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Extraction therapy in patients with Class II/2 malocclusion.
A Stellzig1, E K Basdra, C Kube
1Poliklinik für Kieferorthopädie, Klinik für Mund-, Zahn- und Kieferkrankheiten, University of Heidelberg, Germany. Angelika-Stellzig@ukl.uni-heidelberg.de
Summary
This study examined Class II, Division 2 malocclusion development and treatment effects. Premolar extraction caused significant upper lip recession and renewed spacing, while second molar extraction had minimal profile changes.
Area of Science:
- Orthodontics
- Craniofacial Growth
Background:
- Class II, Division 2 malocclusion presents unique developmental patterns.
- Understanding treatment impacts on facial profile and dental stability is crucial.
Purpose of the Study:
- To analyze the natural development of Class II, Division 2 malocclusion.
- To evaluate the cephalometric effects of premolar and maxillary second molar extraction in these patients.
- To compare extraction outcomes with untreated Class II/2 patients.
Main Methods:
- Longitudinal cephalometric analysis of 20 untreated Class II/2 patients (Belfast Growth Study).
- Comparison with 20 patients undergoing four-quadrant premolar extraction and 20 undergoing maxillary second molar extraction.
- Evaluation of third molar eruption from panoramic radiographs and overbite from study models.
Main Results:
- Untreated Class II/2 patients showed profile flattening during growth.
- Premolar extraction led to significant upper lip recession and renewed spacing.
- Maxillary second molar extraction resulted in minimal profile flattening and reduced interincisal angle, similar to Class I occlusion.
Conclusions:
- Premolar extraction significantly impacts the upper lip profile and can cause spacing issues.
- Maxillary second molar extraction offers a more favorable profile change compared to premolar extraction.
- The benefit of premolar extraction for third molar eruption is questionable and should not drive treatment decisions.