Craniocervical Posture Improvement Using Twin Block: A Scoping Review

Authors

  • Mulia Ayu Hanifa Universitas Padjadjaran
  • Ratna Indriyanti Universitas Padjadjaran

DOI:

https://doi.org/10.46799/jhs.v6i5.2551

Keywords:

Skeletal class II malocclusion, twin block appliance, mandibular improvement, craniocervical posture

Abstract

Functional appliances, such as twin block, effectively treat for skeletal class II malocclusion. The twin block exerts a significant influence on mandibular growth, that contributes to the improvement of craniocervical posture. This scoping review aims to systematically map and evaluate the current literature on the effects of twin block appliance treatment on craniocervical posture. A scoping review followed to PRISMA-ScR guidelines.  A comprehensive research conducted in three online databases-Scopus, Pubmed, Springer Link- from 2014-2024. Article selection followed the PCC framework. Studies about the impact of twin block appliance on craniocervical posture were included. A total of 49 articles selected after eliminating duplicates, four articles met the inclusion criteria. The findings from these studies indicate the effect of twin block appliance usage on craniocervical posture. The twin block appliance not only impacts skeletal and dentoalveolar changes, but also craniocervical posture. Evidence suggest that mandibular advancement may induce postural adaptations by altering the craniofacial and cervical spine relationship.

References

Aglarci, C. (2016). Evaluation of cervical spine posture after functional therapy with twin-block appliances. Journal of Orthodontic Research, 4(1), 8. https://doi.org/10.4103/2321-3825.179739

Alsheikho, H. O., Jomah, D. H., Younes, M., Tizini, M., Hassan, H., & Khalil, F. (2024). Evaluation of head and cervical spine posture after functional therapy with Twin‑Block and Bionator appliances: A pilot randomized controlled trial. Cranio - Journal of Craniomandibular and Sleep Practice, 42(1), 102–111. https://doi.org/10.1080/08869634.2021.1909455

Buyukcavus, M. H., & Kale, B. (2021). Skeletal and Dental Effects of Twin-Block Appliances in Patients Treated with or without Expansion. Turkish Journal of Orthodontics, 34(3), 155–162. https://doi.org/10.5152/TurkJOrthod.2021.20103

Chang, J., Park, S. H., Park, J. H., Lee, S., Yu, H. S., Lee, K. J., Chung, C. J., & Kim, K. H. (2025). Craniocervical Posture and Cervical Curvature Variations in Adult Females with Different Vertical Facial Patterns: A Cross-Sectional Study. Applied Sciences (Switzerland), 15(5), 1–14. https://doi.org/10.3390/app15052391

Clark, W. J. (2015). Twin block functional therapy.

Çoban Büyükbayraktar, Z., & Camcı, H. (2023). Dentoalveolar, skeletal, pharyngeal airway, cervical posture, hyoid bone position, and soft palate changes with Myobrace and Twin-block: a retrospective study. BMC Oral Health, 23(1), 1–12. https://doi.org/10.1186/s12903-023-02773-x

Di Giacomo, P., Ferrara, V., Accivile, E., Ferrato, G., Polimeni, A., & Di Paolo, C. (2018). Relationship between cervical spine and skeletal Class II in subjects with and without temporomandibular disorders. Pain Research and Management, 2018. https://doi.org/10.1155/2018/4286796

Dogra, B., Handa, A., Chakravarthy, N., Sarda, A. S., Chavan, A., & Nalawade, K. (2022). Different realms of twin block- A review article. IP Indian Journal of Orthodontics and Dentofacial Research, 7(4), 291–300. https://doi.org/10.18231/j.ijodr.2021.048

Dr. Risti Saptarini Primarti., S. K. (2019). Perawatan maloklusi Kelas II divisi I dengan Twin Blok.

