The timing of treatment for Class II malocclusions in children: a literature review

Two basic strategies for the timing of treatment for Class II malocclusions in children are common: (1) correction achieved in two phases, one during pre-adolescence (early treatment) and the other during the teen years; and (2) correction accomplished in one phase of active treatment during the adolescent years. The issues of efficacy and cost(risk)-benefit of these strategies have not been well delineated. Most clinical studies examining these issues have suffered serious methodological deficiencies, such as being retrospective, lacking adequate controls, and evaluating only successfully treated cases. However, despite a lack of objective data, clinicians have shown considerable interest in recent years in two-phase treatment. This paper reviews major issues of two-phase Class II treatment and concludes by delineating several important clinical questions which could be resolved by a carefully controlled prospective study.