• 대한치과기공학회지
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• 제32권2호
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• pp.105-109
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• 2010

• 대한소아치과학회지
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• 제25권1호
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• pp.134-143
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• 1998

Twin Blocks are simple bite-blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. These devices use upper and lower bite-blocks that engage on occlusal inclined planes. Twin Blocks use the forces of occlusion as the functional mechanism to correct the malocclusion. To get an excellent result in the treatment by using the Twin Block appliances, proper case selection must be needed. Twin Block treatment is performed in two stages. Twin Blocks are used in the active phase to correct the anteroposterior relationship and establish the correct vertical dimension. Once this phase is accomplished, the Twin Blocks are replaced with an upper Hawley type of appliance with an anterior inclined plane, which is then used to support the corrected position as the posterior teeth settle fully into occlusion. The Twin Block is the most comfortable, the most esthetic ane the most efficient of all the functional appliances. Twin Blocks have many advantages compared to other functional appliances. Patients can wear Twin Blocks 24 hours per day and can eat comfortably with the appliances in place. From the moment Twin Blocks are fitted, the appearance is noticeably improved. There is less interference with normal function. Integration with conventional fixed appliances is simpler than with any other functional appliance. Twin Blocks allow independent control of upper and lower arch width. Appliance design is easily modified for transverse and sigittal arch development. The authors treated Class II malocclusion with Twin Blocks. and the results as follows; 1. Rapid profile improvement was achieved in 2-3 months. 2. There was excellent patient cooperation. 3. Severe overjet and overbite were reduced. 4. Class II molar relationship was changed to Class I.

• 대한치과교정학회지
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• 제48권1호
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• pp.11-22
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• 2018

Objective: The aim of this study was to determine cephalometric factors that help predict favorable soft-tissue profile outcomes following treatment with the Class II Twin-block appliance. Methods: Pre- and post-treatment lateral cephalograms of 45 patients treated with the Class II Twin-block appliance were retrospectively analyzed. Profile silhouettes were drawn from the cephalograms and evaluated by three orthodontists in order to determine the extent of improvement. Samples were divided into a favorable group (upper 30% of visual analogue scale [VAS] scores, n = 14) and an unfavorable group (lower 30% of VAS scores, n = 14). Skeletal and soft-tissue measurements were performed on the cephalograms and an intergroup comparison was conducted. Results: An independent t-test revealed that the following pre-treatment values were lower in the favorable group compared to the unfavorable group: lower incisor to mandibular plane angle, lower incisor to pogonion distance, point A-nasion-point B angle, sella-nasion line (SN) to maxillary plane angle, SN to mandibular plane angle, gonial angle, and symphysis inclination. The favorable group had a larger incisor inclination to occlusal plane. Moreover, the favorable group showed larger post-treatment changes in gonial angle, B point projection, and pogonion projection than did the unfavorable group. Conclusions: Class II malocclusion patients with a low divergent skeletal pattern and reduced lower incisor protrusions are likely to show more improvement in soft-tissue profile outcomes following Class II Twin-block treatment.

• 대한치과의사협회지
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• 제56권2호
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• pp.103-112
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• 2018

The treatment of skeletal Class II growing patient is to move the mandible into the Class I molar positon via facilitating mandibular growth. The functional appliances are to be designed to exert three major functions such as palatal expansion, forward growth of mandible and increase of the posterior vertical dimension. One of the devices that can achieve both the palatal expansion and the eruption of the mandibular molar is the Twin-Block introduced by Clark in 1982. In this part, we present the treatment method with Twin-Block functional appliance for the correction of skeletal Class II growing patient.

• 대한소아치과학회지
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• 제21권2호
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• pp.577-585
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• 1994

The Twin Blocks technique was developed by Dr. William Clark of Scotland during the early 1980's. Twin Blocks are an uncomplicated system that incorporates the use of upper and lower bite blocks. These blocks reposition the mandible and redirect occlusal forces to achieve rapid correction of malocclusions. They are also comfortable and the patients wear them full-time-inducing eating time. Occlusal forces transmitted through the dentition provide a constant proprioceptive stimulus to influence the rate of growth and the trabecular structure of the supporting bone. The features of Twin Blocks mean easier and quicker treatment. The occlusal inclined plane is the fundamental functional mechanism of the natural dentition. Twin blocks are bite blocks that effectively modify the occlusal inclined plane to induce favorably directed occlusal forces by causing a functional mandibular displacement. Upper and lower bite blocks interlock at a $45^{\circ}$ angle and are designed for full-time wear to take advantage of all functional forces applied to the dentition including the forces of mastication. The patients who were treated with modified Twin Blocks, and following results were observed: 1. Large overjet and deep overbite were corrected. 2. Class II molar relationship was changed into Class I. 3. Labial inclination of upper incisors was corrected by adjustment of labial bow of upper bite block. 4. The profiles of two patients were improved by anterior displacement of mandible.

