Evaluation of Changes in Extraction and Non-Extraction Treatments after Twin-Block

Year 2022, Volume: 9 Issue: 1, 100 - 110, 27.04.2022

Esra Ulusoy Mutluol , Zehra İleri , Mehmet Akın

https://doi.org/10.15311/selcukdentj.980437

Abstract

Background: The purpose of this investigation was to evaluate and compare the changes due to extraction and non-extraction treatments after twin-block therapy.
Methods: Forty Class II division 1, mandibular retrognathic patients were included in the study. Group I comprised 14 girls and 6 boys who has the indication of mandibular premolar extraction after twin-block therapy. Group II comprised 12 girls and 8 boys treated with twin-block appliance and fixed orthodontic therapy without extraction. Lateral cephalometric radiographs were obtained from the patients at the onset of the treatment (T1), at the end of the use of the twin-block appliance (T2) and at the end of active treatment (T3). The Paired Sample t test and Independent Sample t test was used for statistical analyses.
Results: After twin-block therapy, SNB and lower incisor angles increased in both groups while ANB and convexity decreased. In the extraction group, lower lip moved backwards, upper and lower incisors were retracted during the T2-T3 period. In the non-extraction group, only the lower lip vertical length increased. Significant differences were found between the two groups in terms of changes in lower and upper incisor positions/inclinations and lower lip thickness in T2-T3 period (p <0.05).
Conclusion: Even though extraction and non-extraction treatments after twin-block make a difference in the final lower and upper incisor positions and inclinations, they do not create a significant difference in terms of their effects on soft tissues.

Keywords

Extraction Treatments,, Soft Tissue,

Twin-Blok Sonrasında Yapılan Çekimli ve Çekimsiz Tedavilerle Oluşan Değişimlerin Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, twin-blok apareyinin ve sonrasında yapılan çekimli ve çekimsiz tedavilerin sert doku, yumuşak doku ve keser eğimleri üzerinde meydana getirdiği değişimleri değerlendirmek ve karşılaştırmaktır.
Gereç ve Yöntem: Çalışmamıza alt çene geriliği olan 40 Sınıf II bölüm 1 maloklüzyonlu hasta dahil edilmiştir. Grup I, twin-blok tedavisi sonrası çift taraflı alt birinci küçük azı dişi çekimi endikasyonu konulan 14 kız ve 6 erkek (ortalama yaş: 12,21± 1,12) hastadan oluşmuştur. Grup II, twin-blok tedavisi ve çekimsiz sabit tedavi gören 12 kız ve 8 erkek (ortalama yaş= 13.32± 1,02) hastadan oluşmuştur. Hastalardan tedavi başında (T1), twin-blok sonrasında (T2) ve tedavi sonunda (T3) lateral sefalometrik röntgenler alınmıştır. Röntgenler üzerinde sert doku, yumuşak doku ve keser konumları/eğimleri ile ilgili açısal ve çizgisel ölçümler yapılmıştır. İstatistiksel analiz için bağımsız t testi ve eşleştirilmiş t testi kullanılmıştır.
Bulgular: Twin-blok ile her iki grupta SNB ve alt keser açıları artarken, ANB ve konveksite azalmıştır. Çekimli grupta T2-T3 döneminde alt ve üst keserler retrakte olmuştur ve alt dudak geri gitmiştir. Çekimsiz grupta ise sadece alt dudak vertikal uzunluğu artmıştır. İki grup arasında T2-T3 döneminde alt ve üst keser konum ve eğimleri ile alt dudak kalınlığında oluşan değişimler açısından önemli fark saptanmıştır (p<0,05).
Sonuç: Twin-blok sonrası planlanan çekimli ve çekimsiz tedaviler nihai alt ve üst keser konum ve eğimleri açısından bir farklılık oluştursa bile yumuşak doku üzerine olan etkileri açısından önemli bir faklılık yaratmamaktadır.

