Effects of fixed functional orthodontic treatment in hypodivergent and hyperdivergent class II patients : a retrospective cephalometric investigation

Abstract

Objective To compare skeletal and dentoalveolar changes after orthodontic treatment of class II malocclusion in patients with hypodivergent and hyperdivergent growth patterns through cast splint fxed functional appliances (FFA). Materials and methods N=42 out of n=47 patients with mandibular plane angles<34° or≥34° were divided into a hypodivergent (n=24) and a hyperdivergent (n=18) group. All patients received a single-step mandibular advancement protocol through an FFA. Lateral cephalograms were analyzed after initial leveling and alignment (T1) and immediately after FFA removal (T2). The therapeutic efect was calculated through comparison with age-matched controls from a growth survey. Statistical signifcance was set at p<0.05. Results Hypodivergent and hyperdivergent patients showed diferent treatment outcomes, but signifcant diferences existed only for overbite and interincisal angle. Nearly all measurements suggested similar treatment-related changes for both groups with exception for dentoalveolar parameters. Conclusion Treatment with FFA causes similar skeletal and dentoalveolar efects in hypodivergent and in hyperdivergent patients. The correction of overjet and molar relationship is mainly caused by dentoalveolar changes. Clinical relevance Hyperdivergent patients do not respond unfavorably to FFA treatment compared to hypodivergent patients. Lower incisor protrusion occurs more pronounced in hypodivergent patients. The growth pattern ought to be considered when choosing FFA for class II treatment.