{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:39:58Z","timestamp":1786653598078,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Disturbances in sleep have a wide-ranging effect on a child\u2019s life profoundly impacting the standard of living. The aim of this study was to investigate levels of Salivary Tumor Necrosis Factor-Alpha (TNF-\u03b1) and Malondialdehyde (MDA) in a group of children with class II malocclusion and sleep problems before and after twin block appliance therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Eleven children aged 8\u201312 years with skeletal class II malocclusion and at least one sleep disorder participated in the study. All children were subjected to a recording of their sleep history and a clinical and radiographic examination. Pre-treatment levels of salivary TNF-\u03b1 and MDA were recorded. A twin block appliance was custom made and delivered to every child. After a minimum follow-up period of 9 months, all children were recalled for a re-evaluation of salivary biomarker levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Levels of salivary biomarkers TNF-\u03b1 and MDA significantly decreased in children following myofunctional therapy using a twin block appliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The measurement of TNF-\u03b1 and MDA could be used as an alternative and noninvasive method to evaluate prognosis of twin block therapy for children with sleep-disordered breathing (SDB).<\/jats:p>\n                  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