Introduction:In the practices of roughly one third of orthodontists, at least one patient has experienced the loss of a tooth following orthodontic movement of a tooth with a history of dentoalveolar trauma. Such teeth are more susceptible to pulp necrosis, pulp canal obliteration, resorption (with or without ankylosis), and alveolar bone loss. Objective:This article aims to provide orthodontic practitioners with a clear and accessible guide to managing patients presenting with trauma or a history thereof. Materials and Method:A literature review and a synthesis of current recommendations regarding orthodontic management of traumatized permanent teeth or those with a history of trauma were conducted. This work is a narrative review of the literature, with articles included having been consulted between January 1990 and June 2023. Results:Complications from dentoalveolar trauma weaken the tooth and the periodontium, impacting the planning and execution of orthodontic treatment. Conclusion:Knowledge of dental traumatology and its possible consequences helps minimize risks during post-traumatic orthodontic treatment.
Introduction:While the anterior cantilevered resin-bonded fixed dental prosthesis (RBFDP) is now well established among orthodontists and general practitioners, the posterior cantilevered RBFDP has only more recently gained attention in the international literature. The aim of this article is to provide an overview of this therapeutic option and its rationale, based on an original chairside clinical case performed in a single session. Materials and Method:A clinical case involving a 20-year-old female patient is presented. The patient exhibited a missing mandibular molar due to extraction following a vertical root fracture. A posterior cantilevered RBFDP was proposed and accepted. The restoration was designed as a monolithic stained and glazed 4Y-TZP zirconia with partial occlusal veneer preparation on abutment tooth. Tooth preparation was limited to the enamel. The intaglio surface of the prosthesis was sandblasted with 50 µm aluminum oxide and treated with a universal primer. The prosthesis was bonded under rubber dam isolation using preheated resin composite, following a strict light-curing protocol and a "no-finishing" approach. Clinical adjustments were made and postoperative occlusion was verified. Results:The single-visit restoration demonstrated good aesthetic and functional integration at follow-up. The key steps in fabricating a posterior cantilevered RBFDP are illustrated and discussed. Discussion:Through the simple, systematic, and reproducible approach proposed in this article, the posterior cantilever RBFDP emerges as a reliable therapeutic option. Although the chairside approach is less commonly used, it can enhance treatment efficiency and patient comfort. Conclusion:This innovative treatment strategy is of particular interest to orthodontists and general practitioners, especially for patients in whom implant therapy is contraindicated or undesirable, such as younger individuals. It also holds value for the general population once the implant alternative has been discussed.
Objective:This clinically oriented article aims to describe specific situations of root resorption, whether suspected or confirmed, and to provide a focused analysis. Materials and Method:Eight clinical cases are presented in different contexts: presence of presumptive signs of root resorption, pre-existing resorption prior to treatment, and resorption occurring during treatment, among others. Discussion:The integration of these resorptions when developing the treatment plan and the medico-legal aspect associated with this issue must be taken into consideration. Although this article does not seek to introduce new data on a topic that has already been widely studied, it offers a distinctive clinical perspective through specific comments and considerations illustrated by well-defined clinical cases. Conclusion:These insights should enable practitioners to be better prepared to manage root resorption, including its medico-legal aspects.
Introduction:To correct bilateral Class II malocclusions or Class II subdivisions, various therapeutic options are available to the orthodontist, depending on the patient and the amount of tooth movement required. Retro-tuberosity screws (RTSs) represent one such alternative; however, they remain poorly documented in the literature. The aim of this article is to present a series of cases managed using RTSs. Materials and method:Four cases treated with RTSs are presented. Discussion:RTSs enabled effective sequential distalization. Adverse effects were limited, except for the risk of vestibular-palatal angulation . Placement can be technically demanding and requires the absence of wisdom teeth. The failure rate seems comparable to that reported for the rest of the oral cavity if a 2 mm diameter screw is used. Conclusion:RTSs represent a relevant distalization option for the correction of Class II malocclusions or certain asymmetries in adults without third molars. To confirm their indications and limitations, randomized controlled trials need to be conducted.
