Impact of Functional Therapy on Skeletal Structures and Airways in Patients with Class II Malocclusion: Comparison of Treatment in Prepubertal and Pubertal Phases

This study aimed to assess skeletal and upper airway modifications induced by the Twin Block appliance in patients with Class II malocclusion due to mandibular retrusion, using two-dimensional imaging techniques. A total of 11 patients (6 males, 5 females) were included and stratified into two groups (Pre-Peak and Peak) based on skeletal maturity evaluated through the cervical vertebral maturation (CVM) method. Lateral cephalometric radiographs were obtained at the beginning (T0) and end (T1) of treatment and analyzed using DeltaDent software. The appliance was worn full-time, except during meals and oral hygiene procedures, with monthly follow-ups. Significant changes were observed between T0 and T1 across the sample. Comparison between groups revealed statistically significant differences only in the H-C3a1 and vertical height (th) parameters (p < 0.05). In conclusion, the Twin Block appliance proved effective in enhancing mandibular and dental positioning, while also exerting a favorable influence on upper airway development.