Skeletal Changes Seen in Nonsurgically Treated Patients with Skeletal Class II Malocclusion

Aims and objectives: To evaluate and compare the skeletal changes before and after the treatment of skeletal class II malocclusion with the extraction of premolars followed by fixed appliance therapy.Materials and methods: Thirty individuals, with class II skeletal patterns due to a prognathic maxilla, were selected as per the inclusion criteria.Pretreatment and posttreatment lateral cephalograms of the selected study participants were obtained, analyzed, and compared to assess the changes that might have occurred.Descriptive statistics mean and standard deviation were calculated for all variables.The pretreatment and posttreatment changes were calculated using the paired t-test.A value of p < 0.05 is considered to be statistically significant.Results: There was a decrease in mean SNA posttreatment, i.e., 1.82° and there was a decrease in mean SNB posttreatment, i.e., 0.65°.The mean ANB values also showed a significant decrease of 1.17°.Both the SN-GoGn and the FMA increased significantly by 0.83 and 1°, respectively.There was a significant increase in all facial height values [total anterior facial height (TAFH), lower anterior facial height (LAFH), and posterior facial height (PFH)].The WITS values were observed to significantly decrease by 0.79 mm.There was also a statistically significant increase in the n-B and N-Pog values.Conclusion: The results showed that extraction therapy in skeletal class II patients due to a prognathic maxilla (with class II div 1 malocclusion) has an overall improvement of the patients' skeletal profile since most of the reduction in the sagittal parameters was due to the remodeling of point A rather than the forward displacement of point B. An increase in the overall facial height was also observed in all the study participants.This in turn led to a backward displacement of point B leading to a potential worsening of the facial profile which was overcome by the significant remodeling of point A. Clinical significance:An important factor to be taken into consideration is the control of vertical height while retracting the anteriors as this study proves that there was a definite increase in the anterior facial height and TAFH of patients at the end of the treatment.The use of head gear/mini implants is mandatory to maintain the vertical relationship of the molars especially while treating patients who have a hyperdivergent growth pattern.