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Comparative Evaluation of Soft Tissue Profile Changes with Herbst and Twin Block Appliances in Class II Malocclusion
Annapurna Kannan1, Sridevi Padmanabhan1
1Department of Orthodontics and Dentofacial Orthopaedics, Sri Ramachandra Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
Objective:
To comparatively evaluate the perception of patients' soft tissue profiles treated with Herbst and Twin Block appliances and correlate the perception with cephalometric parameters.
Methods:
The record of 30 patients (15 Herbst and 15 Twin Block) treated for a period of 6 months (±1.1 months) was included in the study. A total of 60 resulting profile silhouettes (from pre- and post-functional profile photographs) were evaluated by 30 examiners and were divided into 3 groups: orthodontists, general dentists, and laypersons. The profiles were arranged in a randomized order, and the examiners rated the profiles using a visual analog scale. Paired t-test and independent t-test were performed to find a significant difference within and between the appliances, respectively. A treatment outcome correlation was done using Pearson's correlation test between the visual analog scale scores and cephalometric parameters.
Results:
Within the appliances, the orthodontist perceived a difference with only the Twin Block appliance (P = .02). The general dentists perceived a significant difference with both Herbst (P = .02) and Twin Block (P = .001) appliances, whereas the laypersons did not perceive any profile improvement on treatment with functional appliances. However, between the appliances, no statistically significant profile difference was seen with all 3 groups of examiners. The ANB angle had a significant negative correlation (P = .007) to the visual analog scale scores given by the orthodontists for the Herbst appliance.
Conclusion:
No perceptible difference was found in the profile enhancement between Herbst and Twin Block appliances with all 3 groups of examiners. The ANB angle contributed to the difference in profile perception between the appliances for the orthodontists.
