Comparison Between 2 Protocols for the Treatment of Class II Division 2 Malocclusion

A Prospective Randomized Clinical Trial to Compare Between Two Leveling and Alignment Protocols for the Treatment of Class II Division 2 Malocclusion

The aim of this prospective study was to compare between two different treatment modalities of class II division 2; to start treatment in upper arch first until adequate overjet is obtained or to start in the lower arch first with removable anterior bite plane in upper arch.

Fifty four subjects with class II division 2 participated in this study. The subjects were randomly divided into two groups; Group one (28 patients): orthodontic treatment with upper arch bond up first and lower arch was bonded when 4 mm overjet was reached. The treatment continued until 0.019 x 0.025 " stainless steel wires were reached in both arches. Group 2 (26 patients): orthodontic treatment with lower arch bond up first with removable anterior bite plane in upper arch. When 0.019 x 0.025" stainless steel wire was reached, the upper arch was bonded. The treatment continued until 0.019 x 0.025" stainless steel wires were reached. Three cephalograms were taken for each patient in both groups; pretreatment (T0) , after bonding the other arch (T1) and at the end of leveling and alignment in both arches (T2). Cephalometric measurements and superimpositions were made. Skeletal and dentoalveolar treatment changes were compared within and between the 2 groups.

Inclusion Criteria:

• Age ≥ 17 years and ≤ 26 years
• Class II division 2 malocclusion.
• Overjet (OJ) < 4 mm.
• Overbite (OB) covering more than half of the lower incisor height.
• Mild to moderate crowding with tooth contact displacement no more than 2 mm.
• Good oral hygiene and healthy periodontium.

Exclusion Criteria:-

• Systemic health problems and medications were taken.
• History of previous orthodontic treatment.