Twin-Block and LIPUS for TMJ Outcomes in Skeletal Class II Patients

Inclusion Criteria: * Skeletal class II due to retrognathic mandible. * Angle's class II Molar relationship. * All patients involved in the study were in stages II and III based on the modified cervical vertebral maturation stages (CVMS) by Bacetti et al.5 * Proclined upper incisors * Increased overjet \> 5 mm. * Aligned lower arch or average inclination * Minimal crowding of lower arch. * No history of previous orthodontic treatment. Exclusion Criteria: * Skeletal class II due to prognathic maxilla. * Patient with gross facial asymmetry. * Previous orthodontic or orthopedic treatment. * Clinical signs and symptoms of any Temporomandibular joint disorders. * Increased anterior facial vertical dimension. * Poor oral hygiene.