| Abstract | Twin block je novija miofunkcionalna ortodontska naprava koja se koristi u korekciji malokluzija klase II/1. Učinak naprave procjenjuje se rengentskom kefalometrijom na latero-lateralnim (LL) kefalogramima.
Cilj istraživanja bio je utvrditi učinak twin blocka na dentoalveolarne, skeletne i mekotkivne orofacijalne strukture.
Istraživanje je bilo prospektivno, a praćeno je 60 ispitanika dobi 9-15 godina, kod kojih je intraoralno dijagnosticirana klasa II/1. Od terapije je odustalo 42 ispitanika, a na preostalih 18 (medijan dobi 11 godina, interkvartilni raspon 10-12) je analiziran učinak twin blocka usporedbom latero-lateralnih kefalograma prije terapije i nakon postizanja pregriza od 3 mm.
Praćeno je ukupno 38 parametara koji se odnose na dentoalveolarne, skeletne i mekotkivne orofacijalne strukture.
Tijekom terapije mandibula je više bila stimulirana u rastu nego što je maksila bila kočena (co-gn za 4,9 mm, r=0,88; p=0,001 vs. co-A za 2,1mm, r=0,59; p=0,007). Korekcija sagitalne skeletne klase bila je statistički značajna (Wits za 1,7mm, r=0,76mm; p<0,001; ANB za 0,94˚, r=0,59; p=0,008). Utjecaj na vertikalni rast lica nije bio značajan. Twin block je značajno retrudirao gornje incizive u odnosu na bazu maksile za 7,7˚ (r=0,86;p=0,001).
U domeni profila mekih struktura naprava je djelovala samo na smanjenje protruzije gornje usnice (Ls-E za 1,7mm, r=0,65; p=0,003).
Naprava twin block u terapiji malokluzija klase II/1 producira izraziti dentoalveolarni učinak vidljiv u retruziji protrudiranih gornjih inciziva koji se odražava i na retruziju gornje usnice.
Skeletni učinak je manje izražen na kočenje rasta maksile nego na poticanje rasta mandibule. |
| Abstract (english) | Twin block is one of the newest myofunctional orthodontic appliances used for the correction of malocclusions class II division 1. The effect of appliance is estimated by rtg cephalometry using latero-lateral (LL) cephalograms.
The aim of this study was to explore the effect of TB on dentoalveolar, skeletal and soft tissue orofacial structures.
The study was prospective, and 60 patients aged 9-15 with intraoral diagnosis class II division 1, were followed. As 42 respondents dropped out of therapy we analyzed the effect of twin block on the remaining 18 patients (median age 11 years, interquartile range 10-12), comparing latero-lateral cephalograms before treatment and after reaching an overbite of 3 mm. The study included a total of 38 parameters relating to dentoalveolar, skeletal and soft tissue orofacial structures.
During the therapy the mandible was stimulated to grow more than the growth of the maxilla was slowed down (Co-Gn for 4.9 mm, r = 0.88, p = 0.001 vs. Co-A for 2.1 mm, r = 0.59; p=0.007). Correction of the sagittal skeletal class was statistically significant (Wits for 1.7 mm, r = 0.76 mm, p <0.001; ANB to 0.94°, r = 0.59, p = 0.008). Impact on the vertical facial growth was not significant. Twin Block significantly caused retrusion of the upper incisors in relation to the base of the maxilla to 7.7˚ (r = 0.86, p = 0.001). In the domain of soft structures, the appliance only caused reduction of the protruted upper lip (Ls-E for 1.7 mm, r = 0.65, p = 0.003).
Twin block appliance used for the correction of malloclusions of class II division 1, causes significant retrusion of the upper incisors which is also reflected in the retrusion of the upper lip. Skeletal effect is less pronounced at inhibiting the growth of the maxilla than in encouraging the growth of the mandible. |
