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Studying the Prevalence and Etiology of Class II Subdivision Malocclusion Utilizing Cone-Beam Computed Tomography

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Uniformed Services University Of The Health Sciences Bethesda United States

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Treatment of the Class II subdivision malocclusion has long been a challenge for orthodontists. Asymmetric occlusal relationships can occur due to any number of combinations of dentoalveolar or skeletal deviations. Identifying the etiology of asymmetry allows the clinician to make the most prudent treatment decisions and ultimately, achieve optimal treatment outcomes. It was noted by Edward Angle that there seemed to be a higher occurrence of asymmetric occlusion in the Class II Division 2 II2 malocclusion than the Class II Division 1 II1 malocclusion. The Class II2 phenotype is unique in its presentation. Further, the morphologic features of the Class II2 malocclusion are so distinct and consistent, that it often has little in common with the Class II1 malocclusion other than the Class II molar relationship. Despite these differences, the literature is replete with Class II studies that fail to make the distinction between Class II1 and Class II2 malocclusions. Grouping the two Class II types together potentially leads to misleading results and conclusions. Another potential source of error in traditional studies of asymmetry in Class I malocclusions is the use of conventional radiographic techniques in the determination of dentoalveolar and skeletal asymmetries. Cone-beam computed tomography CBCT eliminates magnification error and many of the problems associated with traditional imaging methods and is more ideally suited to the study of asymmetry. The aim of this study was to 1 determine the prevalence of subdivision malocclusion in Class II1 and Class II2 subtypes and 2 compare bilateral dentoalveolar and skeletal linear measurements between patients with Class II1 subdivision and Class II2 subdivision malocclusions using pretreatment CBCT slices.

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