{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:02:42Z","timestamp":1780070562612,"version":"3.54.0"},"reference-count":62,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The purpose of this twin case comparison was to assess the short- and long-term effects of nonsurgical treatment vs orthognathic surgical treatment for Class II correction. Two identical twins (age 13\u00a0years 3\u00a0months) were treated for Class II correction where one patient was treated nonsurgically using a fixed functional appliance, while the other was treated using orthognathic mandibular advancement surgery. The patients were recalled and evaluated 5\u00a0years in retention. Comparing changes in the short and long term, surgical treatment led to superior skeletal results compared to the nonsurgical twin. However, the soft tissue profile was remarkably similar for both patients suggesting that soft tissue profile changes may not necessarily follow similar changes in the bony skeletal structures.<\/jats:p>","DOI":"10.2319\/011314-46.1","type":"journal-article","created":{"date-parts":[[2014,7,30]],"date-time":"2014-07-30T13:16:52Z","timestamp":1406726212000},"page":"142-156","source":"Crossref","is-referenced-by-count":4,"title":["Long-term surgical versus functional Class II correction: A comparison of identical twins"],"prefix":"10.2319","volume":"85","author":[{"given":"Aditya","family":"Chhibber","sequence":"first","affiliation":[{"name":"Assistant Professor, Division of Orthodontics, Section of Growth & Development, Columbia University College of Dental Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhur","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Assistant Professor, Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health Center, Farmington, Conn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Uribe","sequence":"additional","affiliation":[{"name":"Associate Professor, Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health Center, Farmington, Conn."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravindra","family":"Nanda","sequence":"additional","affiliation":[{"name":"Professor and Head, Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health Center, Farmington, Conn."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"angl-86-04-13-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"121","article-title":"Heritability of cephalometric and occlusal variables as assessed from siblings with overt malocclusions","volume":"104","author":"King\n              L,","year":"1993","unstructured":"King\n              L, \n            \n              Harris\n              EF, \n            \n              Tolley\n              EA. \n          \n          Heritability of cephalometric and occlusal variables as assessed from siblings with overt malocclusions. Am J Orthod Dentofacial Orthop. 1993;104:121\u2013131."},{"key":"angl-86-04-13-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"200","article-title":"Heritability of craniofacial characteristics between parents and offspring estimated from lateral cephalograms","volume":"127","author":"Johannsdottir\n              B,","year":"2005","unstructured":"Johannsdottir\n              B, \n            \n              Thorarinsson\n              F, \n            \n              Thordarson\n              A, \n            \n              Magnusson\n              TE. \n          \n          Heritability of craniofacial characteristics between parents and offspring estimated from lateral cephalograms. Am J Orthod Dentofacial Orthop. 2005;127:200\u2013207."},{"key":"angl-86-04-13-b03","series-title":"Am J Orthod","first-page":"150","article-title":"Hereditary factors in the craniofacial morphology of Angle's Class II and Class III malocclusions","volume":"82","author":"Nakasima\n              A,","year":"1982","unstructured":"Nakasima\n              A, \n            \n              Ichinose\n              M, \n            \n              Nakata\n              S, \n            \n              Takahama\n              Y. \n          \n          Hereditary factors in the craniofacial morphology of Angle's Class II and Class III malocclusions. Am J Orthod. 1982;82:150\u2013156."},{"key":"angl-86-04-13-b04","series-title":"Am J Orthod","first-page":"493","article-title":"All in the family: use of familial information in orthodontic diagnosis, case assessment and treatment planning","volume":"69","author":"Harris\n              JE,","year":"1976","unstructured":"Harris\n              JE, \n            \n              Kowalski\n              CJ. \n          \n          All in the family: use of familial information in orthodontic diagnosis, case assessment and treatment planning. Am J Orthod. 