Twin Block Retainers in Orthodontics
Do you have trouble sleeping and breathing at night? Or feel like you cannot close your mouth and lips all the way? And like your tongue is living in your throat? The twin block appliance may be just for you. In this article, we explain the basic problems of “retrognathia” or reverse jaw positioning and how it can be corrected with a twin block retainer device.
Note how the child in the picture cannot close his mouth properly. And after using a twin block, the the mouth and lips can be closed easily and without strain. Also notice how the cheek bones are more developed and the bags under the eyes are better.
Twin Block Corrects Anterior Growth, Lip & Tongue Posture
In the before profile picture, the lower jaw (mandible) and chin is positioned back closer to the throat. In the after picture, the jaw has moved out into a more forward position. When the mandible is positioned forward, the tongue is not living on the throat and blocking airflow and breathing. This is especially a big issue a night during sleep.
How Does the Twin Block Appliance Work
Dr. Adams may use the Twin Block when the lower jaw needs to grow a lot more forward than the upper jaw. And in kids with a lower jaw that is set back. Often this is called a deep bite. And there is poor facial profile in the bottom part of the face. This condition is called retrognathia. The Twin Block is often called a functional orthodontic treatment. “Functional” means to move the lower jaw posture position forward to improve the way your teeth bite together. The situation is about a lot more than teeth. In fact, expanders can not only straighten teeth but also improve breathing and overall health for a lifetime. Orthodontic expanders accomplish this by optimizing the shape and size of the mouth, jaws and nasal passageways for better airflow during inhalation and exhalation.
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How the Twin Block “Moves” the Mandible Forward
Twin Block orthodontic treatment requires a top and bottom device that must be worn together. Each of the appliances has a bite ramp that interlocks when closing to help guide your jaws into a more forward bite position. This will improve the growth of the bottom jaw, the overall bite and a child’s profile. The ramps are also called an index in dental orthopedics. An index is an appliance bite feature where the shape of the device only allows the patient bite into one position. Functional orthodontics increases airflow through the mouth by increasing the space in the mouth for the tongue. Anterior growth of the lower jaw also moves the tongue’s position of posture forward and further away from the airway.
Twin Block stimulates Lateral and Forward Growth:
The Twin Block can also be designed to have width and forward growth elements for the upper and lower jaws. It is a more aggressive and versatile appliance to be used in more extreme cases of underdevelopment in kids.
A Twin Block treatment is a great alternative to removing upper teeth and using retraction orthodontics to bring the upper jaw back to meet the lower jaw. Or in other cases, braces will be used to “hold-back” growth of the upper jaws as the lower jaws “catch up” and grow to meet the upper jaw. Using this strategy kids will end up with teeth that are straight but upper and lower jaws that are proportionately small and too close to the throat and main oropharyngeal airway.
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Twin Block Stimulates Natural Jaw Growth Patterns
Twin Block is an example of an anterior growth appliance for kids. The anterior growth is achieved by changing the relationship between the mandible and the cranium with the bite plane of the Twin Block device. The changes is made as the position of the temporomandibular joint remodels and “moves forward” and down. This is what happens during natural growth and development in childhood as well. The upper jaw grows naturally during development and the lower jaw moves forward as the maxilla grows outward. The twin block assists a lower jaw that for whatever reason did not grow forward on its own, to grow or “move” forward. Twin blocks work best on kids and have not been regularly used for adults.
Anterior Growth Appliances for Adults
The Vivos DNA appliance is an adult anterior growth appliance that is FDA cleared for sleep apnea. The DNA can help with poor profile and retrognathia. The AGGA and the ALF appliances are two other appliances that have been used for adults as well as kids. The Homeoblock expander is another example of an adult device that is very similar to the DNA device that should be explored.
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