Correction of Class II malocclusion with Class II elastics: A systematic review

Introduction: Although Class II elastics have been widely used in the correction of Class II malocclusions, there is still a belief that their side effects override the intended objectives. The aim of this systematic review was to evaluate the true effects of Class II elastics in Class II malocclusion treatment. Methods: A search was performed on PubMed, Scopus, Web of Science, Embase, Medline, and Cochrane databases, complemented by a hand search. Study eligibility criteria were the application of Class II elastics in Class II malocclusion treatment and the presentation of dental or skeletal outcomes of treatment. All age groups were included. Results: The search indentified 417 articles, of which 11 fulfilled the inclusion criteria. Four studied the isolated effects of Class II elastics, and 7 were comparisons between a single use of elastics and another method for Class II malocclusion correction. Because of the differences in treatment modalities in these articles, a meta-analysis was not possible. Conclusions: Based on the current literature, we can state that Class II elastics are effective in correcting Class II malocclusions, and their effects are primarily dentoalveolar. Therefore, they are similar to the effects of fixed functional appliances in the long term, placing these 2 methods close to each other when evaluating treatment effectiveness. Little attention has been given to the effects of Class II elastics on the soft tissues in Class II malocclusion treatment. (Am J Orthod Dentofacial Orthop 2013;143:383-92)