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Class II/2 malocclusion: early treatment with removable appliances and stability after 20 years.

The Class II/2 malocclusion is a challenge in orthodontics, because of its resistance to therapy and its tendency to relapse. The aim of this study is to test effectiveness and long-term stability (at least 20 years out of retention) of early treatment with removable appliances. In the author's practice, 44 Cl. II/2 patients were treated from 1978 to 1985 using an upper plate with an anterior bite plane and a protruding screw. Later a guide plane was added as well as an inferior splint acting as an activator. Thirty-seven patients were invited for a check-up visit in 2005 and 18 responded positively. The treatment was able to correct the malocclusion within 31-36 months, correcting the Cl. II intercuspation into a Cl. I, aligning and normalizing the inclination of upper and lower incisors and normalizing the deep bite. Little or no change was detected to ANB-angle, Wits appraisal and hypodivergency of the palatal plane-mandibular plane angle. These results were remarkably stable after 20 years, with the only exception of a minimal relapse of upper and lower anterior crowding.