Efficiency in the correction of Class II division 1 malocclusions with prominent upper incisors and increased overjet: a comparison between two methods

BACKGROUND: The aim of the present study was to evaluate the efficiency and effectiveness of high-pull traction on a Stephenson plate as well as cervical headgear treatments in Class II Division 1 growing subjects with prominent upper teeth and an increased overjet. METHODS: A prospective study was undertaken, involving participants who underwent maxillary correction of Class II malocclusions. Twenty-three patients (Stephenson plate group, SPG, mean age 10.4 +/- 0.9 years) were treated and compared with 24 subjects treated with headgear (HGG, mean age 9.6 +/- 1.2 years). Lateral cephalograms were analysed using Jarabak and Pancherz analysis. Shapiro-Wilk's and Student's t tests were applied. RESULTS: The SPG showed significant decreases in the overjet (-4.1 versus -0.8 mm) and molar relationship (-6.1 versus -1.5 mm). A significant upper-incisor correction was found in SPG (1/SpP -10.3 degrees versus + 2.2 degrees). SNA (-1.4 versus 0.3 degrees) and WITS (-1 versus 0.3 mm) were reduced in SPG, showing a partial maxillary restraint. In SPG, the overjet correction (4.1 mm) was mainly due to the dental component (65.9%) and occurred almost completely in the maxilla (92.7%); the molar relationships improvement of 6.1 mm was mainly dental (77%); in HGG, the reduction of the overjet was limited (-0.8 mm), and the skeletal maxillary contribution was negligible. CONCLUSIONS: The high-pull traction on the Stephenson plate was more efficient and effective than HG in the treatment of Class II dentoskeletal malocclusions with prominent upper teeth and a severe overjet; the overjet reduction was obtained at approximately 6 months, contributing to the substantial Class II correction.