Improving the diagnosis and orthodontic management of Class II malocclusion in children

Relevance. Numerous approaches to correcting malocclusion in children are based on established orthodontic concepts. However, existing diagnostic principles for pediatric dentofacial anomalies have not been incorporated into a standardized algorithm, which may hinder the achievement of stable orthodontic outcomes. This highlights the need to refine diagnostic protocols and orthodontic management strategies for children with malocclusion. Accounting for the individual spatial relationship of the jaws is essential for effective orthodontic planning.

Objective. To improve diagnostic protocols and orthodontic management for Class II malocclusion in children during the mixed dentition period.

Materials and methods. The study included 90 children aged 6–9 years who were followed for 12 months. The participants were divided into four groups. Groups 1 and 2 each comprised 25 patients who received occlusal overlays followed by aligner treatment. Group 3 comprised 25 patients treated with a removable maxillary plate with an anterior inclined plane. Group 4 included 15 untreated controls. In Group 1, the mandibular position was determined using a facebow transfer and a GAMMA Dental articulator. In Group 2, the mandibular position was registered using a construction bite. The anteroposterior position of the mandibular basal region relative to the anterior cranial base was assessed using the SND angle, while craniocervical parameters were evaluated using Rocabado cephalometric analysis.

Results. At the 12-month assessment, the SND angle was within the reference range in 86.67% of patients in Group 1, 63.3% in Group 2, and 53.3% in Group 3 (p < 0.05). The craniocervical parameters assessed using Rocabado cephalometric analysis normalized in all treated patients, with the greatest improvement observed in Group 1.

Conclusion. Orthodontic assessment using a facebow and articulator allows the optimal mandibular position for appliance fabrication to be determined in children aged 6–9 years while accounting for individual maxillomandibular relationships, thereby facilitating normalization of the assessed craniofacial and craniocervical cephalometric parameters.

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