Dental and facial skeletal characteristics and growth of females and males with Class II Division 1 malocclusion between the ages of 10 and 14 (revisited). Part II. Anteroposterior and vertical circumpubertal growth

Growth changes in the dentition and the facial skeleton of boys and girls with Class I malocclusion from 10 to 14 years of age are presented, and the changes are compared with those for children with Class II Division 1 malocclusion. Radiographs of 335 children with Class II Division 1 malocclusion and 273 Class I controls were assessed. Radiographs were converted to x and y coordinate data, and 52 commonly used linear, angular, and coordinate axis measurements were made. Both the Class II Division 1 and the control groups were subdivided into 6 samples according to sex and skeletal age (10, 12, and 14 years +/- 6 months; chronological age ranged from 8.5 to 15.5 years). The mean plots from the coordinate data for the Class I boys and girls at 14 years were superimposed over the mean plots for the 10-year-old groups, creating circumpubertal growth standards. The standards are supported by growth vector diagrams and other data and lead to the following conclusions: (1) boys and girls with Class I malocclusion differ distinctly from each other in the amount and the direction of circumpubertal growth; (2) radiographic composite standards are useful and accurate clinical tools to show mean dentofacial skeletal growth and change between 10 and 14 years of age; (3) compared with the controls, the maxillary dentition of girls with Class II Division 1 malocclusion grows more horizontally, the maxillary (but not the mandibular) incisors procline farther, and the mandible grows more horizontally; (4) compared with the controls, the midfacial convexity in Class II Division 1 boys is markedly increased, due to more horizontal growth at A-point and less horizontal growth at nasion and pogonion, and maxillary and mandibular anterior teeth are proclined farther; (5) angular measurements involving S, N, A-point, B-point, and Pog are useful only when the position of N is known; and (6) cranial base flexure bears no relationship to the development of Class II Division 1 malocclusion.