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Effect of Treatment with Twin-Block Appliances on Body Posture in Class II Malocclusion Subjects: A Prospective Clinical Study

Dalia Smailienė, Aistė Intienė, Irma Dobradziejutė, Gintaras Kušleika

Department of Orthodontics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania

Med Sci Monit 2017; 23:343-352

DOI: 10.12659/MSM.899088

Available online:

Published: 2017-01-20

BACKGROUND: There is strong evidence that malocclusion and body posture are interdependent. The relationship between improvement of nasopharyngeal airway, correction of malocclusion by orthodontic treatment or orthognathic surgery, and changes in body posture were evaluated in several studies. The purpose of the present study was to analyze the effect of the orthodontic treatment with Twin-block appliance on body posture.
MATERIAL AND METHODS: The study group consisted of 23 children (mean age 12.45 (1.06) years). They were orthopedically (back shape analysis) and orthodontically (cephalometric radiograph analysis) examined before the treatment with Twin-block appliance and 10-14 months after the beginning of treatment.
RESULTS: Treatment with Twin-block appliance caused mandibular protrusion as SNB increased by 0.91°, distance Ar-B increased by 4.9 mm, ANB decreased by 0.15°; and increase of face height. Oropharynx airway increased by 1.54 mm and deep pharynx airway by 1.08 mm. The decrease in kyphotic, lordotic, craniocervical angles, upper thoracic, pelvic, and trunk inclinations was found to be statistically significant. When comparing orthopedic measurements between study and control groups, no differences were detected. The control group also showed reduction of all measured angles. Although the decrease of kyphotic angle, upper thoracic inclination, trunk inclination, and craniocervical angle were more pronounced in the study group, the differences were not significant.
CONCLUSIONS: Based on these results, the body posture changes during treatment with Twin-block appliance were an expression of the physiological growth, not a response to improvement in occlusion.

Keywords: airway management, Cephalometry, Orthodontic Appliance Design