An evaluation of combination second molar extraction and functional appliance therapy

The purpose of this study was to examine the results of a treatment regimen involving the extraction of four second molars followed by a combination of sagittal, Bionator, and fixed appliance therapy. The pretreatment and posttreatment cephalometric and dental cast records of 30 consecutively treated Class II, Division 1 cases were evaluated. Results showed that the Class II skeletal correction was achieved by a "headgear" effect inhibiting maxillary growth in conjunction with normal forward mandibular growth. No significant distal bodily movement or tipping of either maxillary or mandibular first molars was found. Significant increases were seen in maxillary arch length, maxillary intercanine and intermolar width, and mandibular intermolar width as a result of treatment. Maxillary third molar position tended to improve following second molar extraction; mandibular third molar changes were more variable.