Effect of Twin Block Therapy Versus Fixed Functional Appliances on Pharyngeal Airway Space in Skeletal Class II Patients: A Prospective Cephalometric Study

BACKGROUND

Class II malocclusion is one of the most common malocclusion with varied prevalence. Functional therapy with appliances like Twin Block or Fixed functional appliances forms the mainstay of treatment in growing Class II patients. These patients might demonstrate narrow airway due to the retrognathic position of the mandible. This study investigated the effects of twin block and fixed functional appliance therapy (Forsus™ FRD) on the pharyngeal airway space in skeletal Class II patients.

METHODS

Forty patients with Class II malocclusion were selected and divided into two equal groups of 20 patients each for both Twin block and Forsus group. Lateral cephalograms were obtained before and after the functional appliance therapy. Evaluation was done for changes in hyoid bone position, pharyngeal airway dimensions and tongue position.

RESULTS

The variables of the study showed better hyoid position in both the groups. In Twin Block group, an increase in hy-apw2 and hy-PoFH suggested anterior positioning of hyoid and a decrease in H-MP and hy-ML indicated superior positioning. In Forsus group an increase in H-H', hy-FH, hy-ML, hy-NL, hy-NSL and hy-OL suggested inferior positioning of hyoid, while an increase in hy-apw2, hy-CVT, hy-PoFH, hy-RL and hy'-tgo indicated anterior positioning of hyoid bone after functional therapy.

CONCLUSION

Both the twin block and Forsus™ FRD improved the position of the hyoid bone after the functional appliance therapy however the changes were not statistically significant. Twin block and Forsus™ had similar effect on the hyoid bone position, pharyngeal dimensions and the tongue position.

Comparative effect of micro-osteoperforation and Photo-biomodulation on the rate of maxillary canine retraction: A split mouth randomized clinical trial

INTRODUCTION

The lengthy duration of comprehensive orthodontic treatment has always been a major concern. Various modalities have been proposed to accelerate the orthodontic tooth movement (OTM) with varying degree of success. However, there is limited literature, comparing the efficiency of two commonly used modalities which are relatively simple, safe and comfortable chair-side procedures to accelerate orthodontic tooth movement viz. Photo-biomodulation (PBM) being non-invasive and micro-osteoperforations (MOPs) being minimally invasive. The aim was to evaluate the comparative effect of PBM and MOPs on the rate of orthodontic tooth movement (OTM).

METHODS

In this split mouth study, thirty patients requiring ma-xillary first premolar extraction were randomly allocated for Photo-biomodulation (PBM) on one side and for micro-osteoperforations (MOPs) on other side of maxilla. Separate canine retraction was performed and movement was measured over a three month period.

RESULTS

Micro-osteoperforations (MOPs) significantly increased the rate of maxillary canine retraction by 1.1 fold when compared to the Photo-biomodulation (PBM).The MOPs can successfully reduce the comprehensive fixed orthodontic treatment time by around 9% as compared to PBM.

CONCLUSIONS

Micro-osteoperforation is a more efficient modality of accelerating tooth movement as compared to Photo-biomodulation which can be used in routine orthodontic practice.

A rare case of primary retroperitoneal extraovarian granulosa cell tumor

Extraovarian granulosa cell tumors (GCTs) are rare neoplasms. They arise from the ectopic gonadal tissue along the embryonal route of genital ridge. We present a case of an extraovarian tumor in an elderly female who presented with lump in the abdomen occupying the pelvic region. She was operated and the mass was excised with intact capsule. Histopathology revealed the mass to be an adult granulosa cell tumor. Extraovarian granulosa cell tumors are very rare with only 13 such cases reported in literature to date. The present case is the largest primary retroperitoneal adult granulosa cell tumor reported till date.