Keywords

Çekimli Tedavi,, Twin Blok,, Yumuşak Doku

References

• 1. Başçiftçi FA, Demir A, Sarı Z, Uysal T. Konya yöresi okul çocuklarında ortodontik maloklüzyonların prevelansının araştırılması: Epidemiyolojik çalışma. Turkish Journal of Orthodontics 2002; 15: 92-8.
• 2. Keeling SD, Wheeler TT, King GJ, Garvan CW, Cohen DA, Cabassa S et al. Anteroposterior skeletal and dental changes after early Class II treatment with bionators and headgear. Am J Orthod Dentofacial Orthop 1998; 113(1): 40-50.
• 3. Clark W, The twin block technique A functional orthopedic appliance system. Am J Orthod Dentofacial Orthop 1988; 93(1): 1-18.
• 4. Chadwick SM, Banks P, Wright JL. The use of myofunctional appliances in the UK: a survey of British orthodontists. Dental update 1998; 25(7): 302- 08.
• 5. Basciftci FA, Akin M, Ileri Z, Bayram S. Long-term stability of dentoalveolar, skeletal, and soft tissue changes after non-extraction treatment with a self-ligating system. The Korean Journal of Orthodontics 2014; 44(3): 119-27.
• 6. Khan M. and Fida M, Soft tissue profile response in extraction versus non-extraction orthodontic treatment. J Coll Physicians Surg Pak 2010; 20(7): 454.
• 7. Lim HJ, Ko KT, Hwang HS. Esthetic impact of premolar extraction and nonextraction treatments on Korean borderline patients. Am J Orthod Dentofacial Orthop 2008; 133(4): 524-31.
• 8. Yashwant VA, Arumugam E. Comparative evaluation of soft tissue changes in Class I borderline patients treated with extraction and nonextraction modalities. Dental Press J Orthod 2016;21: 50-9.
• 9. Sidlauskas A. The effects of the Twin-block appliance treatment on the skeletal and dentolaveolar changes in Class II Division 1 malocclusion. Medicina (Kaunas), 2005; 41(5): 392-400.
• 10. Baysal A and Uysal T, Soft tissue effects of Twin Block and Herbst appliances in patients with Class II division 1 mandibular retrognathy. Eur J Orthod 2013; 35(1): 71-81.
• 11. Lee R, Kyi C, Mack G. A controlled clinical trial of the effects of the Twin Block and Dynamax appliances on the hard and soft tissues. Eur J Orthod 2007; 29(3): 272-82.
• 12. Varlık SK, Gültan A, Tümer N. Comparison of the effects of Twin Block and activator treatment on the soft tissue profile. Eur J Orthod 2008; 30(2): 128-34.
• 13. Sharma AA, Lee RT. Prospective clinical trial comparing the effects of conventional Twin-block and mini-block appliances: Part 2. Soft tissue changes. Am J Orthod Dentofacial Orthop 2005; 127(4): 473-82.
• 14. Trenouth M. Cephalometric evaluation of the Twin-block appliance in the treatment of Class II Division 1 malocclusion with matched normative growth data. Am J Orthod Dentofacial Orthop 2000; 117(1):54-9.
• 15. Mills CM, McCulloch KJ.Treatment effects of the twin block appliance: a cephalometric study. Am J Orthod Dentofacial Orthop 1998; 114(1): 15-24.
• 16. Tümer N, Gültan AS. Comparison of the effects of monoblock and twin-block appliances on the skeletal and dentoalveolar structures. Am J Orthod Dentofacial Orthop 1999; 116(4): 460-68.
• 17. Toth LR, McNamara Jr JA. Treatment effects produced by the Twin-block appliance and the FR-2 appliance of Fränkel compared with an untreated Class II sample. Am J Orthod Dentofacial Orthop 1999; 116(6): 597-09.
• 18. Lund DI, Sandler PJ. The effects of Twin Blocks: a prospective controlled study. Am J Orthod Dentofacial Orthop 1998; 113(1): 104-10.
