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Updated: Jan 31, 2026

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Class II division 1 malocclusions: comparisons between one- and two-step treatment
C Maspero1, G Galbiati1, L Giannini1
1Department of Orthodontics, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico. University of Milan, Italy.
Aim:
The aim of this study consists in comparing the two-step treatment with that performed in a single-step in adolescent patients.
Materials And Methods:
Study design: This paper is a critical review of the literature with a systematic approach. The search for scientific articles was performed on the US National Library of Medicine database using the PubMed service. Keywords set: "Early treatment Class II OR 1-phase orthodontics OR orthodontic timing Class II". From the initial screening 20 articles were selected of which the full text has been researched and evaluated.
Results:
The selected articles were reviewed and evaluated by two independent operators, who both excluded two papers. Ultimately 13 articles were selected that refer to four major working groups, respectively from Manchester, North Carolina, Florida and Queen Mary University of London.
Conclusion:
We can assume that both the one- and two-step treatment are effective in correcting Class II malocclusion, with no significant difference of outcome, except for the incidence of incisor trauma, which was significantly lower for the early treatment group.
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