Esthetic myofunctional intervention for mandibular retrognathia in skeletal Class II: A case report

• Author Details:   
• Nausheer Ahmed
• Rajalakshmi S.J
• Eduru Niharika
• Abrar Younus A ^*
• Chethana .

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A 13-year-old male patient presenting with a developing Class II Division 1 malocclusion, characterized by a retrognathic mandible, average growth pattern, convex facial profile, posterior divergence, negative lip step, and a favorable visual treatment objective, was identified to be at cervical vertebral maturation stage 3 (CVMI). The patient was planned for treatment using a esthetic version of the conventional twin block appliance.
Although various myofunctional devices such as Activators, Bionators, and Frankel appliances are available, the twin block—comprising two separate blocks—is often the preferred choice due to its ease of fabrication and simple design when compared with other options.
A significant challenge in treating growing children with skeletal Class II discrepancies is maintaining consistent appliance usage. The modified twin block described in this case replaces traditional wire elements like delta clasps and labial bows with Essix-based thermoformed sheets that provide full tooth coverage. This design is intended to enhance patient comfort and promote longer appliance usage.In summary, with careful case planning and precise implementation, the esthetic twin block can effectively address Class II Division 1 malocclusions in growing patients.