1.Skeletal Class II Malocclusion Treatment with Combined Twin Block and Lip Bumper Appliances: A Case Report
Hilda Fitria Lubis ; Nurhayati Harahap ; Ananda Permata Sari
Archives of Orofacial Sciences 2021;16(SUPP 1):51-57
ABSTRACT
Functional appliances have been used over a century in clinical orthodontic treatments for skeletal
Class II malocclusion patients. Its popularity is attributed to its high patient adaptability and ability to
produce rapid treatment changes. The twin block and lip bumper can be combined depending on the
patient’s cases. The purpose of therapy with twin block is effective in mandibular growth deficiencies
to induce supplementary lengthening of mandibular by stimulating increased growth at the condylar
cartilage. The patient was a ten-year-old male patient with skeletal Class II malocclusion. He had a
convex facial profile, SNA (sella, nasion, A point) angle of 77.5°, SNB (sella, nasion, B point) angle of
73.0°, ANB (A point, nasion, B point) angle of 4.5°, overjet of 6.5 mm, overbite of 11/41 = 5.0 mm,
21/31 = 4.5 mm, abnormal upper labial frenulum, crossbite in the second left premolar of maxilla,
crowded anterior teeth of mandibular, deficiency of mandibular growth, lower lip sucking habit, anterior
teeth of maxilla with diastema and proclination. Orthodontic treatment for patient is a combination of
twin block and lip bumper appliances. After seven months, frenectomy is used to eliminate and correct
the spacing in the frenulum. After 10 months, the patient’s skeletal and profile had improved to skeletal
Class I malocclusion, SNA angle of 78.0°, SNB angle of 75.0°, ANB angle of 3.0°, overbite and overjet
of 4.0 mm, and the lower lip sucking habit had stopped. Twin block and lip bumper appliances are
particularly good alternative treatment in managing selected cases of skeletal Class II malocclusion.
Malocclusion, Angle Class II