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• W2000576169 abstract "On the first page of their recent article, Keski-Nisula et al (Keski-Nisula K, Lehto R, Lusa V, Keski-Nisula L, Varrela J. Occurrence of malocclusion and need of orthodontic treatment in early mixed dentition. Am J Orthod Dentofacial Orthop 2003:124:631-8) go to the heart of the argument against the conclusions drawn from the 3 large studies1Wheeler T.T. McGorray S.P. Dolce C. Taylor M.G. King G.J. Effectiveness of early treatment of Class II malocclusion.Am J Orthod Dentofacial Orthop. 2002; 121: 9-17Abstract Full Text Full Text PDF PubMed Scopus (117) Google Scholar, 2Keeling S. Wheeler T.T. King G.J. Garvan C.W. Cohen D.A. Cabassa S. et al.Anteroposterior skeletal and dental changes after early Class II treatment with binonators and headgear.Am J Orthod Dentofacial Orthop. 1998; 113: 40-50Abstract Full Text Full Text PDF PubMed Scopus (199) Google Scholar, 3Tulloch J.F. Phillips C. Proffit W.R. Benefit of early Class II treatment: Progress report of a two-phase randomized clinical trial.Am J Orthod Dentofacial Orthop. 1998; 113: 62-72Abstract Full Text Full Text PDF PubMed Scopus (189) Google Scholar conducted in the United States. I believe their focus is right on the money. All 3 of those studies had the same recommendation; ie, there was no significant advantage to intervention in the early mixed dentition for Class II malocclusions. The support for this is based on research with a flawed sample. That sample is supposed to represent Class II patients. If one is to obtain any meaningful information about whether there is an advantage to treat early, it is necessary to differentiate cephalometrically between the types of Class II cases that are being studied and, in addition, either to eliminate or identify Class I skeletal cases with overlying Class II dental malocclusions. Comparison of data is valid only if it is between accurately diagnosed samples. Unfortunately, in reviewing other articles in the literature on related topics of early treatment or the effectiveness of different appliance for early treatment, I see the same type of flawed sample used to report results.4Bremen J. Pancherz H. Efficiency of early and late Class II Division 1 treatment.Am J Orthod Dentofacial Orthop. 2002; 121: 31-37Abstract Full Text Full Text PDF PubMed Scopus (65) Google Scholar, 5Ghafari J. Shofer F.S. Jacobsson-Hunt U. Markowitz D.L. Laster L.L. Headgear versus function regulator in the early treatment of Class II, Division 1 malocclusion: a randomized clinical trial.Am J Orthod Dentofacial Orthop. 1998; 113: 51-61Abstract Full Text Full Text PDF PubMed Google Scholar, 6O'Brien K. Wright J. Conboy F. Sanjie Y. Mandall N. Chadwick S. et al.Effectiveness of treatment for Class II malocclusion with the Herbst or Twin-block appliances: a randomized, controlled trial.Am J Orthod Dentofacial Orthop. 2003; 124: 128-137Abstract Full Text Full Text PDF PubMed Scopus (168) Google Scholar In other words, know what you are studying. Categories might be divided into Class II skeletal, Class II dental, or a combination of both Class II skeletal with an overlying Class II dental malocclusion. In addition, the subjects need to be further subdivided into normodivergent, hypodivergent, and hyperdivergent categories. The cephalometric analysis that is used to confirm and divide the different samples to be studied and confirm the results obtained should be able to differentiate between skeletal dysplasias in both the horizontal and vertical planes. Only then will a valid study have been completed, resulting in useful information for the practitioner. Dental molar relationship and amount of overjet are a superficial and overly simplistic definition of Class II." @default.
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• W2000576169 title "Early mixed dentition treatment" @default.
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• W2000576169 doi "https://doi.org/10.1016/j.ajodo.2004.01.012" @default.
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