Initial treatment of class ii division i malocclusion with twin block functional appliance in 10 year old girl: A case report

Aprillia P. Rachmadani, Sarworini B. Budiardjo, Mochamad F. Rizal

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Introduction: Class II division 1 malocclusion is the most frequent problem in the orthodontic practice. It is characterized with a retrognathic mandible, and repositioning the mandible forward is needed to enhance its growth and improve dentoskeletal relationships. Functional twin block appliance is a widely used functional appliance for the management of Class II malocclusion. Case report: a 10-year-11-month old girl patient attended Dental Hospital of Faculty of Dentistry, Universitas Indonesia with a chief complaint of her upper anterior teeth were more protrude than lower anterior teeth. On clinical examination, her facial profile is convex, symmetry. She had proclined maxillary anterior teeth with a 10mm overjet and a 5mm overbite. The lateral cephalometric radiography indicated a skeletal class II pattern with hyper-divergent growth which was due to mandibular retroposition and maxillary protrusion. The initial treatment objective was reduce overjet by skeletal improvement, thus promoting mandibular growth by correction class II relationship, attain normal overjet and overbite by using functional twin block appliance and then consider fixed orthodontic treatment after functional appliance treatment. The use of twin block functional appliances have skeletal effects such as increase mandibular growth (increase height of mandibular ramus and length of mandible), the SNB value was improved to 2°. The ANB value was reduce 2°, decrease overjet 4.5mm and overbite 1mm. Conclusion: This case has demonstrated the successful management of the first phase of treatment of a patient with Angle Class II Division 1 malocclusion using the Twin Block appliances in 6 months. The Second phase of treatment will be continued with fixed appliances.

Original languageEnglish
Title of host publicationClinical Reports in Dentistry
PublisherNova Science Publishers, Inc.
Number of pages9
ISBN (Electronic)9781536173291
ISBN (Print)9781536173284
Publication statusPublished - 3 Apr 2020


  • Class II division 1 malocclusion
  • Functional appliances
  • Twin block


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