1976;69:493\u2013509."},{"key":"angl-86-04-13-b05","series-title":"World J Orthod","first-page":"405","article-title":"Genetics or environment? A twin-method study of malocclusions","volume":"8","author":"Kawala\n              B,","year":"2007","unstructured":"Kawala\n              B, \n            \n              Antoszewska\n              J, \n            \n              Necka\n              A. \n          \n          Genetics or environment? A twin-method study of malocclusions. World J Orthod. 2007;8:405\u2013410."},{"key":"angl-86-04-13-b06","series-title":"Textbook of Orthodontics. 1st ed","first-page":"324","article-title":"Treatment of Class II malocclusions","author":"Spalding\n              PM.","year":"2001","unstructured":"Spalding\n              PM. \n          \n          Treatment of Class II malocclusions. In: BisharaSE, ed. Textbook of Orthodontics. 1st ed. Philadephia, PA: WB Saunders; 2001;324\u2013374."},{"key":"angl-86-04-13-b07","series-title":"Angle Orthod","first-page":"718","article-title":"Mechanism of Class II correction in prepubertal and postpubertal patients with Twin Force Bite Corrector","volume":"83","author":"Chhibber\n              A,","year":"2013","unstructured":"Chhibber\n              A, \n            \n              Upadhyay\n              M, \n            \n              Uribe\n              F, \n            \n              Nanda\n              R. \n          \n          Mechanism of Class II correction in prepubertal and postpubertal patients with Twin Force Bite Corrector. Angle Orthod. 2013;83:718\u2013727."},{"key":"angl-86-04-13-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"250","article-title":"Functional appliances: a review","volume":"95","author":"Bishara\n              SE,","year":"1989","unstructured":"Bishara\n              SE, \n            \n              Ziaja\n              RR. \n          \n          Functional appliances: a review. Am J Orthod Dentofacial Orthop. 1989;95:250\u2013258."},{"key":"angl-86-04-13-b09","series-title":"Am J Orthod Dentofacial Orthop","first-page":"451","article-title":"Long-term comparison of treatment outcome and stability of Class II patients treated with functional appliances versus bilateral sagittal split ramus osteotomy","volume":"127","author":"Berger\n              JL,","year":"2005","unstructured":"Berger\n              JL, \n            \n              Pangrazio-Kulbersh\n              V, \n            \n              George\n              C, \n            \n              Kaczynski\n              R. \n          \n          Long-term comparison of treatment outcome and stability of Class II patients treated with functional appliances versus bilateral sagittal split ramus osteotomy. Am J Orthod Dentofacial Orthop. 2005;127:451\u2013464."},{"key":"angl-86-04-13-b10","series-title":"Angle Orthod","first-page":"304","article-title":"Dentoskeletal effects of functional appliances vs bimaxillary surgery in hyperdivergent Class II patients","volume":"81","author":"Ibitayo\n              AO,","year":"2011","unstructured":"Ibitayo\n              AO, \n            \n              Pangrazio-Kulbersh\n              V, \n            \n              Berger\n              J, \n            \n              Bayirli\n              B. \n          \n          Dentoskeletal effects of functional appliances vs bimaxillary surgery in hyperdivergent Class II patients. Angle Orthod. 2011;81:304\u2013311."},{"key":"angl-86-04-13-b11","series-title":"Eur J Orthod","first-page":"553","article-title":"The influence of functional orthodontics and mandibular sagittal split advancement osteotomy on dental and skeletal variables\u2014a comparative cephalometric study","volume":"28","author":"Lohrmann\n              B,","year":"2006","unstructured":"Lohrmann\n              B, \n            \n              Schwestka-Polly\n              R, \n            \n              N\u00e4gerl\n              H, \n            \n              Ihlow\n              D, \n            \n              Kubein-Meesenburg\n              D. \n          \n          The influence of functional orthodontics and mandibular sagittal split advancement osteotomy on dental and skeletal variables\u2014a comparative cephalometric study. Eur J Orthod. 2006;28:553\u2013560."