DOI

10.17077/etd.lxy86kyz

Document Type

Thesis

Date of Degree

Spring 2016

Degree Name

MS (Master of Science)

Degree In

Orthodontics

First Advisor

Veerasathpurush Allareddy

First Committee Member

Sreedevi Srinivasan

Second Committee Member

Satheesh Elangovan

Third Committee Member

Robert Staley

Abstract

Introduction: Class II Division 1 malocclusions are characterized by a retrusive mandible and prominent upper incisors. Despite Class II malocclusions being one of the most frequently treated cases in orthodontists' office, there is no uniform consensus in the orthodontic community on the best treatment modality and biomechanical approach to use in treating patients with Class II malocclusions.

Purpose: This paper examines the end-of-treatment outcomes of severe Class II Division I malocclusion patients treated with surgical versus non-surgical approaches.

Study Design: This is a retrospective study of consecutively treated severe Class II Division I patients at the University of Iowa. Initial and deband lateral cephalometric radiographs were compared between 45 non-surgical and 21 surgical patients. All patients that were debanded between the ages of 13 to 19 years were included. Multivariable regression analyses were used to examine differences in outcomes between treatment groups.

Results: Following adjustment for patient level confounders (age, gender, and race), those treated surgically had better end of treatment cephalometric outcomes. Those treated surgically had a more balanced skeletal profile, greater reduction in overjet, and improvement in ANB angle (p

Conclusion: Orthodontic treatment in conjunction with orthognathic surgery is a more ideal treatment for patients with severe Class II Division I malocclusion. When treated surgically, a greater amount of overjet can be reduced while keeping lower incisors in a more stable position in bone.

Public Abstract

Class II Division 1 malocclusions are characterized by a retrusive lower jaw and prominent upper incisors. Despite Class II malocclusions being one of the most frequently treated cases in orthodontists’ office, there is no uniform consensus in the orthodontic community on the best treatment modality and biomechanical approach to use in treating patients with Class II malocclusions. This paper examines the end-of-treatment outcomes of severe Class II Division I malocclusion patients treated with surgical versus non-surgical approaches. This is a retrospective study of consecutively treated severe Class II Division I patients at the University of Iowa. Initial and deband lateral head films were compared between 45 non-surgical and 21 surgical patients. All patients that were debanded between the ages of 15 to 19 years were included. Following adjustment for patient level confounders (age, gender, and race), those treated surgically had better end of treatment outcomes. Those treated surgically had a more balanced skeletal profile, greater reduction in incisor prominence, and improvement in ANB angle (p<0.05). Those treated non-surgically had proclined lower incisors (p<0.01). Orthodontic treatment in conjunction with orthognathic surgery is a more ideal treatment for patients with severe Class II Division I malocclusion. When treated surgically, a greater amount of upper incisor prominence can be reduced while keeping lower incisors in a more stable position in bone.

Keywords

publicabstract, Cephalometric, Class II Division 1, Masking, Orthognathic surgery, Orthopedic, Severe malocclusion

Pages

vii, 28 pages

Bibliography

Includes bibliographical references (pages 25-28).

Copyright

Copyright 2016 Patrick Brady

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