Alternative plan In Phase I, additional functional appliances, such as the Activator, might be used instead of the Twin Block. Headgear therapy is another alternative, although it is not suggested in this case since it has a restraining effect on the maxilla, whereas repositioning the mandible would enhance the facial profile more. Twin Block was chosen over Activator because to increased patient...

Model study revealed a missing upper left central incisor, which is linked to space loss (3 mm), and a little crowded lower arch (4 mm). The patient's occlusion included a 7 mm overjet, an average and incomplete bite on the palatal mucosa, and midlines that coincided between the upper and lower teeth. Special examinations of the upper incisors revealed normal tooth color and normal cold and percus...