The following studies found that Twin-Block appliance has some mandibular lengthening effect on Class ii malocclusion.
Veronica Giuntini, Andrea Vangelisti, Caterina Masucci, Efisio Defraia, James A. McNamara Jr, Lorenzo Franchi, Treatment effects produced by the Twin-block appliance Vs the Forsus Fatigue Resistant Device in growing Class II patients. Angle Orthod, DOI: 10.2319/090514-624.1, (2015).
Gong Y, Yu Q, Li PL, Wang HH, Wei B, Shen G, Efficacy evaluation of fixed Twin-block appliance and tooth extraction in skeletal Class II malocclusion. Shanghai Kou Qiang Yi Xue, 23(5):597-600, (2014).
Luciano Zilio Saikoski, Rodrigo Hermont Cançado, Fabrício Pinelli Valarelli, Karina Maria Salvatore de Freitas, Dentoskeletal effects of Class II malocclusion treatment with the Twin Block appliance in a Brazilian sample: A prospective study. Dental Press J Orthod, 19(1):36-45, (2014).
Aslı Baysal, Tancan Uysal, Dentoskeletal effects of Twin Block and Herbst appliances in patients with Class II division 1 mandibular retrognathy. Eur J Orthod, 36: 164-172, (2014).
Hanoun A, Al-Jewair TS, Tabbaa S, Allaymouni MA, Preston CB, A comparison of the treatment effects of the Forsus Fatigue Resistance Device and the Twin Block appliance in patients with class II malocclusions. Clin Cosmet Investig Dent, 2;6:57-63, (2014).
Fareen N, Alam M.K., Khamis M.F.The efficacy of twin block as a functional appliance: An overview. INTERNATIONAL JOURNAL OF PHARMA AND BIO SCIENCES 6(3):1066-1075 · JULY 2015
Our study showed about 28% increase in growth localized in the condylar neck region, which could account for increased ramal lengthening. There were also localized increases in size in the dento-alveolar regions. Please see;
Singh GD and Clark WJ. Localization of mandibular changes in patients with Class II division 1 malocclusions treated using Twin Block appliances: finite-element modeling. Am J Orthod Dentofacial Orthop. 119(4), 419-425, 2001.
As per present literature skeletal changes induced by twin block are 30- 40%. Rest are dentoalveolar.
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