• 19. Illing HM, Morris DO, Lee RT. A prospective evaluation of Bass, Bionator and Twin Block appliances. Part I-The hard tissues. Eur J Orthod 1998; 20(5): 501-16.
• 20. Baccetti T, Franchi L, Toth LR, McNamara Jr JA. Treatment timing for Twin-block therapy. American Journal of Orthodontics and Dentofacial Orthopedics 2000; 118(2): 159-70.
• 21. Björk A. Timing of interceptive orthodontic measures based on stages of maturation. Transactions. Eur J Orthod 1972; 61-74.
• 22. Clark W, Clark WJ. Twin block functional therapy. 2014; JP Medical Ltd.
• 23. Mills CM, McCulloch KJ. Posttreatment changes after successful correction of Class II malocclusions with the twin block appliance. Am J Orthod Dentofacial Orthop 2000; 118(1): 24-33.
• 24. Gögen H, Parlar S. Evaluation of facial profile changes in individuals with skeletal Class II anomaly treated with activator and activator+ occipital headgear. Turk J Orthod 1989; 2(2): 299-06.
• 25. Cura N, Saraç M, Öztürk Y, Sürmeli N. Orthodontic and orthopedic effects of activator, activator-HG combination, and Bass appliances: a comparative study. Am J Orthod Dentofacial Orthop 1996; 110(1): 36-45.
• 26. Holdaway RA. A soft-tissue cephalometric analysis and its use in orthodontic treatment planning. Part I. Am J Orthod 1983; 84(1): 1-28.
• 27. Morris DO, Illing HM, Lee RT. A prospective evaluation of Bass, Bionator and Twin Block appliances. Eur J Orthod 1998; 20(6): 663-84.
• 28. Quintão C, Helena I, Brunharo VP, Menezes RC, Almeida MA. Soft tissue facial profile changes following functional appliance therapy. Eur J Orthod 2006; 28(1), 35-41.
• 29. Fränkel R. The treatment of Class II, Division 1 malocclusion with functional correctors. Am J Orthod 1969; 55(3): 265-75.
• 30. Kocadereli I. Changes in soft tissue profile after orthodontic treatment with and without extractions. Am J Orthod Dentofacial Orthop 2002; 122(1): 67-72.
• 31. Ayhan Basciftci F, Uysal T, Buyukerkmen A, Demir A. The influence of extraction treatment on Holdaway soft-tissue measurements. Angle Orthod 2004; 74(2), 167-73.
• 32. Erdinc AE, Nanda RS, Dandajena TC. Profile changes of patients treated with and without premolar extractions. Am J Orthod Dentofacial Orthop 2007; 132(3): 324-31.
• 33. Iared W, da Silva EMK, Iared W, Macedo CR. Esthetic perception of changes in facial profile resulting from orthodontic treatment with extraction of premolars: a systematic review. The Journal of the American Dental Association 2017; 148(1), 9-16.
• 34. Bravo LA. Soft tissue facial profile changes after orthodontic treatment with four premolars extracted. Angle Orthod 1994; 64(1): 31-42.
• 35. Zierhut EC, Joondeph DR, Artun J, Little RM. Long-term profile changes associated with successfully treated extraction and nonextraction Class II Division 1 malocclusions. The Angle Orthodontist 2000; 70(3), 208-19.
• 36. Germeç. Erişkin borderline olgularda çekimli ve aeretor stripping ile çekimsiz tedavinin fasiyal estetiğe etkilerinin değerlendirilmesi. [Tez]. Ankara: Hacettepe Üniversitesi; 2005.
• 37. Ismail S, Moss J, The three-dimensional effects of orthodontic treatment on the facial soft tissues–a preliminary study. British dental journal, 2002; 192(2): 104-08.
• 38. Basciftci FA, Usumez S. Effects of extraction and nonextraction treatment on class I and class II subjects. Angle Orthod 2003; 73(1): 36-42.