Purpose: The purpose of this study was to assess the bony trabecular pattern changes seen in growing skeletal class-II malocclusion treated with twin block therapy and comparison with non-treated group. Material and Methods: Full mouth Periapical radiographs of patients were taken pre and post twin block therapy. Regions of interest (100__ampersandsigntimes;100 pixels) were located between apices of the teeth of the maxillary and mandibular anterior, premolar, and molar area. The fractal dimension (FD) was calculated by using the box counting method. The particle count (PC) and area fraction (AF) analyses were also performed. Results: There was significant difference in the FD values among the different groups of age, gender, upper, and lower jaws. The p-value of FD-0.011, PC-0.001 and AF-0.002 showed significant results after post twin block therapy. Conclusion: In this study pre-treatment radiographs showed irregular vertical arrangement of the spongy trabeculae running from the walls of the socket of one tooth or root to the next and also parallel to the long axis of tooth. Post-treatment radiograph showed a regular horizontal arrangement of spongiosa and dense trabeculation and perpendicular to long axis of tooth.