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. 2025 Jul-Aug;15(4):864-868.
doi: 10.1016/j.jobcr.2025.06.003. Epub 2025 Jun 13.

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

Maen Zreaqat  1 , Sahal Alforaidi  2 , Rozita Hassan  1
Affiliations

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

Maen Zreaqat et al. J Oral Biol Craniofac Res. 2025 Jul-Aug.

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.

Keywords: Quality of life; Sleep apnea; Twin block.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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