Long-term stability of Angle Class II, division 1 malocclusions with successful occlusal results at end of active...

The purpose of this study was to examine long-term stability of Angle Class II, Division 1 malocclusions with successful occlusal results at the end of active appliance therapy, search for predictors of relapse, and look for characteristics associated with successful treatment. Records taken before and after treatment and a mean of 14.0 years postretention of adolescent patients treated for a significant Angle Class II, Division 1 malocclusion both with and without tooth extraction were evaluated. The sample was limited to successfully treated cases as judged by subjective evaluation of intercuspation and incisor occlusion of posttreatment study models and included 78 patients. Cephalometric characteristics or postretention occlusion was not considered in sample selection. The mode response was no change postretention for molar, premolar, and canine relationships and relapse of 0.5 mm for overjet and overbite. Maximum relapse was 3.5 mm for molar, premolar, and canine relationship, 3 mm for overjet, and 4.5 mm for overbite. Stepwise backward multiple regression analyses revealed no associations between either pretreatment characteristics or skeletal and dental treatment changes and relapse of overjet. However, relapse of overjet was associated with relapse of molar, premolar, and canine relationships, postretention increase in overbite, postretention proclination of maxillary incisors, and postretention retroclination of mandibular incisors. Active treatment changes included redirection or inhibition of maxillary growth and retraction of maxillary incisors. Mandibular incremental growth was favorable both during and after treatment. It was concluded that successful correction of Angle Class II, Division 1 malocclusions through differential growth adaptation and tooth movement appears to be very stable.