Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types

Background The dentoalveolar component of a Class II division 1 malocclusion can be orthodontically treated either with extractions or by distalization of the molars. This study aimed to compare skeletal, dentoalveolar and profile changes in normodivergent and hyperdivergent Class II Division I grow...

Full description

Bibliographic Details
Main Authors: Johan Willem Booij, Marta Fontana, Marco Serafin, Rosamaria Fastuca, Anne Marie Kuijpers-Jagtman, Alberto Caprioglio
Format: Article
Language:English
Published: PeerJ Inc. 2022-12-01
Series:PeerJ
Subjects:
Online Access:https://peerj.com/articles/14537.pdf
_version_ 1827606264362827776
author Johan Willem Booij
Marta Fontana
Marco Serafin
Rosamaria Fastuca
Anne Marie Kuijpers-Jagtman
Alberto Caprioglio
author_facet Johan Willem Booij
Marta Fontana
Marco Serafin
Rosamaria Fastuca
Anne Marie Kuijpers-Jagtman
Alberto Caprioglio
author_sort Johan Willem Booij
collection DOAJ
description Background The dentoalveolar component of a Class II division 1 malocclusion can be orthodontically treated either with extractions or by distalization of the molars. This study aimed to compare skeletal, dentoalveolar and profile changes in normodivergent and hyperdivergent Class II Division I growing patients orthodontically treated with fixed appliances including maxillary first molar extraction. Methods Sixty-four patients treated orthodontically with full fixed appliances including maxillary first molar extractions were retrospectively analyzed. Patients were divided into a normodivergent group (Group N; 30° ≤ SN^GoGn < 36°) consisting of 38 patients (17M, 21F; mean age 13.2 ± 1.3 years) and a hyperdivergent (Group H; SN^GoGn ≥ 36°) including 26 patients (12M, 14F; mean age 13.7 ± 1.1 years). Lateral cephalograms were available before (T0) and after treatment (T1) and cephalometric changes were calculated for 10 linear and 13 angular variables. The Shapiro–Wilk test confirmed a normal distribution of data, hence parametric tests were employed. The Student t-test was used to compare groups at baseline. The paired t-test was used to analyze intragroup changes between timepoints, and the Student t-test for intergroup comparisons. The level of significance was set at 0.05. Results The Class II division 1 malocclusion was successfully corrected, and the facial profile improved both in normodivergent and hyperdivergent patients. Divergency increased by 0.76 ± 1.99° in Group N (p = 0.02) while it decreased −0.23 ± 2.25° (p = 0.60); These changes were not significant between groups after treatment (p = 0.680). Most dentoskeletal measurements changed significantly within groups but none of them showed statistically significant differences between groups after treatment. Dental and soft tissue changes were in accordance with the biomechanics used for this Class II orthodontic therapy. Discussion The effect of orthodontic treatment of Class II division 1 malocclusion including extraction of the maxillary first molars in growing patients can be considered clinically equivalent in normodivergent and hyperdivergent patients. For this reason, this orthodontic treatment can be considered a viable option in the armamentarium of the Class II Division I therapy for both facial types.
first_indexed 2024-03-09T06:35:45Z
format Article
id doaj.art-f5c679e55bd44cd0a7358e4af016bf5f
institution Directory Open Access Journal
issn 2167-8359
language English
last_indexed 2024-03-09T06:35:45Z
publishDate 2022-12-01
publisher PeerJ Inc.
record_format Article
series PeerJ
spelling doaj.art-f5c679e55bd44cd0a7358e4af016bf5f2023-12-03T10:59:55ZengPeerJ Inc.PeerJ2167-83592022-12-0110e1453710.7717/peerj.14537Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial typesJohan Willem Booij0Marta Fontana1Marco Serafin2Rosamaria Fastuca3Anne Marie Kuijpers-Jagtman4Alberto Caprioglio5Gorinchem, The NetherlandsVarese, ItalyDepartment of Biomedical Sciences for Health, University of Milan, Milan, ItalyVarese, ItalyFaculty of Dentistry, Universitas Indonesia, Jakarta, IndonesiaDepartment of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, ItalyBackground The dentoalveolar component of a Class II division 1 malocclusion can be orthodontically treated either with extractions or by distalization of the molars. This study aimed