Introduction:The choice of retainer wire is crucial to ensuring long-lasting orthodontic results. Beyond simple mechanical retention, it must meet specific requirements in terms of design, physical properties, and biocompatibility. To date, there is no consensus on the best material, and new generations of wires continue to emerge to address the limitations of existing systems. Objective:This article aims to describe and compare various types of retainer wires, whether they are shaped manually, such as Respond and Ortho-Flextech, or produced using a robotic process, such as Memotain, TMA Winnove Medical, or PolyEther-Ether-Keton (PEEK) wire. Materials and methods:The "ideal wire" should ensure a custom fit, appropriate mechanical properties, smooth surface quality, biocompatibility, durability, and acceptable aesthetics. Current options include chairside wires (Respond and Ortho-FlexTech), CAD/CAM or robot-made retainers (laser-cut NiTi Memotain and robot-bent TMA Winnove), and milled PEEK devices. Each option involves trade-offs: adaptability and flexibility versus rigidity and control; isotropy of round sections versus anisotropy of square sections; and added costs and logistical demands associated with digital workflows. Discussion:In multistranded wires, Young's modulus (E) corresponds to that of the base alloy; clinical stiffness depends instead on the effective EI (geometry, compaction, and inter-strand slip). Clinical success also relies heavily on bonding quality: thin, even resin layers and short spans between composite pads are as important as the wire itself. Overall performance therefore results from the synergy of wire, adhesive, and clinical technique. Conclusion:Future developments are likely to focus on increased robotization, adhesive optimization, and the use of high-performance polymers. However, no current solution can yet be considered flawless.
Introduction:Orofacial myofunctional disorders (OMDs) refer to alterations in orofacial functions that may hinder craniofacial development. Early screening by dentists and orthodontists, together with timely referral for a speech-language evaluation and possible orofacial myofunctional therapy, is essential to optimize patient care. This study aims to assess the knowledge, practices, and training needs of French dentists and orthodontists regarding OMDs and the role of speech therapy in their management. Material and Methods:A descriptive survey was conducted using an online questionnaire distributed between October 2024 and January 2025 to dentists and orthodontists practicing in France. Results:A total of 227 complete responses were analyzed (58 orthodontists and 169 general dentists). Among them, 95% of orthodontists reported systematically screening for OMDs, compared to 24% of general dentists. Regarding speech therapy referrals, 83% of orthodontists reported often or always referring patients after screening, versus 20% of general dentists. Furthermore, 51% of general dentists considered such referrals to fall outside their professional scope. Practice location significantly influenced referral patterns: Urban practitioners referred more frequently than those in rural areas. Regular orthodontic practice among general dentists was associated with increased referral rates, whereas pedodontic practice was not. Finally, knowledge of the speech therapist's role remained limited: Only 31% of general dentists reported knowing it very well or fairly well. Discussion:These disparities are primarily explained by differences in initial training. Although official recommendations exist, their implementation remains insufficient, particularly among general dentists and those practicing pedodontics. The central role of speech therapists in orofacial myofunctional rehabilitation also appears to remain poorly understood. The shortage of speech therapists in rural areas also hinders timely patient care. Conclusion:This study highlights the need to strengthen initial training for general dentists and promote interdisciplinary collaboration to improve the screening and management of OMDs.
Introduction:Improving professional practice is a quality assurance process that aims to control practices by reference to evidence-based studies and academic standards. This study describes the method developed in a university hospital setting to improve the collection of clinical data in orthodontics. Material and Methods:The Deming cycle method (PDCA) was used. Results:1) "PLAN" phase: A literature search and two national and local surveys were conducted to describe clinical data collection practices in orthodontics; 2) "DO" phase: A list of indicators to characterize malocclusions and dysmorphoses, as well as their functional and aesthetic effects, was drawn up in a digital format, then used in the orthodontic department for five months; 3) "CHECK" phase: The use and limitations of this tool were analyzed; 4) "ACT" phase: The form for "Evaluation of Malocclusions and Dysmorphoses and their Aesthetics and Functionals Effects" was finalized and the procedures for its implementation were specified. Discussion:The EPIEF MaloDys tool allows us to identify the existence of malocclusions or dysmorphoses and their aesthetic and functional effects, but its implementation may encounter some resistance to change. Conclusion:This study contributes to the harmonization of orthodontics clinical data for clinical, educational, and research purposes.