Ehsani, S., Nebbe, B., Normando, D., Lagravere, M. O., & Flores-Mir, C. (2014). Short-term treatment effects produced by the Twin-block appliance: A systematic review and meta-analysis. European Journal of Orthodontics, 37(2), 170–176. https://doi.org/10.1093/ejo/cju030

Kamal, A. T., & Fida, M. (2019). Evaluation of cervical spine posture after functional therapy with twin-block appliances: A retrospective cohort study. American Journal of Orthodontics and Dentofacial Orthopedics, 155(5), 656–661. https://doi.org/10.1016/j.ajodo.2018.06.012

Khan, M. I., Neela, P. K., Unnisa, N., Jaiswal, A. K., Ahmed, N., & Purkayastha, A. (2022). Dentoskeletal effects of Twin Block appliance in patients with Class II malocclusion. Medicine and Pharmacy Reports, 95(2), 191–196. https://doi.org/10.15386/mpr-1989

Krishna, S. S. S., Shashikumar, B., & Naik, R. D. (2023). Evaluation and Comparison of Cervical Spine Posture in Class II Division I Patients Treated with Twin Block Appliances, Forsus Appliances, and Bilateral Sagittal Split Osteotomy: A Cephalometric Study. Contemporary Clinical Dentistry, 8(September), 157–165. https://doi.org/10.4103/ccd.ccd

Kui, A., Bereanu, A., Condor, A. M., Pop, D., Buduru, S., Labunet, A., Șoicu, S., Buduru, R., & Chisnoiu, A. (2024). Craniocervical Posture and Malocclusion: A Comprehensive Literature Review of Interdisciplinary Insights and Implications. Medicina (Lithuania), 60(12), 1–17. https://doi.org/10.3390/medicina60122106

Lubis, H. F., Idrus, E., S, D. F. S., Widayati, R., & P, M. K. (2024). Biological Mechanism of Orthodontic Movement in The Treatment of Skeletal Class II Malocclusion Using Twin Block. Interdental Jurnal Kedokteran Gigi (IJKG), 20(3), 395–399. https://doi.org/10.46862/interdental.v20i3.9656

Murali, S., Kannan, A., & Kailasam, V. (2024). Cervical spine changes with functional appliance treatment: A systematic review and meta-analysis. Journal of Oral Biology and Craniofacial Research, 14(4), 446–454. https://doi.org/10.1016/j.jobcr.2024.05.015

Peng, H., Liu, W., Yang, L., Yan, P., Zhong, W., Gao, X., & Song, J. (2024). Craniocervical posture in patients with skeletal malocclusion and its correlation with craniofacial morphology during different growth periods. Scientific Reports, 14(1), 1–11. https://doi.org/10.1038/s41598-024-55840-w

Sandoval, C., Díaz, A., & Manríquez, G. (2021). Relationship between craniocervical posture and skeletal class: A statistical multivariate approach for studying Class II and Class III malocclusions. Cranio - Journal of Craniomandibular Practice, 39(2), 133–140. https://doi.org/10.1080/08869634.2019.1603795

Sharmila, R., & Balashanmugam, B. (2022). Assessment of Correction of Cervical Hypolordosis in Class II Skeletal Patients with Mandibular Retrognathism after Twinblock Therapy. International Journal of Innovative Science and Research Technology, 7(5).

Smailiene, D., Intiene, A., Dobradziejute, I., & Kusleika, G. (2017). Effect of Treatment with Twin-Block Appliances on Body Posture in Class II Malocclusion Subjects : A Prospective Clinical Study. Medical Science Monitor, 23, 343–352. https://doi.org/10.12659/MSM.899088

Suleman Shah, S., Rasool, G., & Faiz-Ul-Hassan. (2015). Relationship Between Head Posture and Lower Arch Dental Crowding. Pakistan Oral & Dental Journal, 35(3), 420–423.

Yoana, Y., Chemiawan, E., & Setiawan, A. S. (2017). Dentoalveolar changes in post-twin block appliance orthodontic treatment class II dentoskeletal malocclusion. Dental Journal (Majalah Kedokteran Gigi), 50(4), 211. https://doi.org/10.20473/j.djmkg.v50.i4.p211-215

Zokaitė, G., Lopatienė, K., Vasiliauskas, A., Smailienė, D., & Trakinienė, G. (2022). Relationship between Craniocervical Posture and Sagittal Position of the Mandible: A Systematic Review. Applied Sciences (Switzerland), 12(11). https://doi.org/10.3390/app12115331

Downloads

Published

2025-05-30

Issue

Vol. 6 No. 5 (2025): Journal Health Sains

Section

Articles

License

Copyright (c) 2025 Mulia Ayu Hanifa

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Authors who publish with this journal agree to the following terms:

  • Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under aCreative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA). that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  • Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  • Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.