Longitudinal cephalometric growth of untreated subjects with Class II Division 2 malocclusion

•Craniofacial growth was compared in untreated Class II Division 2 subjects and Class I controls.•Relative maxillary and mandibular sizes and anteroposterior positions were similar.•Growth pattern was more hypodivergent in untreated Class II Division 2 subjects.•Maxillary incisors were more upright in untreated Class II Division 2 subjects.•Hypodivergence is established early and increases through early adulthood.

IntroductionOur objective was to evaluate the craniofacial growth of subjects with untreated Class II Division 2 malocclusion.MethodsA mixed longitudinal sample of 39 white Class II Division 2 subjects was analyzed at 5 time points: T1 (6 or 7 years), T2 (9 or 10 years), T3 (12 or 13 years), T4 (15 or 16 years), and T5 (18 or 19 years). They were compared with an age- and sex- matched sample of Class I controls. Seventeen measurements (12 angular, 5 proportional) were computed. Multilevel modeling procedures were used to statistically describe the growth changes and to evaluate group differences.ResultsThere were no group differences in the relative sizes and anteroposterior positions of the jaws during childhood, adolescence, or early adulthood. Subjects with Class II Division 2 malocclusion demonstrated significantly (P <0.05) smaller mandibular plane angles, smaller palatal-to-mandibular plane angles, larger posterior-to-anterior facial height ratios, smaller gonial angles, smaller cranial base angles, larger interincisal angles, and more retroclined maxillary incisors than did the Class I subjects. The hypodivergent patterns were established early and became more pronounced over time. Group differences in the mandibular plane angle, palatal-to-mandibular plane angle, gonial angle, interincisal angle, and maxillary incisor-to-cranial base angle, as well as the posterior-to-anterior facial height ratio all increased over time; the difference in the cranial base angle remained unchanged over time. Retroclination of the maxillary incisors occurred primarily during the early mixed dentition.ConclusionsSubjects with Class II Division 2 malocclusion are more hypodivergent and have more upright maxillary incisors than do subjects with Class I occlusion. Hypodivergence establishes itself early and increases progressively through early adulthood; maxillary incisor retroclination occurs early.