Evaluation of Knowledge, Attitude, and Clinical Practices Related to Twin Block Therapy in Pediatric Class II Malocclusion: A National Survey of Dental Professionals
Abstract
Class II malocclusion is a common orthodontic condition in growing children and adolescents, with mandibular retrusion being a frequent skeletal component. Functional appliances such as the Twin Block appliance are commonly used for growth modification during the mixed dentition and early adolescent period. Variations in clinicians’ knowledge, attitudes, and clinical practices may influence appliance selection, timing, compliance monitoring, and treatment outcomes. A cross-sectional questionnaire-based survey was conducted among pediatric dentists, orthodontists, postgraduate students in pediatric dentistry, and postgraduate students in orthodontics practicing or training in India. The study was conducted from the Department of Pediatric and Preventive Dentistry, Terna Dental College, Navi Mumbai, Maharashtra, India, after ethical approval. A validated questionnaire assessed knowledge, attitudes, and clinical practices related to Twin Block therapy. Content validity was established by expert review, and the questionnaire was pilot-tested before dissemination. Data were analyzed using Chi-square and Kruskal–Wallis tests. Statistical significance was set at P < 0.05. A total of 192 complete responses were analyzed. Most participants correctly identified Class II Division 1 malocclusion as the primary indication for Twin Block therapy. The horizontal growth pattern was considered most favorable by 78.6% of respondents. Most participants reported that Twin Block therapy produces both skeletal and dentoalveolar changes. No statistically significant difference in knowledge scores was observed among the professional groups ( P = 0.074). Attitudes toward treatment predictability and stability were positive, and attitude scores did not differ significantly among groups ( P = 0.168). Dental professionals demonstrated adequate knowledge and a favorable attitude toward Twin Block therapy for growing patients with Class II malocclusion. Continued clinical training and standardized protocols are recommended, especially for postgraduate students, to improve confidence in case selection, appliance management, and long-term follow-up.