Introduction:Orthognathic surgery practices depend on patient characteristics, which may vary from one country to another, and they may also evolve with new techniques and developments. Objective:The aim of this study is to describe the epidemiological characteristics of patients and orthognathic surgical procedures performed in the maxillofacial surgery department at Pitié-Salpêtrière University Hospital (Paris, France). Material and Methods:This was a retrospective study covering the period from January 2017 to December 2020. All patient records from this period were reviewed. The following data were collected: demographic characteristics (age at the time of surgery, gender), type of dentofacial deformity (Angle class I, II, or III, transverse and vertical facial dimensions), and type of surgical procedure. Results:A total of 667 patient records were included. Analysis of the parameters studied showed a female predominance (60.82%) with a mean age of 27.9 years. The most common Angle dental class was class II (56.4%) followed by class III (35.4%). Long-face patients accounted for 47.86% of the sample, short-face 41.61%, and balanced-face 10.53%, with 44.4% exhibiting facial asymmetry. A reduced transverse dimension was observed in 22.12% of cases. The most common orthognathic procedure was maxillomandibular osteotomy (56.08%), followed by mandibular osteotomy (20.7%), and maxillary osteotomy (19.12%). Overall, 23.4% of patients underwent dental extractions during surgery and 4.4% of records reported reinterventions (revision surgery, hardware removal, or pseudarthrosis repair). Discussion:Class II malocclusion is common in the French population and is frequently encountered in orthodontic-surgical protocols. According to the literature, maxillomandibular surgery appears to be on the rise. Conclusion:The results of this four-year retrospective study reveal a predominance of young, female patients. Class II malocclusion was the most frequent, and maxillomandibular surgery was the most commonly performed procedure. Given the lack of epidemiological data, further studies should be conducted to assess variations in surgical practices across different geographic regions and types of institutions (private, public, etc.).
Introduction:The aim of this study is to examine, among adult patients who had completed orthodontic treatment, the relationship between treatment satisfaction and personality type. Material and Methods:This was an observational, comparative, cross-sectional study based on a survey conducted during the first three months following the completion of active orthodontic treatment. The required sample size was calculated in advance. A total of 74 patients (30 men and 44 women aged 18 to 40) were included: 55 with metal multi-bracket appliances, 9 with ceramic multi-bracket appliances, and 10 with clear aligners. Patient satisfaction was assessed using the questionnaire developed by Rojas-Garcia, et al. Personality was evaluated using the Big Five Inventory test. The study was approved by the University Ethics Committee (No. 2021_11/107). To compare mean values among different patient groups, Student's t-test and one-way ANOVA were used when the variables were normally distributed; otherwise, Mann-Whitney and Kruskal-Wallis tests were used. Results:A relationship was found between personality traits and patient satisfaction following orthodontic treatment. The more extroverted, agreeable, and conscientious a patient was, the more satisfied they were with the treatment (p < 0.05). However, neuroticism, gender, treatment type, and initial case complexity were not associated with patient satisfaction (p > 0.05). Patient satisfaction also decreased with age (p > 0.05). Discussion:Although participants may have been subject to central tendency or social desirability bias, this study provides insights into the correlation between personality traits and satisfaction with orthodontic treatment. Further studies should consider not only the initial malocclusion but also the degree of improvement achieved. Conclusion:Personality appears to influence patient satisfaction at the end of orthodontic treatment.
Introduction:Cases of focal oral bacterial infections - including infective endocarditis - have been reported during orthodontic treatment in patients with no previous medical history. This raises the question of whether orthodontic treatment is responsible for the development of these infections. Objective:The aim of this narrative literature review was to determine whether or not bacteremia, directly or indirectly related to orthodontic treatment, is present and what precautions should be taken in orthodontic treatment of patients with and without risk of infective endocarditis. Material and Methods:A narrative literature review was carried out using two keyword searches on PubMed. Results:Transient bacteremia may occur during everyday activities and dental procedures. This bacteremia is influenced by factors linked to the invasiveness of the procedure and the patient's periodontal indices. In patients at risk of infective endocarditis, the new French professional recommendations do not contraindicate any orthodontic procedure. In patients at high risk of infective endocarditis, stripping, corticotomies, orthodontic exposure of impacted teeth, and insertion and removal of bone anchors require antibiotic prophylaxis. The following procedures are contraindicated in these patients: pulpectomy of temporary teeth, pulp capping of mature permanent teeth, use of bone regeneration membranes, and conservative treatment of peri-implantitis. Discussion:Any procedure, whether therapeutic or not, generates bacteremia, which is often minimal and depends on the procedures performed. Orthodontic appliances, because of the length of time they are worn and the difficulty of maintaining good oral hygiene, are likely to generate an additional bacteremia which, in principle, should have no consequences in a healthy patient. Although orthodontic procedures are relatively frequent, studies are rare and often have a low level of evidence. Conclusion:The role of the orthodontist is to identify the patient's level of risk, to educate and motivate the patient in oral hygiene, and to apply the precautionary measures set out in the new HAS recommendations for patients at risk of infective endocarditis.
