{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T11:39:34Z","timestamp":1789385974185,"version":"build-2803163510"},"reference-count":50,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["ajodo.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Orthodontics and Dentofacial Orthopedics"],"published-print":{"date-parts":[[2023,5]]},"DOI":"10.1016\/j.ajodo.2022.05.020","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T15:34:14Z","timestamp":1673019254000},"page":"677-689","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cephalometric effects of Twin-block and van Beek Headgear-Activator in the correction of Class II malocclusion"],"prefix":"10.1016","volume":"163","author":[{"given":"Rohan S.","family":"Kirtane","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Wiltshire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badri","family":"Thiruvenkatachari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia","family":"Bittencourt Dutra dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Henrique de Sa Leitao Pinheiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajodo.2022.05.020_bib1","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/S0889-5406(05)81491-X","article-title":"Methods used to evaluate growth modification in Class II malocclusion","volume":"98","author":"Tulloch","year":"1990","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib2","first-page":"177","article-title":"Components of Class II malocclusion in children 8-10 years of age","volume":"51","author":"McNamara","year":"1981","journal-title":"Angle Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib3","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1067\/mod.2003.8","article-title":"Treatment effects of the mandibular anterior repositioning appliance on patients with Class II malocclusion","volume":"123","author":"Pangrazio-Kulbersh","year":"2003","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib4","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1093\/ejo\/20.5.501","article-title":"A prospective evaluation of Bass, bionator and Twin block appliances. Part I--the hard tissues","volume":"20","author":"Illing","year":"1998","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib5","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0889-5406(98)70282-3","article-title":"The effects of Twin blocks: a prospective controlled study","volume":"113","author":"Lund","year":"1998","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib6","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.ajodo.2007.10.042","article-title":"Early treatment for Class II Division 1 malocclusion with the Twin-block appliance: a multi-center, randomized, controlled trial","volume":"135","author":"O\u2019Brien","year":"2009","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib7","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/S0889-5406(03)00345-7","article-title":"Effectiveness of treatment for Class II malocclusion with the Herbst or Twin-block appliances: a randomized, controlled trial","volume":"124","author":"O\u2019Brien","year":"2003","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib8","doi-asserted-by":"crossref","first-page":"907","DOI":"10.2319\/061706-244","article-title":"Short-term anteroposterior treatment effects of functional appliances and extraoral traction on Class II malocclusion. A meta-analysis","volume":"77","author":"Antonarakis","year":"2007","journal-title":"Angle Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib9","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.ajodo.2010.04.028","article-title":"Effectiveness of orthodontic treatment with functional appliances on mandibular growth in the short term","volume":"139","author":"Marsico","year":"2011","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib10","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12903-017-0339-8","article-title":"Effect of removable functional appliances on mandibular length in patients with Class II with retrognathism: systematic review and meta-analysis","volume":"17","author":"Santamar\u00eda-Villegas","year":"2017","journal-title":"BMC Oral Health"},{"key":"10.1016\/j.ajodo.2022.05.020_bib11","first-page":"302","article-title":"The use of myofunctional appliances in the UK: a survey of British orthodontists","volume":"25","author":"Chadwick","year":"1998","journal-title":"Dent Update"},{"key":"10.1016\/j.ajodo.2022.05.020_bib12","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1093\/ejo\/4.2.129","article-title":"The Twin block traction technique","volume":"4","author":"Clark","year":"1982","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib13","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S0889-5406(96)70058-6","article-title":"Orthopedics in orthodontics: Part I, Fiction or reality--a review of the literature","volume":"110","author":"Aelbers","year":"1996","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib14","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1093\/ejo\/4.4.279","article-title":"Overjet correction by a combined headgear and activator","volume":"4","author":"van Beek","year":"1982","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib15","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1093\/ejo\/cjl052","article-title":"Comparison of the headgear activator and Herbst appliance--effects and post-treatment changes","volume":"28","author":"Phan","year":"2006","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib16","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1093\/ejo\/14.2.140","article-title":"Skeletal and dento-alveolar changes