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TREATMENT OF CLASS II DIVISION I MALOCCLUSION WITH TWIN BLOK APPLINCE USING PHYSIOLOGICAL MATURATION INDICATORS DURING THE MIXED DENTITION PHASE

TREATMENT OF CLASS II DIVISION I MALOCCLUSION WITH TWIN BLOK APPLINCE USING PHYSIOLOGICAL MATURATION INDICATORS DURING THE MIXED DENTITION PHASE
Willem Santana, Endah Mardiati
Majalah Ortodonti
Indonesia
Willem Santana, Endah Mardiati, Majalah Ortodonti
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Background :Dentoskeletal Class II division 1 malocclusion can be found in adult and growth development patients. In addition to curative orthodontic treatment in adult patient, interseptive orthodontic treatment is very useful in modificating and guiding the growth and development pattern in growth and development patient with Class II division I malocclusion. Twin Block functional appliance is used to push the mandible down and forward. Physiological maturation indicators support the diagnose and treatment planning of growth modification patient. Purpose of this case report is to correct convex profile of the patient by pushing the mandible forward and achieve class I molar relationship.Case management:Male patient aged 11 years and 5 monthsdiagnosed with dentoskeletal Class II malocclusion caused by retrognatic mandible (<SNB : 74°), chin retrusion, convex facial profile, open lips relation, i-NA protrusive (7 mm), i-NB protrusive (7 mm), interinsical angle protrusive (<i-i 114°), mandibular plane-FHP high angle, lower face height longer, overjet 9 mm, overbite 6 mm, midline diastema 1 mm, upper midline shift to left 1 mm, anterior deepbite, molar relationship class II, canine relationship class II. Hand-wrist analysis shows MP5 (stage 3 Fishman), mean age Indonesian children 10,40 ± 0,74 years. Cervical vertebral analysis (CVMI) shows second stage, mean age Indonesian children 10,61 ± 0,98 age. Base on analysis above, patient was treated with twin block appliance to move mandible forward to create molar relationship class I. Treatment result: in 1 year and 2 months shows right molar relationship class I, left molar relationship cusp to cusp, right canine relationship class I, left canine relationship class II, overjet 4 mm. Conclusion :There are good response in growth modification treatment in growth patient.