},{"key":"angl-86-04-13-b12","series-title":"Angle Orthod","first-page":"177","article-title":"Growth changes in the soft tissue facial profile","volume":"60","author":"Nanda\n              RS,","year":"1990","unstructured":"Nanda\n              RS, \n            \n              Meng\n              H, \n            \n              Kapila\n              S, \n            \n              Goorhuis\n              J. \n          \n          Growth changes in the soft tissue facial profile. Angle Orthod. 1990;60:177\u2013190."},{"key":"angl-86-04-13-b13","series-title":"Angle Orthod","first-page":"471","article-title":"Facial and dental changes in adolescents and their clinical implications","volume":"70","author":"Bishara\n              SE.","year":"2000","unstructured":"Bishara\n              SE. \n          \n          Facial and dental changes in adolescents and their clinical implications. Angle Orthod. 2000;70:471\u2013483."},{"key":"angl-86-04-13-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"335","article-title":"Mandibular growth as related to cervical vertebral maturation and body height","volume":"118","author":"Franchi\n              L,","year":"2000","unstructured":"Franchi\n              L, \n            \n              Baccetti\n              T, \n            \n              McNamara\n              JA, Jr. \n          \n          Mandibular growth as related to cervical vertebral maturation and body height. Am J Orthod Dentofacial Orthop. 2000;118:335\u2013340."},{"key":"angl-86-04-13-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"395","article-title":"Facial keys to orthodontic diagnosis and treatment planning\u2014part II","volume":"103","author":"Arnett\n              GW,","year":"1993","unstructured":"Arnett\n              GW, \n            \n              Bergman\n              RT. \n          \n          Facial keys to orthodontic diagnosis and treatment planning\u2014part II. Am J Orthod Dentofacial Orthop. 1993;103:395\u2013411."},{"key":"angl-86-04-13-b16","series-title":"Am J Orthod Dentofacial Orthop","first-page":"258","article-title":"Heritability of craniometric and occlusal variables: a longitudinal sib analysis","volume":"99","author":"Harris\n              E,","year":"1991","unstructured":"Harris\n              E, \n            \n              Johnson\n              MG. \n          \n          Heritability of craniometric and occlusal variables: a longitudinal sib analysis. Am J Orthod Dentofacial Orthop. 1991;99:258\u2013268."},{"key":"angl-86-04-13-b17","series-title":"J Clin Orthod","first-page":"363","article-title":"Long-term stability of Class II correction with the Twin Force Bite Corrector","volume":"44","author":"Chhibber\n              A,","year":"2010","unstructured":"Chhibber\n              A, \n            \n              Upadhyay\n              M, \n            \n              Uribe\n              F, \n            \n              Nanda\n              R. \n          \n          Long-term stability of Class II correction with the Twin Force Bite Corrector. J Clin Orthod. 2010;44:363\u2013376."},{"key":"angl-86-04-13-b18","series-title":"A Prospective Clinical Analysis of a Push-Type Fixed Intermaxillary Class II Correction Appliance [thesis]","author":"Campbell\n              E.","year":"2003","unstructured":"Campbell\n              E. \n          \n          A Prospective Clinical Analysis of a Push-Type Fixed Intermaxillary Class II Correction Appliance [thesis]. Farmington, Conn: University of Connecticut; 2003."},{"key":"angl-86-04-13-b19","series-title":"Angle Orthod","first-page":"319","article-title":"Prospective study of dentoskeletal changes in Class II division malocclusion treatment with twin force bite corrector","volume":"83","author":"Guimaraes\n              CH, Jr,","year":"2013","unstructured":"Guimaraes\n              CH, Jr, \n            \n              Henriques\n              JF, \n            \n              Janson\n              G, \n            \n          . Prospective study of dentoskeletal changes in Class II division malocclusion treatment with twin force bite corrector. Angle Orthod. 2013;83:319\u2013326."},{"key":"angl-86-04-13-b20","series-title":"Am J Orthod Dentofacial Orthop","first-page":"556","article-title":"A comparison of outcomes of orthodontic and surgical-orthodontic treatment of Class II malocclusion in adults","volume":"101","author":"Proffit\n              WR,","year":"1992","unstructured":"Proffit\n              WR, \n            \n              Phillips\n              C, \n            \n              Douvartzidis\n              N. \n          \n          A comparison of outcomes of orthodontic and surgical-orthodontic treatment of Class II malocclusion in adults. Am J Orthod Dentofacial Orthop. 