Outcome Quality and Treatment Efficacy of Early Class II elastics compared to Late Class II elastics: A Retrospective Clinical Investigation

Introduction: Class II elastics are widely used treatment modalities in correction of class II malocclusion. Class II elastics are traditionally used in combination with multibracket appliances after completion of the initial leveling phase. The use of early short and light class II elastics on initial leveling wires has been advocated to reduce the treatment time and increase the treatment efficiency. However, there is a lack of sufficient evidence in the literature. Therefore, the aim of this retrospective study was to investigate the outcome quality and treatment efficiency of early class II elastics compared to late class II elastics using the PAR index. Materials and Methods: Patient records from September 2005 until April 2017 in the archive of the university of Frankfurt have been sighted to generate data for this retrospective study. Patients with class II malocclusion undergoing a treatment with multibracket appliance after their peak of growth were included in the study. 16 Patients were included in the group IEA (early class II elastics) and 21 were allocated to the group IEL (late class II elastics). The peer assessment rating index (PAR) was used to assess the treatment outcome in each group. Results: Both early and late class II elastics showed great improvement of the occlusal traits in the patients. However, the treatment duration was significantly shorter in group IEA, showing the higher efficiency of early class II elastics. Conclusion: Incorporation of early class II elastics on the initial leveling arch wires can increase the treatment efficiency without compromising the occlusal outcome of the treatment. The authors recommend the use of short and light elastics in the initial stages of the treatment. Since early class II elastics were first described scientifically in our study, further studies and especially prospective ones should be performed.