An overjet reduction of class II,division 1 malocclusion in twin block dentofacial orthopedic and fixed orthodontic treatment: Case report

Dentofacial orthopedic treatment is a management of imbalance muscle and skeletal disproportion with functional orthopedic appliances. functional appliances were developed to correct muscle deviation and jaw relationship to attain facial balance through functional repair of muscle and bone. to obtain more optimal and effective improvements in muscle and bone functions,a combination of fixed appliance and functional appliance treatment is necessary. overjet refers to a horizontal relationship between maxillary and mandibular incisors. normal range of overjet is 2-4 mm. some clinical problems due to increased overjet were injury of maxillary permanent incisors during growth ages,periodontal destruction,difficulty with normal lip closure,and social influences such as lack of confidence for a child. management of increased overjet depends on some factors related to skeletal pattern and soft tissue,as well as patient's age. one of effective appliances in reducing overjet of class ii malocclusion treatment is a functional twin block appliance. twin block appliance is worn by growth age children for certain periods to allow mandibular movement,easy to wear,and patient will be cooperative. an optimal treatment depends on the compliance of each patient. this appliance is made up with 700 of tilt angulation to occlusal plane. lateral expansion of maxilla is obtained through expansion screw. patient should be instructed to wear this appliance for 24 hours a day. in this case report,a 10-year-6-month old male patient with 13 mm overjet treated with twin block appliance and followed by fixed orthodontic appliance to correct his teeth position and occlusion. the use of twin block appliance indicated a reduced overjet into 4 mm in 11 months of treatment periods. early treatment of this case was effectively resulted in overjet reduction,change of skeletal pattern,and improvement of patient's psychology related to self-confidence with significantly aesthetic repair of patient's face.