1992;101:556\u2013565."},{"key":"angl-86-04-13-b21","series-title":"Am J Orthod","first-page":"339","article-title":"Facial development and tooth eruption: an implant study at the age of puberty","volume":"62","author":"Bj\u00f6rk\n              A,","year":"1972","unstructured":"Bj\u00f6rk\n              A, \n            \n              Skieller\n              V. \n          \n          Facial development and tooth eruption: an implant study at the age of puberty. Am J Orthod. 1972;62:339\u2013383."},{"key":"angl-86-04-13-b22","series-title":"Am J Orthod Dentofacial Orthop","first-page":"566.e1","article-title":"Dental and skeletal changes associated with Class II surgical-orthodontic treatment","volume":"135","author":"Potts\n              B,","year":"2009","unstructured":"Potts\n              B, \n            \n              Shanker\n              S, \n            \n              Fields\n              HW, \n            \n              Vig\n              KW, \n            \n              Beck\n              FM. \n          \n          Dental and skeletal changes associated with Class II surgical-orthodontic treatment. Am J Orthod Dentofacial Orthop. 2009;135:566.e1\u20137."},{"key":"angl-86-04-13-b23","series-title":"Am J Orthod Dentofacial Orthop","first-page":"7.e1","article-title":"A cephalometric study of Class II malocclusion treated with mandibular surgery","volume":"131","author":"Burden\n              D,","year":"2007","unstructured":"Burden\n              D, \n            \n              Johnston\n              C, \n            \n              Kennedy\n              D, \n            \n              Harradine\n              N, \n            \n              Stevenson\n              M. \n          \n          A cephalometric study of Class II malocclusion treated with mandibular surgery. Am J Orthod Dentofacial Orthop. 2007;131:7.e1\u20138."},{"key":"angl-86-04-13-b24","series-title":"Angle Orthod","first-page":"365","article-title":"Perception of facial esthetics: a comparison of similar class ii cases treated with attempted growth modification or later orthognathic surgery","volume":"73","author":"Shell\n              TL,","year":"2003","unstructured":"Shell\n              TL, \n            \n              Woods\n              MG. \n          \n          Perception of facial esthetics: a comparison of similar class ii cases treated with attempted growth modification or later orthognathic surgery. 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J Oral Maxillofac Surg. 2012;70:e77\u201386."},{"key":"angl-86-04-13-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"121","article-title":"Heritability of cephalometric and occlusal variables as assessed from siblings with overt malocclusions","volume":"104","author":"King\n              L,","year":"1993","unstructured":"King\n              L, \n            \n              Harris\n              EF, \n            \n              Tolley\n              EA. \n          \n          Heritability of cephalometric and occlusal variables as assessed from siblings with overt malocclusions. Am J Orthod Dentofacial Orthop. 1993;104:121\u2013131."},{"key":"angl-86-04-13-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"200","article-title":"Heritability of craniofacial characteristics between parents and offspring estimated from lateral cephalograms","volume":"127","author":"Johannsdottir\n              B,","year":"2005","unstructured":"Johannsdottir\n              B, \n            \n              Thorarinsson\n              F, \n            \n              Thordarson\n              A, \n            \n              Magnusson\n              TE. \n          \n          Heritability of craniofacial characteristics between parents and offspring estimated from lateral cephalograms. Am J Orthod Dentofacial Orthop. 2005;127:200\u2013207."},{"key":"angl-86-04-13-b03","series-title":"Am J Orthod","first-page":"150","article-title":"Hereditary factors in the craniofacial morphology of Angle's Class II and Class III malocclusions","volume":"82","author":"Nakasima\n              A,","year":"1982","unstructured":"Nakasima\n              A, \n            \n              Ichinose\n              M, \n            \n              Nakata\n              S, \n            \n              Takahama\n              Y. \n          \n          Hereditary factors in the craniofacial morphology of Angle's Class II and Class III malocclusions. Am J Orthod. 