1分类错牙合，下颌后缩，下牙弓拥挤，水平生长型，侧面凸，颏肌亢进，颈椎成熟指标（CVMI）处于4期时视觉治疗目标（VTO）为阳性，计划采用改良传统双阻板矫治器进行治疗。虽然可以为患者提供多种肌功能矫治器，如肌激动器、生物调节器和Frankel矫治器，但双阻板矫治器作为一种机械-功能矫治器，由于其设计和构造比其他矫治器更简单，因此临床医生通常更倾向使用。在治疗生长发育期的安氏II类骨性错牙合患者时，最大的挑战之一是患者佩戴肌功能矫治器的依从性。此外，由于同伴压力，这些功能性矫治器中的大多数钢丝框架会让年幼的孩子感到羞耻。一种消除这种钢丝框架的矫治器有助于增加佩戴时间。由于双阻板矫治器是大多数临床医生最青睐的肌功能矫治器，因此尝试通过简化其设计，特别是消除三角卡环和唇弓框架，使其对患者更方便。三角卡环被粘结在下颌第一前磨牙和上颌第一磨牙颊面的复合纽扣所取代。通过使用Essix热成型片材实现牙齿的全覆盖，从而消除了唇弓框架。观察到消除钢丝框架确实有助于提高患者的依从性。因此，运动与肌功能矫治器治疗相结合有助于在固定机械治疗之前纠正正在发展的安氏II类1分类错牙合。总之，精心规划和细致执行E型双阻板治疗可以实现对正在发展的安氏II类1分类错牙合的矫治。
萨万特HR，贾德卡尔AM，甘古德PV，《11岁女性患者正在发展的安氏II类1分类错牙合矫治的美学双阻板方法：病例报告》。《国际临床儿科牙科学杂志》2024；17（10）：1181 - 1188。
