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Effects of twin-block appliance on quality of life in OSA children with class 2 malocclusion and mandibular retrognathia

Maen Zreaqat, Sahal A. Alforaidi, Rozita Hassan

Journal of Oral Biology and Craniofacial Research, 2025

47 participants · 2 citations

Abstract

Purpose Twin block has been proposed as a potential oral appliance for the treatment of obstructive sleep apnea (OSA) in children with class 2 skeletal malocclusion. This study aimed to evaluate the impact of twin block appliance on quality of life in children with OSA. Materials and methods This case series study comprised 47 growing OSA children with Class 2 skeletal malocclusion and mandibular retrognathia aged 10–12 years. Patients were treated with a functional twin block appliance and the quality of life was assessed using the OSA-18 questionnaire, which was administered before appliance insertion and 30 days after the end of treatment. Additionally, a second standard overnight polysomnography (PSG) was performed to determine changes in respiratory parameters. Results All domains of the OSA-18 questionnaire showed significant changes (P < 0.025), except for physical suffering domain (P = 0.075). The mean total scores of the OSA-18 questionnaire decreased from 81.55 to and 53.07 scores (28.49 scores, P < 0.001). At the end of the treatment, the apnea-hypopnea index decreased significantly by 4.53 events/h (74.0 %), P < 0.001). Conclusion The twin block appliance resulted in a significant improvement in four of the five domains of the OSA-18 questionnaire, with a positive impact on the quality of life in OSA children with Class 2 skeletal malocclusion. Patients showed significant improvements in respiratory sleep parameters and parent-reported symptoms.

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 47 participants or records.

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