Class II division 1 malocclusion treatment with extraction of maxillary first permanent molars: cephalometric evaluation of treatment and post-treatment changes

Booij, Johan Willem; Kuijpers-Jagtman, Anne Marie; Bronkhorst, Ewald M.; Rangel, Frits A.; Livas, Christos; Ren, Yijin; Katsaros, Christos; Ongkosuwito, Edwin M. (2021). Class II division 1 malocclusion treatment with extraction of maxillary first permanent molars: cephalometric evaluation of treatment and post-treatment changes. Australasian orthodontic journal, 37(2), pp. 294-310. Australian Society of Orthodontists 10.21307/aoj-2021.032

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Objective:
To investigate the cephalometric outcome and post-treatment changes following the orthodontic treatment involving the extraction of maxillary first molars in patients presenting with a Class II division 1 malocclusion.
Methods:
A retrospective longitudinal study was conducted involving 83 patients treated by fixed appliances and the extraction of 16 and 26. The mean age at commencement was 13.2 ± 1.5 years. Lateral cephalograms were available pre-treatment (T1), immediately post-treatment (T2), and at 2.6 years post-treatment (T3). The sample was divided into hypodivergent (n = 18), normodivergent (n = 17), and hyperdivergent (n = 48) facial types. Mean increments, standard deviations, and 95% confidence intervals were calculated for T2–T1 and T3–T2. Increments were tested using paired-samples t-tests, and variables between groups by applying ANOVA followed by Tukey’s post hoc test. Linear regression was used to examine the effect of facial type, age, and gender.
Results:
Significant changes occurred during treatment for most cephalometric variables. Post-treatment, the growth pattern showed a tendency to return to the original form. Facial type had only a minor influence on cephalometric increments during and after treatment.
Conclusions:
Post-treatment skeletal, soft tissue, and dentoalveolar changes were limited. Facial type had only a minor influence during and after treatment and care must be taken to control lower incisor inclination.

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