Posttreatment changes after successful correction of Class II malocclusions with the twin block appliance

This investigation is a continuation of a previously published study assessing the treatment effects of the Twin Block appliance. All active treatment was carried out during the mixed dentition stage (mean starting age, 9 years 1 month) with final follow-up for the treatment group occurring in the permanent dentition (mean age, 13 years 1 month). Of the original group consisting of 28 consecutively treated severe skeletal Class II patients, 26 were available for follow-up. A comparison group of 28 untreated Class II subjects matched for age, sex, and vertical facial type was obtained from the Burlington Growth Centre according to the original study design. Of these 28 control subjects, 24 had 4-year follow-up cephalometric films available. The mean age of the controls was 12 years 11 months at the time of follow-up. During the active treatment phase, the Twin Block group experienced an average increase in mandibular unit length of 6.5 mm over a mean of 14 months (annualized rate of change of 5.6 mm per year). In comparison, the control group experienced a 2.3 mm increase in mandibular unit length during the 13-month observation period (annualized rate of 2.1 mm per year). In the posttreatment phase, the change in mandibular unit length for the Twin Block group was 6.0 mm over a 36-month period (annualized rate of change of 2.0 mm per year). The control group experienced an average increase in mandibular unit length of 6.7 mm over the posttreatment assessment period that was 34 months in duration (annualized rate of change of 2.4 mm per year). Although there was a slight reduction in mandibular growth rate after treatment, much of the significant increase in mandibular length achieved during the active phase of treatment with the Twin Block appliance was still present 3 years later when the subjects had matured into the permanent dentition stage.