to compare skeletal, dentoalveolar and profile changes in normodivergent and hyperdivergent Class II Division I growing patients orthodontically treated with fixed appliances including maxillary first molar extraction. Methods Sixty-four patients treated orthodontically with full fixed appliances including maxillary first molar extractions were retrospectively analyzed. Patients were divided into a normodivergent group (Group N; 30° ≤ SN^GoGn < 36°) consisting of 38 patients (17M, 21F; mean age 13.2 ± 1.3 years) and a hyperdivergent (Group H; SN^GoGn ≥ 36°) including 26 patients (12M, 14F; mean age 13.7 ± 1.1 years). Lateral cephalograms were available before (T0) and after treatment (T1) and cephalometric changes were calculated for 10 linear and 13 angular variables. The Shapiro–Wilk test confirmed a normal distribution of data, hence parametric tests were employed. The Student t-test was used to compare groups at baseline. The paired t-test was used to analyze intragroup changes between timepoints, and the Student t-test for intergroup comparisons. The level of significance was set at 0.05. Results The Class II division 1 malocclusion was successfully corrected, and the facial profile improved both in normodivergent and hyperdivergent patients. Divergency increased by 0.76 ± 1.99° in Group N (p = 0.02) while it decreased −0.23 ± 2.25° (p = 0.60); These changes were not significant between groups after treatment (p = 0.680). Most dentoskeletal measurements changed significantly within groups but none of them showed statistically significant differences between groups after treatment. Dental and soft tissue changes were in accordance with the biomechanics used for this Class II orthodontic therapy. Discussion The effect of orthodontic treatment of Class II division 1 malocclusion including extraction of the maxillary first molars in growing patients can be considered clinically equivalent in normodivergent and hyperdivergent patients. For this reason, this orthodontic treatment can be considered a viable option in the armamentarium of the Class II Division I therapy for both facial types.https://peerj.com/articles/14537.pdfClass II malocclusionNormodivergencyHyperdivergencyMaxillary first molar extractionCephalometric analysis
spellingShingle Johan Willem Booij
Marta Fontana
Marco Serafin
Rosamaria Fastuca
Anne Marie Kuijpers-Jagtman
Alberto Caprioglio
Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types
PeerJ
Class II malocclusion
Normodivergency
Hyperdivergency
Maxillary first molar extraction
Cephalometric analysis
title Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types
title_full Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types
title_fullStr Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types
title_full_unstemmed Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types
title_short Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types
title_sort treatment outcome of class ii malocclusion therapy including extraction of maxillary first molars a cephalometric comparison between normodivergent and hyperdivergent facial types
topic Class II malocclusion
Normodivergency
Hyperdivergency
Maxillary first molar extraction
Cephalometric analysis
url https://peerj.com/articles/14537.pdf
work_keys_str_mv AT johanwillembooij treatmentoutcomeofclassiimalocclusiontherapyincludingextractionofmaxillaryfirstmolarsacephalometriccomparisonbetweennormodivergentandhyperdivergentfacialtypes
AT martafontana treatmentoutcomeofclassiimalocclusiontherapyincludingextractionofmaxillaryfirstmolarsacephalometriccomparisonbetweennormodivergentandhyperdivergentfacialtypes
AT marcoserafin treatmentoutcomeofclassiimalocclusiontherapyincludingextractionofmaxillaryfirstmolarsacephalometriccomparisonbetweennormodivergentandhyperdivergentfacialtypes
AT rosamariafastuca treatmentoutcomeofclassiimalocclusiontherapyincludingextractionofmaxillaryfirstmolarsacephalometriccomparisonbetweennormodivergentandhyperdivergentfacialtypes
AT annemariekuijpersjagtman treatmentoutcomeofclassiimalocclusiontherapyincludingextractionofmaxillaryfirstmolarsacephalometriccomparisonbetweennormodivergentandhyperdivergentfacialtypes
AT albertocaprioglio treatmentoutcomeofclassiimalocclusiontherapyincludingextractionofmaxillaryfirstmolarsacephalometriccomparisonbetweennormodivergentandhyperdivergentfacialtypes