On the efficiency of two stage treatment for Class II division 1 malocclusions: a retrospective clinical study of 38 cases treated in one or two stages

Abstract

Recent evidence based prospective studies, reported by the Revue Cochrane of May 2009, suggest that the best course of action for treatment of Class II, division 1 malocclusions is to await the full eruption of the adolescent dentition and then to install a full banded and bonded appliance because at the end of treatment there is no significant difference between results obtained by a two-stage, orthopedic followed by full fixed appliance, treatment and a onestage only of full banded and bonded therapy. These studies also judge that adding a preliminary orthopedic stage to the therapeutic scheme lengthens total treatment time. In a plea for increased efficiency these authors conclude that two-stage treatment should no longer be employed in contemporary orthodontics. Nevertheless, more and more patients are seeking treatment at orthodontic offices at younger and younger ages, usually when they are between 9 and ten years old and 75% of them, according to Bassigny’s estimate, have Class II malocclusions. Ideally, orthodontists ought to be able to take advantage of this time of growth, often accompanied by change in patients’ dentitions, by instituting early treatment. The average age of patients beginning orthodontic treatment, according to these authors, is