ORIGINAL RESEARCH article
Front. Dent. Med.
Sec. Pediatric Dentistry
Volume 6 - 2025 | doi: 10.3389/fdmed.2025.1581032
Soft tissue evaluation of functional therapy in growing patients with Class II malocclusion: Mandibular Advancement vs Twin Block -A retrospective study
Provisionally accepted
Letizia Lugli1*
Chiara Pavoni1
Francesca Chiara De Razza1,2Francesca Gazzani1saveria loberto1Elisabetta Cretella Lombardo1Paola Cozza1*Roberta Lione1- 1Saint Camillus International University of Health and Medical Sciences, Rome, Italy
- 2Sapienza University of Rome, Rome, Lazio, Italy
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The aim of this retrospective study was to assess the soft tissues changes resulting from Class II treatment with functional appliances (Twin Block versus Mandibular Advancement), when compared to an untreated Class II control group.The records of 45 Class II patients who underwent treatment with Twin Block (TB group: n= 22; mean age: 11.3 ± 1.4 years) or Mandibular Advancement (MA group: n=23; mean age: 11.2 ± 1.3 years) were analyzed in comparison with a control sample of untreated Class II subjects (Untreated Control group = 24; mean age: 11.2 ± 1.1 years). The data were collected before treatment (T1) and at the conclusion of the functional therapy phase (T2). Cephalometric modifications were assessed among the three groups using ANOVA and Tukey's post hoc tests.Results: Significant improvements were observed for mandibular sulcus and the facial profile angle in the treated groups compared to the Untreated control group (facial profile angle: TB group: +5.67°; MA group: +6.34°; mandibular sulcus: TB group: +10.0°; MA group: 11.77°). The distance of Pogonion (Pg) to the True Vertical Line (TVL) exhibited significant differences among the three groups, with a more pronounced advancement of the soft tissue pogonion in the TB group (TVL-Pg': TB group: +3 mm; MA group: +0.9 mm; untreated control group: -1.6 mm).Treatment with removable functional devices (TB or MA) during puberty produced beneficial effects on the soft tissue profile. Both treated groups demonstrated a significant improvement in the Class II convex profile, accompanied by a less evident mandibular sulcus.
Keywords: Class II malocclusion, Functional therapy, Clear aligners, Twin Block, Mandibular Advancement
Received: 21 Feb 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Lugli, Pavoni, De Razza, Gazzani, loberto, Cretella Lombardo, Cozza and Lione. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Letizia Lugli, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
Paola Cozza, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
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