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Classification and treatment of Class II subdivision malocclusions
Sara E Cassidy1, Stona R Jackson2, David L Turpin3
1Private practice, Seattle, Wash.
Summary
Class II subdivision malocclusions, often challenging due to asymmetry, were categorized into three groups, with mandibular asymmetry being the most common. Treatment trends show less surgery and more fixed functional appliances, though midline correction can be difficult.
Area of Science:
- Orthodontics and Dentofacial Orthopedics
- Dental Malocclusion Classification
- Craniofacial Asymmetry Analysis
Background:
- Class II subdivision malocclusions present significant clinical challenges, particularly in achieving arch symmetry.
- Mandibular skeletal asymmetry often necessitates surgical intervention, which may not be preferred by all patients.
- Exploring non-surgical treatment options and understanding etiologies is crucial for managing these complex cases.
Purpose of the Study:
- To evaluate the etiologies of Class II subdivision malocclusions.
- To assess treatment outcomes for Class II subdivision malocclusions.
- To analyze treatment trends over a 15-year period at a graduate orthodontic clinic.
Main Methods:
- Retrospective analysis of 110 Class II subdivision subjects treated between 1995 and 2011.
- Classification of 98 subjects into three groups based on midline position and dental/skeletal etiology.
- Measurement of peer assessment rating scores, midlines, overjet, overbite, molar positions, and cephalometric variables.
Main Results:
- Mandibular asymmetry was the most prevalent etiology (approx. 50%) in Class II subdivision malocclusions.
- Treatment trends indicated reduced use of surgery, extractions, and headgear, with increased reliance on fixed functional appliances.
- Ideal midline correction was not always achieved, especially with mandibular skeletal asymmetry; mandibular incisor proclination increased with fixed functional appliance use.
Conclusions:
- Class II subdivision malocclusions can be categorized into three main groups, with mandibular asymmetry being the largest.
- Treatment strategies have evolved, showing a shift towards non-surgical approaches and fixed functional appliances.
- Midline and molar correction success varies, particularly in cases with skeletal asymmetry, and mandibular incisor proclination is a notable outcome.
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