Does Early Treatment Improve Clinical Outcome of Class II Patients? A Retrospective Study

Abstract

The present study was carried out to evaluate the benefits from one-phase Class II Early Treatment (ET) using extraoral forces and functional appliances but without intermaxillary forces and eventual lower leeway space preservation compared to two-phase Class II Late Treatment (LT) with the need for extractions and full fixed appliances as well as lower incisor proclination. The ET group (n = 239, 115 M, 124 F, mean age 10.6 ± 1.2 years), with first premolars not in contact and the second deciduous lower molars preserved, was compared to the LT group (n = 288, 137 M, 151 F, mean age 12.4 ± 1.5 years). The ET group was first treated with headgears, growth guide appliances, or Teuscher activators and, in borderline crowding cases, with lower space maintenance by a lingual arch, lip bumper, or fixed utility arch. The LT group and the second phase of ET were treated with full fixed appliances including intermaxillary forces such as Class II elastics or noncompliance devices; headgear and a growth guide appliance were also used. Cephalograms and plaster models were taken before (T1) and after treatment (T2) to calculate cephalometric changes and space balance discrepancies. The differences between T1 and T2 were analyzed by a t-test for normally distributed data and by the Mann–Whitney Test for nonnormally distributed data at a level of p < 0.05. The groups were defined as statistically homogeneous at T1. A statistical analysis showed that the ET group (mean treatment time 35.3 ± 13.3 months) was significantly associated with a 22.2% lower extraction rate, 15.9% less need for a full fixed appliance, and more than 5° less incisor proclination in the nonextraction cases compared to the LT group (mean treatment time 25.9 ± 8.1 months); treatment time significantly increased in the ET group compared to the LT group. Early Class II treatment resulted in a significant treatment effort reduction in more than one third of the patients and less lower incisor proclination, even if it clinically increased treatment time.

Skeletal, Dental and Soft Tissue Cephalometric Changes after Orthodontic Treatment of Dental Class II Malocclusion with Maxillary First Molar or First Premolar Extractions

“…Several treatment approaches have been proposed to manage an Angle Class II malocclusion, taking into consideration skeletal relationship, dentoalveolar discrepancies and residual facial growth [ 1 ]. Extraction strategies should consider the patient’s soft tissue, sagittal and vertical discrepancy, growth pattern and crowding, in order to improve or, at least, not worsen esthetic, occlusal and functional relationships [ 2 , 3 , 4 ].…”

The Effectiveness of Using Twin Block Functional Appliances and Activators in Class II Malocclusion

“…(9) Class II malocclusion is one of the most common malocclusions in the world. (11)(12)(13)(14) The correct diagnosis to decide on the appropriate treatment plan should be considered. Treatment options for Class II malocclusion may include extraoral appliances, functional appliances, and fixed appliances.…”

“…Treatment options for Class II malocclusion may include extraoral appliances, functional appliances, and fixed appliances. (12) Harun Achmad et al: The Effevtiveness of Using Twin Block Functional Appliances and Activators in Class II Malocclusion There are various functional tools that can be used for the correction of class II malocclusion, such as: Activator and twin block. According to Clark, the twin block appliance is the most widely used among other types of functional appliance.…”

Changes in the anterior and posterior occlusal plane in nongrowing females with hyperdivergent skeletal Class II malocclusion treated with mini-implant anchorage

“…The key to correct these inconsistencies is to induce the mandible to rotate in a counterclockwise direction [3]. Early interventions, such as cervical headgear [4], growth guide appliances [5], Herbst appliances [6,7], and clear aligners [8],…”