title: Class II division 2 treatment--does skeletal maturity influence success and stability?
abstract: OBJECTIVE
  To analyze the influence of skeletal maturity on Herbst multibracket (MB) treatment of Class II division 2 malocclusions and its stability.
  
  
  METHODS
  A total of 37 patients fulfilled the inclusion criteria (Class II division 2, fully erupted premolars and canines, Class II molar relationship ≥1/2 cusp widths bilaterally or 1 cusp width unilaterally, retention period ≥24 months). According to pretreatment hand wrist skeletal maturity the subjects were assigned to the groups EARLY (n=9), LATE (n=14) and ADULT (n=14). Lateral headfilms (T1: before treatment, T2: after Herbst MB treatment, T3: after retention) were analyzed using the Sagittal-Occlusal analysis and standard cephalometrics.
  
  
  RESULTS
  During Herbst MB treatment (T2-T1), significant (p<0.001) molar relationship improvement was seen in all groups (EARLY: 3.6 mm; LATE: 3.7 mm; ADULT: 3.2 mm). The amount of skeletal effects contributing to molar correction varied markedly between the groups (EARLY: 19%; LATE: 62%; ADULT: 31%). Improvement (p<0.01) was also seen for ssNB angle (EARLY: 1.8°; LATE: 1.8°; ADULT: 0.9°) and overbite (EARLY: 3.3 mm; LATE: 4.5 mm; ADULT: 4.3 mm). During retention (T3-T2), minimal changes of molar relationship (<0.2 mm) and ssNB angle (<0.5°) were seen in all groups. Also the overbite relapsed (EARLY: 0.5 mm; LATE: 1.0 mm; ADULT: 1.1 mm) only to a clinically irrelevant extent.
  
  
  CONCLUSIONS
  Irrespective of skeletal maturity, Herbst MB treatment of Class II division 2 malocclusions showed to be successful and stable. However, the LATE group showed the highest amount of skeletal effects contributing to the correction of the molar relationship.
authors: Department of Orthodontics, University of Giessen, Germany. niko.c.bock@dentist.med.uni-giessen.de
authors: N C
authors: NC
authors: Bock
authors: S
authors: S
authors: Ruf
mesh_terms: D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton; D002508:Cephalometry; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000175:diagnosis* / Q000534:rehabilitation*; D008334:Mandible / Q000000981:diagnostic imaging*; D016910:Orthodontic Brackets; D009971:Orthodontics, Corrective / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome
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