• 대한소아치과학회지
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• 제47권3호
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• pp.235-247
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• 2020

이 연구의 목적은 소아청소년에서의 2급 부정교합 치료에 사용되는 기능성 악교정 장치의 효과 및 치료 시기에 따른 효과를 평가하고자 하였다. 경희대학교 소아치과에 내원한 2급 부정교합환자 30명을 대상으로 하였으며 치료에 사용된 기능성 악교정 장치에 따라 군을 나누었다. 치료 시기에 따른 비교를 위하여 경추골 성숙도 방법을 이용하여 2개의 군으로 나누어졌다. 각 실험군은 치료 전(T0)과 치료 후(T1)의 측모두부방사선사진을 비교 분석하였다. 기능성 악교정 장치 중, Twin block과 Activator는 하악골의 길이(Co-Gn)와 하안모의 길이(ANS to Me)의 유의한 증가를 보였으며, overjet과 overbite의 유의한 감소를 보였다. 반면 Fränkel appliance를 이용한 환자에서는 상하악 간의 관계 및 overjet의 유의한 개선을 보였다. 최대성장기에 기능성 악교정 장치를 사용하였을 때 최대성장기 전에 사용한 것에 비하여 유의한 하악 길이의 증가, 상악과 하악간의 관계 개선, overjet의 감소, 하악 중절치의 순측 경사의 증가를 보였다. 이 연구를 통하여 2급 부정교합을 가진 소아청소년에서 기능성 악교정 장치의 효과를 검증하였으며, 최대성장기에 치료를 시행하는 것이 더 효과적인 것을 확인하였다.

• 대한치과교정학회지
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• 제50권2호
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• pp.86-97
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• 2020

Objective: To propose a three-dimensional (3D) method for evaluating temporomandibular joint (TMJ) changes during Twin-block treatment. Methods: Seventeen patients with Class II division 1 malocclusion treated using Twin-block and nine untreated patients with a similar malocclusion were included in this research. We collected their cone beam computed tomography (CBCT) data from before and 8 months after treatment. Segmentations were constructed using ITK-SNAP. Condylar volume and superficial area were measured using 3D Slicer. The 3D landmarks were identified on CBCT images by using Dolphin software to assess the condylar positional relationship. 3D models of the mandible and glenoid fossa of the patients were constructed and registered via voxel-based superimposition using 3D Slicer. Thereafter, skeletal changes could be visualized using 3DMeshMetric in any direction of the superimposition on a color-coded map. All the superimpositions were measured using the same scale on the distance color-coded map, in which red color represents overgrowth and blue color represents resorption. Results: Significant differences were observed in condylar volume, superficial area, and condylar position in both groups after 8 months. Compared with the control group (CG), the Twin-block group exhibited more obvious condyle-fossa modifications and joint positional changes. Moreover, on the color-coded map, more obvious condyle-fossa modifications could be observed in the posterior and superior directions in the Twin-block group than in the CG. Conclusions: We successfully established a 3D method for measuring and evaluating TMJ changes caused by Twin-block treatment. The treatment produced a larger condylar size and caused condylar positional changes.

• 대한치과교정학회지
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• 제33권4호
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• pp.247-257
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• 2003

골격성 II급 1류 부정교합을 치료하는 방법으로 Activator, FR(Functional regulator), Headgear, Herbst 장치, Twin-block등의 많은 장치가 사용되어진다. 이러한 장치를 사용할 때 기대하는 가장 바람직 한 효과는 상악골의 수평적, 수직적 성장의 억제와, 하악골의 성장이 촉진되어 바람직한 골격적 관계를 가지게 되고 이러한 토대 위에 치아들이 적절하게 배열되는 것일 것이다. Teuscher장치는 Headgear의 상악골의 전하방 성장억제작용과 Activator의 하악골 성장촉진 작용을 동시에 가질 수 있도록 고안된 장치로서 실제 임상 중에 이러한 효과가 잘 구현될 수 있는지를 평가하기 위하여 성장기 남녀 각각9명(평균연령 남자 8세 11개월, 여자 9세 4개월)을 대상으로 Teuscher appliance를 평균 남아는 평균10개월, 여 아는 평균 11개월간 사용하였으며 이를 대조군과 비교 연구를 시행하였고 그 결과는 다음과 같았다. 1. 상악골의 전방 성장을 효과적으로 억제하여 주었다. 2. 상악 dentoalveolar complex의 전하방 성장을 억제하여 주었다. 3. 하악골의 전방 성장 촉진을 관찰하지 못하였다. 4. Overjet, overbite, molar key 개선에 효과적이었다. 5. 장치의 사용으로 상순의 돌출도의 개선과 안모가 향상되었다.

• 대한소아치과학회지
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• 제36권1호
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• pp.108-113
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• 2009

Functional regulator라고 불리는 $Fr{\ddot{a}}nkel$ appliance는 악안면 발육을 방해하는 비정상적인 근육의 활동을 차단하여 치열 및 악궁에 대한 힘의 불균형을 개선하고 구강 주위 근육을 훈련시켜 새로이 형성된 힘의 균형에 의해 이차적으로 악안면골의 형태 및 크기를 변화시킨다고 알려져 있다. 다른 기능적 악정형 장치물(트윈 블록, 바이오네이터, 액티베이터)과는 달리 $Fr{\ddot{a}}nkel$ 장치는 성장을 조절하는 능력이 연조직에 있고, 적당한 공간은 경조직의 발육에 유용하다는 개념을 갖는 것이 특징 적이다. 하악의 골격성 후퇴가 특징인 II급 부정교합에서 FR-II가 선택될 수 있으며, FR-II를 이용하여 하악의 자세적 위치 변화를 유발하는 것은 물론 악궁의 확대 효과 또한 기대할 수 있다. 근신경 환경의 조화에 의하여 심한 부정교합은 성공적으로 치료될 수 있을 뿐만 아니라 재발의 경향도 감소된다. 본 소아치과에 내원한 II급 부정교합 환자를 대상으로 고정성 장치의 치료없이 FR-II와 space supervision만을 적용하여 성공적인 개선을 보인 몇 가지 증례들을 보고하고자 한다.