Prevalence Of Class II In Dravidian Population Based On Moyers Subtypes: A Cephalometric Study

AbstractBackground: Class II malocclusion exhibits considerable skeletal and dental heterogeneity that is often inadequately described by Angle’s dental classification. Moyers’ cephalometric subclassification, based on horizontal and vertical skeletal–dental relationships, provides a more biologically meaningful framework for understanding Class II patterns. Population-specific evaluation of these subtypes is essential, as craniofacial morphology varies across ethnic groups.Aim: To determine the prevalence and distribution of Moyers’ horizontal and vertical Class II malocclusion subtypes in a Dravidian population and to evaluate their association with age and gender using cephalometric analysis.Materials and Methods: This retrospective study analyzed 455 pretreatment lateral cephalograms of Dravidian subjects diagnosed with Class II malocclusion. Cephalometric assessment was performed digitally using FACAD software with Steiner’s, McNamara’s, Wits, and Rakosi analyses. Each case was classified into Moyers’ horizontal (A–F) and vertical (1–5) subtypes by calibrated examiners. Frequency distribution was calculated, and Chi-square tests were used to assess associations of subtypes with age and gender.Results: Horizontal Subtype F was the most prevalent pattern, while Vertical Subtype 2 predominated among vertical patterns. A statistically significant association was observed between age and horizontal subtypes (p = 0.02), and between gender and horizontal subtypes (p = 0.04). No significant association was found between age or gender and vertical subtypes. Angle’s dental classification showed variable overlap with Moyers’ skeletal subtypes.Conclusion: The Dravidian population demonstrated a distinct distribution of Moyers’ Class II subtypes, emphasizing the influence of ethnic craniofacial characteristics. Moyers’ cephalometric classification provides superior diagnostic insight compared to Angle’s system and facilitates more individualized treatment planning.