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Overjet problems at the growing child, case report using the twin block appliance


Objective : Overjet is a horizontal relationship between maxillary and mandibular incisors. Normal range from overjet is 2-4 mm. Increased overjet is marked by maxillary incisor’s protrusion. A 6 mm overjet will have impact on psychological and social relationship of children due to the aesthetics of the face profile. Increased overjet has relationship with Class II Angle malocclusion, Class II skeletal sagittal relationship, and mandibular retrognathia. Clinical problem caused by increased overjet in children are maxillary permanent incisors trauma in growing age, damaged periodontal tissue, lip incompetency, social impact such as lack of confidence in children, and also increased overjet has a close relationship with Temporomandibular Disorder (TMD) sign and symptoms.Methods : Increased overjet case can be managed by maxillary retraction of labial segment and increasing mandibular labial segment. Case management are based on skeletal and soft tissue pattern and patient’s age. Reducing overjet can be based on using several appliances, such as functional removable appliance to modify dental and skeletal relationship, fixed orthodontic appliances with tipping and bodily movement or using jaw reposition by orthognathic surgery.Results : One of the effective appliance to reduce overjet, especially Class II malocclusion treatment is Twin Block Functional Appliances developed by Clark. Twin Block appliances is used for developing age children in certain time period to support mandibular growth. This appliance is easy to use, so the patient cooperativity can be maintained. Maximum treatment depends on children’s cooperativity.  By using Twin Block functional appliance, we can observe that early treatment can be effective to reduce overjet, to change skeletal pattern, and to increase children psychology such as self-confidence by making aesthetic changes to their faces significantly.[B1] Conclusion : This appliances is made with 70o angle to occlusal plane. Maxillary arch lateral expansion can be achieved with expansion screw. Patient will be instructed to use the appliance for 24 hours a day.[B2]  


  1. Baccetti T, Giuntini V, Vangelisti A, et al. Diagnostic performance of increased overjet in class II division 1 malocclusion and incisor trauma. Prog Orthod 2010;11: 145-150.
  2. Turasi B, Demirkaya AA, Biren S. Comparison of increased overjet cases and controls: normative data for condylar positions. Journal Oral Rehabil 2007;34: 129-135.
  3. Jabbar NSA, Bueno ABM, Silva PED, Bottle feeding, increased overjet and class 2 primary canine relationship : is there any association?. Braz Oral Res 2011;25: 331-337.
  4. Antunes LAA, Gomes IF, Almeida MH, Increased overjet is a risk factor for dental trauma in preschool children. Indi J Den Res 2015;26: 356-360.
  5. Wagner Y, Weltzien RH. Occlusal characteristic in 3 years old children-results of a birth cohort study. BMC Oral Health 2015;15: 1-6.
  6. Antoniou C dan kawan-kawan. Class II Division 1 Malocclusions-early diagnosis & management part. Australian Society of Orthodontist.; 2010. p. 1-4.
  7. Ramesh N, Guruanthan D, Khartikeyyan SA. Association of nonnutritive sucking habits and Malocclusion: a cross‑sectional study. Int J Pedodont Rehab 2016;1; 15-18.
  8. Denny JM, Weiskircher MA, Dorminey JC. Anterior open bite dan overjet treated with camouflage therapy. Am J Orthop 2007;131: 670-678.
  9. O’Brien K, Wright J, Conboy F, et al. Early treatment for Class II division 1malocclusion with the twin-block appliance: A multi-center, randomized, controlled trial. Am J Orthod Dentofacial Orthop 2009;135: 573-579.
  10. Puri T, Patel D. Skeletal Discrepancy Correction In Class II Div 1 Malocclusion Using Fixed Twin Blocks. IOSR JDMS 2014;13: 65-67.
  11. Sood S. Treatment of Class II division 1 Malocclusion in a non growing patient. VJO 2010.
  12. Gupta S, Kumar-Jindal S, Bansal M, et al. Prevalence of traumatic dental injuries and role of incisal overjet and inadequate lip coverage as risk factors among 4-15 years old government school children in Baddi-Barotiwala Area, Himachal Pradesh, India. Med Oral Patol Oral Cir Bucal 2011;16: 960-965.
  13. Saltaji H, Flores-Mir C. The relationship between vertical facial morphology and overjet in untreated Class II subjects. Angle Orthod 2012;82: 432-440.

How to Cite

Achmad, M. H. (2017). Overjet problems at the growing child, case report using the twin block appliance. Journal of Dentomaxillofacial Science, 2(1), 63–69.




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Muhammad H. Achmad
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