PDF: Relevant variables of Class II malocclusion treatment

Success rate in Class II malocclusion treatment can be significantly influenced by factors such as treatment protocol, malocclusion severity, patient age and degree of patient compliance.

Since malocclusion severity and age are inherent patient characteristics which are, therefore, defined ahead of time, these variables are beyond professional control. It has been shown that patient compliance is hard to predict by means of simple anamnestic methods of psychiatric or behavioral evaluation. 

Although unpredictable, degree of compliance is one of the key variables affecting orthodontic treatment success, notably when the treatment plan involves the use of removable appliances, whose effectiveness relies considerably on patient compliance.

In light of the treatment protocols currently available, Class II malocclusion can be treated with or without extractions.

The extraction protocol consists basically in extracting either four or two premolars in the upper arch whereas nonextraction treatment can be performed using extraoral anchorage, functional orthopedic appliances, Class II elastics combined with fixed appliances or, more recently, intraoral distalizing appliances.

According to this review, it was concluded that Class II malocclusion treatment results are strongly influenced by the treatment protocol, while skeletal characteristics do not seem to exert significant influence.