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BioMed Research International
Volume 2017 (2017), Article ID 4861924, 9 pages
Research Article

Comparison of Activator-Headgear and Twin Block Treatment Approaches in Class II Division 1 Malocclusion

1Department of Orthodontics, School of Medicine, University of Rijeka, Rijeka, Croatia
2Private Practice, Tannregulering Kristiansand, Kristiansand, Norway
3Department of Orthodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway

Correspondence should be addressed to Stjepan Spalj

Received 1 November 2016; Accepted 4 January 2017; Published 22 January 2017

Academic Editor: Simona Tecco

Copyright © 2017 Stjepan Spalj et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The purpose was to compare the treatment effects of functional appliances activator-headgear (AH) and Twin Block (TB) on skeletal, dental, and soft-tissue structures in class II division 1 malocclusion with normal growth changes in untreated subjects. The sample included 50 subjects (56% females) aged 8–13 years with class II division 1 malocclusion treated with either AH () or TB () appliances. Pre- and posttreatment lateral cephalograms were evaluated and compared to 50 untreated class II division 1 cases matched by age, gender, ANB angle, and skeletal maturity. A paired sample, independent samples tests and discriminant analysis were performed for intra- and intergroup analysis. Treatment with both appliances resulted in significant reduction of skeletal and soft-tissue facial convexity, the overjet, and the prominence of the upper lip in comparison to untreated individuals (). Retroclination of maxillary incisors and proclination of mandibular incisors were seen, the latter being significantly more evident in the TB group (). Increase of effective mandibular length was more pronounced in the TB group. In conclusion, both AH and TB appliances contributed successfully to the correction of class II division 1 malocclusion when compared to the untreated subjects with predominantly dentoalveolar changes.