Quality of occlusal outcome in adult Class II patients treated with completely customized lingual appliances and Class II elastics compared to adult Class I patients

• Published in: European journal of orthodontics Vol. 46; no. 5
• Main Authors: Janssens, Yann, Foley, Patrick F, Beyling, Frauke, Stamm, Thomas, Schwestka-Polly, Rainer, Schmid, Jonas Q
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-10-2024
• Subjects: Adult; Cephalometry; Female; Humans; Male; Malocclusion, Angle Class I - therapy; Malocclusion, Angle Class II - therapy; Original; Orthodontic Appliance Design; Orthodontic Brackets; Retrospective Studies; Tooth Movement Techniques - instrumentation; Tooth Movement Techniques - methods; Treatment Outcome; Vertical Dimension; Young Adult; Objective Grading System; completely customized lingual appliances; maxillomandibular elastics; Angle Class II correction; adult orthodontics; intermaxillary elastics; orthodontic appliances
• ISSN: 0141-5387; 1460-2210; 1460-2210
• DOI: 10.1093/ejo/cjae031

The aim of this investigation was to evaluate whether Class II malocclusion in adult patients can be successfully corrected using a completely customized lingual appliance (CCLA) in combination with Class II elastics.
In order to detect differences in the final treatment outcome, two groups were matched for age and gender. Treatment results of 40 adult orthodontic patients with a Class I malocclusion (Group 1) were compared to 40 adults with a Class II malocclusion (Group 2). All patients had completed treatment with a CCLA (WIN, DW Lingual Systems, Bad Essen, Germany) without known centric occlusion-centric relation discrepancies, issues of compliance, or overcorrection in the individual treatment plan which was defined by a target set-up. In order to compare the treatment results of the two groups, 7 measurements using the American Board of Orthodontics Model Grading System (ABO MGS) and linear measurements for anterior-posterior (AP) and vertical dimensions were assessed at the start of lingual treatment (T1), after debonding (T2B) and compared to the individual target set-up (T2A).
A statistically significant AP correction was achieved in Group 2 which represented 95% of the planned amount. The planned overbite correction was fully achieved in the Class I and Class II group. In both groups, there was a statistically significant improvement in the ABO scores, with no significant difference between the two groups at T2. 100% of the patients in Group 2 and 92.5% in Group 1 would meet the ABO standards after CCLA treatment.
The main limitation of this study is that only patients who were wearing the elastics as prescribed were retrospectively included. Therefore, the results of this study may have limited generalizability.
Completely customized lingual appliances in combination with Class II elastics can correct a Class II malocclusion successfully in adult patients. The final treatment outcome can be of a similar high quality in Class I and Class II patients.