Outcome differences after orthodontic camouflage treatment in hypo- and hyperdivergent patients - A retrospective cephalometric investigation

Clin Oral Investig. 2023 Dec;27(12):7307-7318. doi: 10.1007/s00784-023-05321-7. Epub 2023 Nov 13.

Abstract

Objectives: To compare differences in outcome in skeletal and dental parameters in hypo- and hyperdivergent Class II patients after extraction of upper first premolars and comprehensive orthodontic treatment.

Materials and methods: 37 Class-II-patients with dental camouflage treatment were divided into a hypo- (n = 18) or a hyperdivergent (n = 19) group depending on the mandibular plane angle (hypo: < 34° or hyper: ≥ 34°). Lateral cephalograms were available before (T1) and after (T2) treatment and were analyzed with customized measurements. Data from a growth survey served as a control and were used to calculate the actual treatment effect. Data were analyzed by one-sample Student's t-tests and independent Student's t-tests. Statistical significance was set at p < 0.05.

Results: The measurements showed similar changes in both groups. The effects were mainly dentoalveolar. Hypodivergent patients showed an almost equal increase in anterior and posterior facial height, while hyperdivergent patients only showed an increase in anterior facial height.

Conclusions: In hyperdivergent patients, the anterior facial height increases despite camouflage treatment. This indicates a tendency towards bite opening and backward rotation of the mandible. Hypodivergent patients do not experience deepening of the bite.

Clinical relevance: In hyperdivergent patients with upper first premolars extraction the anterior facial height increased differently than in hypodivergent patients. This should be considered if a bite opening is a possible contraindication to treatment.

Keywords: Bite opening; Camouflage treatment; Extraction; Hyperdivergent; Hypodivergent.

MeSH terms

  • Cephalometry
  • Humans
  • Malocclusion, Angle Class II* / therapy
  • Mandible
  • Retrospective Studies