as a result of headgear activator therapy related to different vertical growth patterns","volume":"14","author":"Dermaut","year":"1992","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib17","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1093\/ejo\/cjm003","article-title":"Effects of activator and high-pull headgear combination therapy: skeletal, dentoalveolar, and soft tissue profile changes","volume":"29","author":"Mar\u015fan","year":"2007","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib18","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/0002-9416(85)90019-3","article-title":"Activator headgear therapy","volume":"87","author":"Levin","year":"1985","journal-title":"Am J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib19","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1007\/PL00001930","article-title":"Comparison of modified Teuscher and van Beek functional appliance therapies in high-angle cases","volume":"62","author":"U\u00e7\u00fcnc\u00fc","year":"2001","journal-title":"J Orofac Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib20","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1093\/ejo\/20.4.389","article-title":"The initial effects of the treatment of Class II, Division 1 malocclusions with the van Beek activator compared with the effects of the Herren activator and an activator-headgear combination","volume":"20","author":"Altenburger","year":"1998","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib21","first-page":"92","article-title":"[Effects of activator and activator\u00a0+ anterior high-pull headgear on the growth direction of Class 2 cases]","volume":"2","author":"Uner","year":"1989","journal-title":"Turk Ortodonti Derg"},{"key":"10.1016\/j.ajodo.2022.05.020_bib22","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S0889-5406(97)70269-5","article-title":"Initial effects of treatment of Class II malocclusion with the Herren activator, activator-headgear combination, and jasper Jumper","volume":"112","author":"Weiland","year":"1997","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib23","doi-asserted-by":"crossref","first-page":"254","DOI":"10.13076\/1300-3550-2-2-254","article-title":"[Evaluation of the changes occurring in the vertical direction of the face in cases treated with activator\u00a0+ occipital headgear combination]","volume":"2","author":"Altu\u011f","year":"1989","journal-title":"Turk Ortodonti Derg"},{"key":"10.1016\/j.ajodo.2022.05.020_bib24","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1093\/ejo\/cjaa073","article-title":"Early headgear activator treatment of Class II malocclusion with excessive overjet: a randomized controlled trial","volume":"43","author":"Kallunki","year":"2021","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib25","first-page":"323","article-title":"Treatment of Class II open bite in the mixed dentition with a removable functional appliance and headgear","volume":"23","author":"Ngan","year":"1992","journal-title":"Quintessence Int"},{"key":"10.1016\/j.ajodo.2022.05.020_bib26","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1067\/mod.2002.122177","article-title":"Growth and treatment changes in patients treated with a headgear-activator appliance","volume":"121","author":"Bendeus","year":"2002","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/ejo\/cji062","article-title":"Effects of activator and activator headgear treatment: comparison with untreated Class II subjects","volume":"28","author":"T\u00fcrkkahraman","year":"2006","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib28","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.ajodo.2005.04.043","article-title":"Treatment effects of the bionator and high-pull facebow combination followed by fixed appliances in patients with increased vertical dimensions","volume":"131","author":"Freeman","year":"2007","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib29","first-page":"286","article-title":"Comparative evaluation of a new removable jasper Jumper functional appliance vs an activator-headgear combination","volume":"73","author":"Sari","year":"2003","journal-title":"Angle Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib30","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/S0889-5406(99)70193-9","article-title":"Treatment effects produced by the Twin-block appliance and the FR-2 appliance of Fr\u00e4nkel compared with an untreated Class II sample","volume":"116","author":"Toth","year":"1999","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib31","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/S0889-5406(99)70233-7","article-title":"Comparison of the effects of monoblock and Twin-block appliances on the skeletal and dentoalveolar structures","volume":"116","author":"T\u00fcmer","year":"1999","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib32","doi-asserted-by":"crossref","DOI":"10.1155\/2017\/4861924","article-title":"Comparison of activator-headgear and Twin block treatment approaches in Class II Division 1 malocclusion","volume":"2017","author":"Spalj","year":"2017","journal-title":"BioMed Res Int"},{"key":"10.1016\/j.ajodo.2022.05.020_bib33","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1053\/j.sodo.2005.04.005","article-title":"The cervical vertebral maturation (CVM) method for the assessment of optimal treatment timing in dentofacial orthopedics","volume":"11","author":"Baccetti","year":"2005","journal-title":"Semin Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib34","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.ajodo.2005.11.010","article-title":"Mandibular changes produced by