Diagnostic considerations and orthodontic treatment approaches of adolescents with the dentoalveolar form of class II malocclusion

Relevance. Class II malocclusion (distal occlusion) is a common pathology of the maxillofacial region in the sagittal plane and is one of the most prevalent malocclusions. Studies confirm that Class II malocclusion in adolescents exhibits significant variability, prompting the development of various treatment approaches using both removable and fixed orthodontic appliances. The challenges of adolescence include concurrent physiological and psychological changes, which can complicate the treatment process.

Purpose. To enhance the effectiveness of orthodontic treatment for patients with the dentoalveolar form of Class II malocclusion by utilizing the Rotation-Torque Index (RTI).

Material and methods. A study was conducted on 49 residents of St. Petersburg with physiological occlusion types, who were included in the control group. The main group comprised 95 adolescents (aged 12-18) with the dentoalveolar form of Class II malocclusion classified into three levels of severity, based on the proposed working prognostic classification.

Results. A new method was developed to calculate a coefficient that describes the relationship between the position of the upper and lower jaws and the torque of the central incisors. This coefficient helps predict treatment outcomes and guides the selection of the optimal treatment strategy. The Rotation-Torque Index (RTI) was introduced to quantify the relationship between the position of the jaws in the skull (SNA, SNB) and the inclination of the central incisors of the upper jaw relative to the nasal line (NL) and those of the lower jaw relative to the mandibular line (ML).

Conclusions. Based on the Rotation-Torque Index (RTI), a working prognostic classification and treatment strategies for patients with the dentoalveolar form of Class II malocclusion were proposed.

1. Agashina MA, Balakhnichev DN, Fischev SB, Lepilin AV, Dmitrienko SV. Features parameters of the dental arches in two planes with a given diagonal size. Pediatric dentistry and dental prophylaxis. 2016;15(4):61-63 (In Russ). Available from: https://www.elibrary.ru/item.asp?id=27511472

2. Kondratyuk AA, Fischev SB, , Fomin IV, Subbotin RS, Lepilin AV. Features of the torc of medial incisors in people with different types of dental arches, according to the results of the analysis of cone-beam computed tomograms. Pediatric dentistry and dental prophylaxis. 2019;19(1):40-45 (In Russ.). doi: 10.33925/1683-3031-2019-19-69-40-45

3. Malygin YuM, Taybogarova SS, Malygin MYu, Velieva NI. The significance of dentoalveolar arches structure for the differential diagnostics of distal occlusion. Orthodontiya. 2014;(3):10-14. (In Russ). Available from: https://www.elibrary.ru/item.asp?id=23288228

4. Ogir ES, Persin LS, Pankratova NV, Kuznetzova GV, Pronina KS. Values of biopotentials of temporal and masseter muscles under different occlusal forces in children 7-12 years with physiological and distal occlusion. Orthodontiya. 2013;(3):19-25 (In Russ). Available from: https://www.elibrary.ru/item.asp?id=22926259

5. Chromenkova KV, Dybov AM, Ospanova GB. Clinical experience of application myofunctional devices at children. Pediatric dentistry and dental prophylaxis. 2009;8(1):48-51. (In Russ). Available from: https://elibrary.ru/item.asp?id=118988706

6. Baeshen H. The Prevalence of Major Types of Occlusal Anomalies among Saudi Middle School Students. J Contemp Dent Pract. 2017;18(2):142-146. doi: 10.5005/jp-journals-10024-2005

7. Botticelli S, Küseler A, Marcusson A, Mølsted K, Nørholt SE, Cattaneo PM, et al. Do infant cleft dimensions have an influence on occlusal relations? A subgroup analysis within an RCT of primary surgery in patients with unilateral cleft lip and palate. Cleft Palate Craniofac J. 2020;57(3):378-388. doi: 10.1177/1055665619875320

8. Domenyuk DA, Porfyriadis MP, Dmitrienko SV. Major telerenthengogram indicators in people with various growth types offacial area. Archiv Euromedica. 2018;8(1):19-24. doi: 10.35630/2199-885X/2018/8/1/19

9. Lin F, Ren M, Yao L, He Y, Guo J, Ye Q. Psychosocial impact of dental esthetics regulates motivation to seek orthodontic treatment. Am J Orthod Dentofacial Orthop. 2016;150(3):476-82. doi: 10.1016/j.ajodo.2016.02.024

10. Prevalence of malocclusion in primary dentition in mainland China, 1988-2017: a systematic review and meta-analysis. Sci Rep. 2018;8(1):4716. doi: 10.1038/s41598-018-22900-x

11. Sherrard JF, Rossouw PE, Benson BW, Carrillo R, Buschang PH. Accuracy and reliability of tooth and root lengths measured on cone-beam computed tomographs. Am J Orthod Dentofac Orthop. 2010;137(4):100-108. doi: 10.1016/j.ajodo.2009.03.040