Reference

*Clark W J 1988 The twin block technique: a functional orthopedic appliance system. American Journal of Orthodontics 93:1-18.

Fig. 7.122

Fig. 7.125

Fig. 7.128

T.S.Beginning 14.0 years 7/1 5/96

Fig. 7.121

Fig.

7.120

T.S.Beginning 14.0 years 7/1 5/96

Fig. 7.121

SNA 7 78 ° SNB/71 ° ANB/ 7° A-N FH 1 mm Po-N FH -5 mm WITS 9 mm GoGnSN 38 ° FM 25 • MM 32 ° 1 to A-Po 9 mm 1 to A-Po 0 mm 1 to Max Plane 111 ° 1 to Mand Plane/ 91 °

Fig. 7.123

Fig. 7.124

Fig. 7.127

Fig. 7.123

Fig. 7.126

Fig. 7.124

Fig. 7.127

Fig. 7.126

Fig. 7.131

Fig. 7.134

^ Occlusal view of the twin block appliances. These were designed by Dr Bill Clark.

The patient showed good cooperation with the twin block appliances and these views show the dentition 16 months from the start of treatment. The overjet was fully reduced, and a typical lateral open bite had developed.

Fig. 7.131

Fig. 7.137

Fig. 7.135

Fig. 7.136

Fig. 7.138

Fig. 7.139

Fig. 7.132

TWIN BLOCK FUNCTIONAL THERAPY

"Applications in Dentofacia! Orthopaedies

William J Clark />rvr>W W Prtftotr r M Crotrr

Clark W J 1995 Twin block functional therapy: applications in dentofacial orthopedics. Mosby Wolfe (ISBN 0723 42120X) New edition due in 2002.

Fig. 7.133

Facial photographs after 16 months of treatment, together with progress tracings.

Fig. 7.140

SN at S

After 16 months, the twin block appliances were discontinued, and upper and lower fixed appliances were placed. Here, the right side progress is shown 1 month, 3 months, and 8 months after placement of the fixed appliances. Some enamel reduction was carried out among the lower incisors early in the fixed appliance phase. .016 HANT wires were followed by rectangular HANT wires and then steel rectangular working wires. Light Class II elastics were used to maintain the overjet correction.

T.S.Begin T.S.Progress

SN at S

T.S.Begin T.S.Progress

Fig. 7.146

Fixed appliances were in place for a total of 12 months. Here, the case is seen 10 months into fixed appliances, during the typical settling phase.

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Fig. 7.141

SNA 78° SNB/ 74° ANB ' 4° A-N FH 0 mm Po-N FH 0 mm WITS 2 mm GoGnSN 40° FM¿ 27° MM 33° 1 to A-Po 6 mm 1 to A-Po 4 mm 1 to Max Plane 106° 1 to Mand Plane 98°

Palatal Plane & Palate Curvature

T.S. Begin T.S.Progress

T.S.Begin T.S.Progress

Fig. 7.148

Fig. 7.147

Mand. Symphasis & Mand. Plane

Fig. 7.147

Fig. 7.148

Palatal Plane & Palate Curvature

T.S. Begin T.S.Progress

Mand. Symphasis & Mand. Plane

T.S.Begin T.S.Progress

The case after removal of the fixed appliances.

Fig. 7.152

Fig. 7.158

Fig. 7.155

Fig. 7.152

Good progress had been made. Extractions were discussed during treatment planning, but it proved possible to manage the case on a non-extraction basis. It was finished to an ovoid arch form.

A pleasing improvement in facial esthetics was achieved, and Figure 7.158 compares before and after profiles. The ANB angle changed from 1° to 3° during the treatment period (Fig. 7.2, p. 164).

Fig. 7.155

Cephalometric superimpositions show that favorable downward and forward mandibular growth had occurred during treatment, mainly during the twin block phase.

T.S. Begin

T.S.Final

Fig. 7.158

SN at S

Fig. 7.156

Fig. 7.159

Fig. 7.157

T.S.Final 16.0 years 6/30/98

Fig. 7.153

Fig. 7.154

T.S.Begin

T.S.Final

T.S.Begin

T.S.Final

Fig. 7.156

Fig. 7.159

Palatal Plane & Palate Curvature

Fig. 7.157

Mand. Symphasis & Mand. Plane

T.S.Final 16.0 years 6/30/98

Fig. 7.160

SNA 78 ° SNB 75 ° ANB < 3 ° A-N FH 3 mm Po-N FH 3 mm WITS 3 mm GoGnSN 43• FM 28 • MM / 36 0 1 to A-Po 7 mm 1 to A-Po 4 mm 1 to Max Plane 111 " 1 to Mand Plane 93 •

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