1982;82:150\u2013156."},{"key":"angl-86-04-13-b04","series-title":"Am J Orthod","first-page":"493","article-title":"All in the family: use of familial information in orthodontic diagnosis, case assessment and treatment planning","volume":"69","author":"Harris\n              JE,","year":"1976","unstructured":"Harris\n              JE, \n            \n              Kowalski\n              CJ. \n          \n          All in the family: use of familial information in orthodontic diagnosis, case assessment and treatment planning. Am J Orthod. 1976;69:493\u2013509."},{"key":"angl-86-04-13-b05","series-title":"World J Orthod","first-page":"405","article-title":"Genetics or environment? A twin-method study of malocclusions","volume":"8","author":"Kawala\n              B,","year":"2007","unstructured":"Kawala\n              B, \n            \n              Antoszewska\n              J, \n            \n              Necka\n              A. \n          \n          Genetics or environment? A twin-method study of malocclusions. World J Orthod. 2007;8:405\u2013410."},{"key":"angl-86-04-13-b06","series-title":"Textbook of Orthodontics. 1st ed","first-page":"324","article-title":"Treatment of Class II malocclusions","author":"Spalding\n              PM.","year":"2001","unstructured":"Spalding\n              PM. \n          \n          Treatment of Class II malocclusions. In: BisharaSE, ed. Textbook of Orthodontics. 1st ed. 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Angle Orthod. 2013;83:718\u2013727."},{"key":"angl-86-04-13-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"250","article-title":"Functional appliances: a review","volume":"95","author":"Bishara\n              SE,","year":"1989","unstructured":"Bishara\n              SE, \n            \n              Ziaja\n              RR. \n          \n          Functional appliances: a review. 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Am J Orthod Dentofacial Orthop. 2005;127:451\u2013464."},{"key":"angl-86-04-13-b10","series-title":"Angle Orthod","first-page":"304","article-title":"Dentoskeletal effects of functional appliances vs bimaxillary surgery in hyperdivergent Class II patients","volume":"81","author":"Ibitayo\n              AO,","year":"2011","unstructured":"Ibitayo\n              AO, \n            \n              Pangrazio-Kulbersh\n              V, \n            \n              Berger\n              J, \n            \n              Bayirli\n              B. \n          \n          Dentoskeletal effects of functional appliances vs bimaxillary surgery in hyperdivergent Class II patients. Angle Orthod. 2011;81:304\u2013311."},{"key":"angl-86-04-13-b11","series-title":"Eur J Orthod","first-page":"553","article-title":"The influence of functional orthodontics and mandibular sagittal split advancement osteotomy on dental and skeletal variables\u2014a comparative cephalometric study","volume":"28","author":"Lohrmann\n              B,","year":"2006","unstructured":"Lohrmann\n              B, \n            \n              Schwestka-Polly\n              R, \n            \n              N\u00e4gerl\n              H, \n            \n              Ihlow\n              D, \n            \n              Kubein-Meesenburg\n              D. \n          \n          The influence of functional orthodontics and mandibular sagittal split advancement osteotomy on dental and skeletal variables\u2014a comparative cephalometric study. Eur J Orthod. 2006;28:553\u2013560."},{"key":"angl-86-04-13-b12","series-title":"Angle Orthod","first-page":"177","article-title":"Growth changes in the soft tissue facial profile","volume":"60","author":"Nanda\n              RS,","year":"1990","unstructured":"Nanda\n              RS, \n            \n              Meng\n              H, \n            \n              Kapila\n              S, \n            \n              Goorhuis\n              J. \n          \n          Growth changes in the soft tissue facial profile. Angle Orthod. 1990;60:177\u2013190."},{"key":"angl-86-04-13-b13","series-title":"Angle Orthod","first-page":"471","article-title":"Facial and dental changes in adolescents and their clinical implications","volume":"70","author":"Bishara\n              SE.","year":"2000","unstructured":"Bishara\n              SE. \n          \n          Facial and dental changes in adolescents and their clinical implications. 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