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Twin block therapy in a child with class II malocclusion and mouth breathing assisted by AI-driven software for cephalometric analysis: case report Jayanti, Claudia Nur Rizky; Primarti, Risti Saptarini
Padjadjaran Journal of Dentistry Vol 37, No 1 (2025): April 2025 (Supplements 1)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/pjd.vol37no1.59299

Abstract

Introduction: The Twin Block appliance is widely recognized as an effective treatment for Class II malocclusion in growing children. While cephalometric analysis software, including AI-based tools, is a well-established diagnostic aid, its integration into treatment planning enhances diagnostic precision and progress monitoring. This case report aims to highlight the management of a child with Class II malocclusion and mouth breathing using a Twin Block appliance, assisted by AI-driven software for cephalometric analysis to enhance treatment outcomes. Case Report: A 10-year-old boy presented with forward-positioned teeth and low self-confidence. Clinical examination revealed Class II malocclusion characterized by upper incisor protrusion and mandibular retrusion. The water-retention test confirmed mouth breathing. AI-driven cephalometric analysis using WebCeph showed an SNB angle of 75.59° and an ANB angle of 6.77°. The patient underwent nine months of Twin Block therapy with monthly adjustments. Conclusion: Twin Block therapy in this case was ineffective in achieving skeletal growth modification, likely due to factors such as treatment timing, skeletal maturity, or appliance design. AI-driven software for cephalometric analysis proved valuable for monitoring but should be viewed as a diagnostic tool rather than a determinant of treatment success.
Clear aligner versus twin block dalam perawatan maloklusi kelas II pada anak: ulasan sistematik Jayanti, Claudia Nur Rizky; Primarti, Risti Saptarini
Padjadjaran Journal of Dental Researchers and Students Vol 9, No 2 (2025): Juni 2025
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/pjdrs.v9i2.62513

Abstract

ABSTRACT Pendahuluan: Maloklusi Kelas II merupakan salah satu masalah ortodontik yang paling umum dijumpai. Dalam beberapa tahun terakhir, penggunaan aligner bening (clear aligner/CA) telah berkembang untuk menangani kasus-kasus yang lebih kompleks, termasuk maloklusi Kelas II dengan pendekatan kemajuan mandibula (CA dengan mandibular advancement/MA). Meskipun CA menawarkan alternatif modern terhadap alat fungsional tradisional, efektivitasnya dibandingkan dengan alat yang telah mapan seperti Twin Block (TB) belum diteliti secara menyeluruh. Ulasan sistematis ini bertujuan untuk membandingkan hasil perawatan dan efek dentoskeletal antara CA dengan MA dan TB dalam koreksi maloklusi Kelas II pada anak dan remaja. Metode: Kajian ini dilakukan berdasarkan pedoman Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Artikel yang diterbitkan antara tahun 2014 hingga 2024 diambil dari basis data ScienceDirect, PubMed, dan Scopus menggunakan kata kunci yang telah ditentukan sebelumnya dan kerangka kerja Population-Intervention-Comparison-Outcome (PICO). Sebanyak enam studi diikutsertakan untuk mengevaluasi efektivitas kedua modalitas perawatan dalam memperbaiki hubungan sagital rahang, kenyamanan pasien, dan dimensi jalan napas. Hasil: Hasil menunjukkan bahwa baik CA maupun TB efektif dalam meningkatkan hubungan sagital antara maksila dan mandibula. TB menunjukkan perubahan skeletal yang lebih besar, khususnya pada reposisi mandibula, sedangkan CA memberikan kenyamanan, estetika, dan tingkat kepatuhan pasien yang lebih baik. Simpulan: CA terbukti lebih efektif dalam meningkatkan dimensi jalan napas, terutama di area hipofaring. Meskipun kedua pilihan perawatan menunjukkan hasil yang menjanjikan, diperlukan uji coba terkontrol acak jangka panjang untuk mengevaluasi stabilitas dan efektivitas jangka panjangnya. Rencana perawatan sebaiknya disesuaikan dengan kebutuhan spesifik pasien, kondisi klinis, dan luaran yang diharapkan.KATA KUNCI: Alat ortodonti, Maloklusi, Angle Kelas IClear aligner versus twin block in the treatment of class II malocclusion in children: a systematic reviewABSTRACTClass II malocclusions are among the most prevalent orthodontic problems. In recent years, clear aligner (CA) therapy has expanded its scope to include more complex cases, including the clear aligner with mandibular advancement (CA with MA) for treating Class II malocclusions. While CA provides a modern alternative to traditional functional appliances, their effectiveness in comparison to well-established devices like the Twin Block (TB) has not yet been thoroughly studied. This systematic review compares the treatment outcomes and dentoskeletal effects of CA with MA and TB appliances for Class II malocclusion correction in children and adolescents. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles, which covered publications from 2014 to 2024, were taken from the databases of ScienceDirect, PubMed, and Scopus. The search used predefined keywords and a Population-Intervention-Comparison-Outcome (PICO) framework. Six studies were included, evaluating the effectiveness of both treatment modalities in improving sagittal jaw relationships, patient comfort, and airway dimensions. Both CA and TB appliances effectively enhanced the sagittal relationship between the maxilla and mandible. TB appliances showed greater skeletal changes, particularly in mandibular repositioning, while clear aligners offered superior patient comfort, aesthetics, and compliance. CA was also more effective in improving airway dimensions, particularly in the hypopharyngeal region. While both treatment options show promise, further long-term randomized controlled trials are needed to better assess their stability and effectiveness. The treatment plan should be tailored to the patient's specific needs, clinical condition, and desired outcomes.KEYWORDS: Orthodontic appliances, Malocclusion, Angle Class II