title: Mechanism of Class II correction in prepubertal and postpubertal patients with Twin Force Bite Corrector.
abstract: OBJECTIVE
  To compare the dentoskeletal effects and treatment efficiency of the Twin Force Bite Corrector (TFBC) appliance in Class II correction of patients treated before or after the pubertal growth spurt.
  
  
  METHODS
  Forty-one normodivergent Class II patients treated with the TFBC appliance were divided into two groups based on their cervical vertebral maturation stage (CVMS). Group 1 (G1) consisted of 23 patients (mean age 12.44 ± 1.59 years) where treatment was initiated before the pubertal growth spurt (CVMS I and II), while group 2 (G2) consisted of 18 patients (mean age 13.76 ± 1.44 years) where treatment was started after the pubertal growth spurt (CVMS III to V). Dentoskeletal measurements were made on lateral cephalograms taken before (T1) and after orthodontic treatment (T2).
  
  
  RESULTS
  During treatment, G1 had significantly greater skeletal correction than G2, with more dentoalveolar effects being observed in G2 than G1. However, on comparing both groups at the end of treatment (T2) when growth is complete, no differences in the parameters measured were observed. Overall, treatment time was significantly longer for G1 (3.67 ± 1.45 years) compared to G2 (2.75 ± 1.07 years).
  
  
  CONCLUSIONS
  There is no difference in overall dentoskeletal effects obtained at the end of treatment by the TFBC appliance in normodivergent prepubertal vs postpubertal patients. However, treatment efficiency based on treatment timing is significantly greater for the postpubertal group.
authors.affiliation: Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA. adityachhibber14@gmail.com
authors.forename: Aditya
authors.initials: A
authors.lastname: Chhibber
authors.forename: Madhur
authors.initials: M
authors.lastname: Upadhyay
authors.forename: Flavio
authors.initials: F
authors.lastname: Uribe
authors.forename: Ravindra
authors.initials: R
authors.lastname: Nanda
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods; D059925:Anatomic Landmarks / Q000473:pathology; D002508:Cephalometry / Q000379:methods; D002574:Cervical Vertebrae / Q000254:growth & development; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000473:pathology; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D008334:Mandible / Q000473:pathology; D008437:Maxilla / Q000473:pathology; D008963:Molar / Q000473:pathology; D009295:Nasal Bone / Q000473:pathology; D016382:Orthodontic Appliance Design; D017289:Orthodontic Appliances, Functional; D057887:Overbite / Q000473:pathology / Q000628:therapy; D011627:Puberty / Q000502:physiology*; D012189:Retrospective Studies; D012658:Sella Turcica / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome