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ONSD measurements were taken at six different time points: before appliance placement (T0), 1\u00a0min after placement (T1), 10\u00a0min after placement (T2), one month after the start of treatment with twin block (T3), immediately after appliance removal (T4), and 10\u00a0min after removal (T5). Mean arterial pressure (MAP), heart rate, and peripheral oxygen saturation (SpO2) were also monitored. Statistical analyses were performed using Friedman and Wilcoxon Signed-Rank tests with Bonferroni correction, considering\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 as statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant increases in ONSD were observed at T1 and T2 compared to T0 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), with the highest ONSD recorded at T1. No significant changes in ONSD were noted at T3 or T5, indicating that the initial increase in ONSD was temporary. MAP showed a significant decrease at T2, but no significant changes were observed in SpO2 or heart rate across the time points.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study is the first to report a significant increase in ICP, as indicated by ONSD, in adolescents using Twin Block appliances. The observed rise in ONSD shortly after appliance placement suggests a temporary increase in ICP. These findings highlight the importance of monitoring intracranial pressure during orthodontic treatment, particularly in adolescents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-025-06214-7","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T23:51:03Z","timestamp":1739922663000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of twin block on intracranial pressure"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3701-3484","authenticated-orcid":false,"given":"Yasin","family":"Hezenci","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3624-566X","authenticated-orcid":false,"given":"Musa","family":"Bulut","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4756-6496","authenticated-orcid":false,"given":"O\u011fuzhan","family":"Demirel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"6214_CR1","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/S0889-5406(99)70193-9","volume":"116","author":"LR Toth","year":"1999","unstructured":"Toth LR, McNamara JA Jr (1999) Treatment effects produced by the twin-block appliance and the FR-2 appliance of Fr\u00e4nkel compared with an untreated class II sample. 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The Clinical Research and Ethics Committee of Bolu Abant Izzet Baysal University approved all study procedures (Decision No: 2023\/17). This study was carried out in accordance with Declaration of Helsinki. Informed consent was obtained from all volunteers and\/or legal guardian(s).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent for publication was obtained from each participant.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"140"}}