EVALUATION OF EFFECTS OF THE TWIN BLOCK APPLIANCE (TBA) THERAPY ON CHANGES IN POSTERIOR PHARYNGEAL AIRWAY SPACE DIMENSIONS AND IMPROVEMENT IN MILD SLEEP APNOEA SYMPTOMS IN CLASS 2 DIV 1 GROWING PATIENT WITH RETROGNATHIC MANDIBLE: A CASE REPORT

Dr. S. M. Shahnawaj Tahir*, Prof. Kuldeep DMello, Dr. Atul Singh, Dr. Jitesh Wadhwa and Dr. Omkar Yadav

ABSTRACT

Objective: To evaluate the effect of twin block appliance for changes in posterior pharyngeal airway (PPA) dimensions and improvement in mild sleep apnoea symptoms in class 2 division 1 growing patient with retrognathic mandible in a case report. Materials and Methods: 13 years old male patient with retrognathic mandible class 2 molar relation large overjet and the deep overbite selected for the case report. Polysomnography was done to confirm the sleep apnoea symptoms. Pt. given a twin block appliance with instructions to wear 24 hrs a day until the patient got pterygoid reflex. Preoperative and postoperative conventional Lateral ceph taken, traced manually on an 8×16 matte tracing sheet with an HB pencil. Various landmarks were used for cephalometric evaluation. Results: Marked improvement in the SA symptoms posts sagittal correction in the patient TBA therapy. There was a decrease in soft palatal length post-treatment and an increase in soft palatal thickness. Significant improvement seen in soft palate inclination following class 2 correction. Depth of the Oropharynx and Hypopharynx increased significantly post-treatment. Conclusion: Significant improvement of sleep apnoea symptoms in this patient, which showed that class 2 correction by a twin block appliance may help in reducing predisposing factors of obstructive sleep apnoea by mandibular advancement.

Keywords: Twin Block Appliance, Sleep Apnoea, Polysomnography, Retrognathic Mandible, Pterygoid reflex. Aberrations used: PPA–Posterior pharyngeal airway, TBA–Twin block appliance, SA-sleep apnoea, DOP-the depth of oropharynx, PAP-Pharyngeal airway passage.