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Background  This study cephalometrically compared the dentoskeletal and soft tissue changes consequent to one and three-premolar extraction protocols of class II subdivision malocclusion treatment.    Methods  A sample of 126 lateral cephalometric radiographs from 63 patients was selected and divided into two groups. Group 1 consisted of 31 type 1 class II subdivision malocclusion patients treated with asymmetric extractions of two maxillary premolars and one mandibular premolar on the class I side, with an initial mean age of 13.58 years. Group 2 consisted of 32 type 2 class II subdivision malocclusion patients treated with asymmetric extraction of one maxillary first premolar on the class II side, with an initial mean age of 13.98 years.  t  test was used for intergroup comparison at the pre- and posttreatment stages and to compare the treatment changes.    Results  Group 1 had greater maxillomandibular sagittal discrepancy reduction and greater maxillary first molar extrusion. Group 2 had mandibular incisor labial inclination and protrusion, and group 1 had mandibular incisor lingual inclination and retraction. Maxillary molar asymmetry increased in group 2, while mandibular molar asymmetry increased in group 1.    Conclusions  The treatment changes produced by these two class II subdivision protocols are different to adequately satisfy the different needs for types 1 and 2 class II subdivision malocclusions.

Dentoskeletal and soft tissue changes in class II subdivision treatment with asymmetric extraction protocols