Comparison of 2 types of treatment of skeletal Class II malocclusions: a 5-year post-retention analysis

Aim: To compare 2 types of treatment for Class II malocclusion assessing mandibular behavior in subjects submitted to full orthodontic treatment with standard edgewise appliance and cervical headgear (Kloehn appliance) and those who used cervical headgear in the first period and with full orthodontic appliance in the second period. Methods: The sample consisted of 80 children treated with either cervical headgear combined with full fixed appliances (n=40, group 1), or with cervical headgear at first (n=40, group 2). In both groups, lateral cephalometric radiographs were compared with those made at the beginning of treatment, at its end and at 5-year post-retention phase, in order to quantify the cephalometric measures (8 angular and 3 linear), presenting the mandibular behavior in the antero-posterior and vertical directions. All patients were treated with no extraction and no use of Class II intermaxillary elastics during the full orthodontic treatment. Results: In both groups, the effective treatment of skeletal Class II malocclusion did not interfere in the direction and amount of growth of mandibular condyles and remodeling at the lower border, with no influence on the anti-clockwise rotation of the mandible. The mandibular growth also was observed after the orthodontic treatment, suggesting that it is influenced by genetic factors. Conclusions: These observations may lead to the speculation that growing patients with skeletal Class II malocclusion and low mandibular plane are conducive to a good treatment and long-term stability with one or two periods of treatment.