functional appliances in Class II malocclusion: a systematic review","volume":"129","author":"Cozza","year":"2006","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib35","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/0002-9416(53)90082-7","article-title":"Cephalometrics for you and me","volume":"39","author":"Steiner","year":"1953","journal-title":"Am J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib36","first-page":"115","article-title":"Perspectives in the clinical application of cephalometrics. The first fifty years","volume":"51","author":"Ricketts","year":"1981","journal-title":"Angle Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib37","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/S0002-9416(84)90352-X","article-title":"A method of cephalometric evaluation","volume":"86","author":"McNamara","year":"1984","journal-title":"Am J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib38","series-title":"Technique and Treatment With Light-wire Edgewise Appliances","author":"Jarabak","year":"1972"},{"key":"10.1016\/j.ajodo.2022.05.020_bib39","series-title":"The Design and Analysis of Clinical Experiments","year":"1986"},{"key":"10.1016\/j.ajodo.2022.05.020_bib40","doi-asserted-by":"crossref","first-page":"e455","DOI":"10.1016\/j.ajodo.2010.01.035","article-title":"Relationship between cervical vertebral maturation and mandibular growth","volume":"139","author":"Ball","year":"2011","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib41","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.2319\/103111-673.1","article-title":"Cervical vertebral maturation as a biologic indicator of skeletal maturity","volume":"82","author":"Santiago","year":"2012","journal-title":"Angle Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib42","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ajodo.2007.03.033","article-title":"Dentofacial growth changes in subjects with untreated Class II malocclusion from late puberty through young adulthood","volume":"135","author":"Baccetti","year":"2009","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib43","first-page":"185","article-title":"Combination headgear-activator","volume":"18","author":"van Beek","year":"1984","journal-title":"J Clin Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib44","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1177\/00220345630420014701","article-title":"Variations in the growth pattern of the human mandible: longitudinal radiographic study by the implant method","volume":"42","author":"Bjork","year":"1963","journal-title":"J Dent Res"},{"key":"10.1016\/j.ajodo.2022.05.020_bib45","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/S0889-5406(03)00540-7","article-title":"The \u201cWits\u201d appraisal of jaw disharmony. 1975","volume":"124","author":"Jacobson","year":"2003","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib46","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1093\/ejo\/20.6.663","article-title":"A prospective evaluation of Bass, bionator and Twin block appliances. Part II--the soft tissues","volume":"20","author":"Morris","year":"1998","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib47","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1053\/j.sodo.2006.01.004","article-title":"The importance of masticatory muscle function in dentofacial growth","volume":"12","author":"Kiliaridis","year":"2006","journal-title":"Semin Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib48","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1093\/ejo\/23.2.115","article-title":"A prospective optical surface scanning and cephalometric assessment of the effect of functional appliances on the soft tissues","volume":"23","author":"McDonagh","year":"2001","journal-title":"Eur J Orthod"},{"key":"10.1016\/j.ajodo.2022.05.020_bib49","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.ajodo.2004.03.027","article-title":"Prospective clinical trial comparing the effects of conventional Twin-block and mini-block appliances: part 2. Soft tissue changes","volume":"127","author":"Sharma","year":"2005","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"10.1016\/j.ajodo.2022.05.020_bib50","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/S0889-5406(98)70275-6","article-title":"Anteroposterior skeletal and dental changes after early Class II treatment with bionators and headgear","volume":"113","author":"Keeling","year":"1998","journal-title":"Am J Orthod Dentofacial Orthop"}],"container-title":["American Journal of Orthodontics and Dentofacial Orthopedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0889540622007843?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0889540622007843?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:14:56Z","timestamp":1760174096000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0889540622007843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":50,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["S0889540622007843"],"URL":"https:\/\/doi.org\/10.1016\/j.ajodo.2022.05.020","relation":{},"ISSN":["0889-5406"],"issn-type":[{"value":"0889-5406","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Cephalometric effects of Twin-block and van Beek Headgear-Activator in the correction of Class II malocclusion","name":"articletitle","label":"Article Title"},{"value":"American Journal of Orthodontics and Dentofacial Orthopedics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajodo.2022.05.020","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 by the American Association of Orthodontists. All rights reserved.","name":"copyright","label":"Copyright"}]}}