{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T02:05:07Z","timestamp":1782439507402,"version":"3.54.5"},"update-to":[{"DOI":"10.12688\/f1000research.109040.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000}},{"DOI":"10.12688\/f1000research.109040.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000}}],"reference-count":20,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T00:00:00Z","timestamp":1713830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Class II malocclusions represent anteroposterior dysplasia usually resulting from mandibular retrusion. Along with a retropositioned mandible, it can be associated with either upward or backward jaw rotation. High angle cases are often associated with a short ramal height, steeper mandibular plane, and large gonial angle. Twin block is a commonly used myofunctional appliance that incorporates bite planes that direct the occlusal forces in a more favorable direction for correction of the retrognathic mandible. We aimed to evaluate skeletal, dental, and soft tissue changes following modified twin block appliance therapy in high-angle cases. Methods A cephalometric study was performed on 15 growing (10-14 years) high angle (Frankfort mandibular angle 28-35\u00b0) Class II Division I malocclusion patients undergoing twin block therapy. Skeletal, dental, and soft tissue changes were evaluated by cephalometric analysis using Dolphin software. Results Pre- and post-treatment changes in cephalograms were assessed by analysis of variance and paired t-test. Significant changes in the position of the mandible (angle between Sella-Nasion-Point B [SNB] increased by 3.9 degrees, P=0.02), Wits appraisal (decreased by 1.54 mm, P=0.04), maxillo-mandibular relationship (angle between Point A-Nasion-Point B [ANB] decreased by 3.74 degrees, P=0.02) were observed. Soft tissue changes like the nasolabial angle were also significant, increasing by 3.8 degrees (P=0.04) and lower lip relation to E-line (reduction in lower lip protrusion) by 2 mm (P=0.04). Vertical parameters showed non-significant changes, like the Frankfort mandibular angle (FMA) increased by 0.07 degrees, (P=0.67), the angle between Sella-Nasion and Gonion-Gnathion (SN-Go-Gn) increased by 0.33 degrees, (P=0.67), Y-axis increased by 0.2 degrees, (P=0.32). The upper incisor inclination decreased non-significantly from 115.27\u00b11.33 to 113.42\u00b11.65 degrees, (P=0.12) and lower incisor increased non-significantly from 100.13\u00b12.23 to 101.80 \u00b11.37 degrees, (P=0.08). Conclusions Modified twin block appliance can be used to successfully treat Class II Division I high angle cases with good vertical control.<\/ns3:p>","DOI":"10.12688\/f1000research.109040.3","type":"journal-article","created":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T11:20:12Z","timestamp":1713871212000},"page":"459","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of modified twin block appliance in growing Class II high angle cases: A cephalometric study"],"prefix":"10.12688","volume":"11","author":[{"given":"Kanistika","family":"Jha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6015-4165","authenticated-orcid":false,"given":"Manoj","family":"Adhikari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2024,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"477-494","DOI":"10.1016\/0002-9416(80)90299-7","article-title":"Differential diagnosis of Class II malocclusions.","volume":"78","author":"R Moyers","year":"1980","journal-title":"Am. 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A functional orthopedic appliance system.","volume":"93","author":"W Clark","year":"1988","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1-8","DOI":"10.1016\/0889-5406(88)90188-6","article-title":"The twin block technique A functional orthopedic appliance system.","volume":"93","author":"W Clark","year":"1988 Jan 1","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"159-170","DOI":"10.1067\/mod.2000.105571","article-title":"Treatment timing for Twin-block therapy.","volume":"118","author":"T Baccetti","year":"2000","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"209-216","DOI":"10.1179\/14653121043110","article-title":"Design and management of Twin Blocks: reflections after 30 years of clinical use.","volume":"37","author":"W Clark","year":"2010","journal-title":"J. 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