Introduction:In dentistry, managing anxious children is a daily challenge. Anxiety, affecting 10-20% of children, poses a barrier to care. This issue is exacerbated by deinstitutionalization and the law for equal rights, exposing orthodontists to a new patient group combining disability-related traits and heightened anxiety. Faced with anxious children, orthodontists have various management strategies. However, conventional behavioral techniques (CBT) have shown limits in children with neurodevelopmental disorders (NDD), contributing to disparities in access to care. Practitioners' reluctance to treat these patients underscores the need for ongoing training and tailored approaches. Emerging techniques combining virtual reality (VR) and hypnosis have proven effective in reducing anxiety in children. However, their effectiveness in children with NDD remains underexplored, despite independent successes of hypnosis and VR in other contexts. Material and Methods:In this context, we conducted a prospective randomized controlled trial at Bretonneau Hospital to evaluate the effectiveness of VR distraction in children aged 6 to 18 with NDD during orthodontic assessments. Results:The results indicate that VR distraction is similarly effective to CBT in reducing anxiety, although the small sample size may limit the generalization of these results. The findings suggest that VR could be a promising technique for alleviating anxiety in children with NDD during orthodontic assessments. Conclusion:These preliminary results suggest that virtual reality may serve as a viable alternative approach to CBT for reducing anxiety in children with NDD during orthodontic procedures. Further studies are required to validate these findings in larger cohorts.
Introduction:The aim of this study was to investigate the factors influencing patient adherence in orthodontics. Material and Methods:A literature review was conducted using keywords on PubMed, focusing on randomized clinical trials. Results:In total, 31 articles were included. Adults appeared to be more cooperative than adolescents, as were patients of higher socioeconomic status. The influence of gender on adherence remains open to debate. Appointment reminders seem to provide substantial benefit, at least in the short term. The most effective communication is multimodal - oral, written, and participatory. Pain management and adherence to the prescribed treatment duration also play a role. With removable devices, whether during the active phase or retention, a tendency to overestimate wearing time and suboptimal adherence were reported. Discussion:The difficulty of evaluation lies in the many forms that adherence can take. Some factors are straightforward and easily quantifiable, such as wearing time of an appliance or auxiliary device - either self-reported or measured electronically via sensors - while others are more difficult to assess and require the use of indirect indicators reflecting the consequences of poor adherence. As a result, potential biases abound. The Hawthorne effect and the novelty effect further complicate the evaluation of adherence. Conclusion:Identifying uncooperative or non-cooperative patients - both at the initial assessment (motivation, hygiene, etc.) and throughout treatment (missed appointments, late arrivals, breakages/detachments, etc.) - is essential and can help orthodontists adapt their approach and implement measures to optimize patient adherence.
The agenesis of the maxillary lateral incisor can be treated by preservation or reopening of the space, which implies the prosthetic replacement of the missing tooth. Metal-based bonded bridges, followed by implants, have been the reference options in recent decades. However, the complexity of their implementation encouraged the closure of spaces. A better understanding of the negative impact of the phenomena of continuous facial growth on very young patients has made the implant option even less attractive. The bonded ceramic cantilever bridge then gradually emerged. This article describes the indications and protocol of this new prosthetic approach. Choosing the canine as the wing location offers several advantages: superior root anchorage, better morphology and palatal surface for bonding, easier dynamic occlusal balancing, less delamination. The ceramics of choice are zirconia or lithium disilicate. There are several well coded steps to optimize the choice of materials, the preparation of the gingiva, the tooth preparation and the bonding of the wing to the supporting tooth. A compressive splint can be used for temporization. A groove can be provided in the bonded bridge for the retention wire. The choice of tooth for the bonded wing remains controversial. Orthodontic preparation must take into account the choice of supporting tooth, and allow for minimal overlap and a slightly increased incisal overhang.
With its high success and survival rates, dental transplantation (surgical transposition of a tooth from its original site to another site within the same patient to compensate for missing or lost teeth), particularly for third molars, is a technique of significant interest in children and adolescents, i.e. for patients whose development is not yet complete, thereby precluding the immediate consideration of implant placement. Transplantation allows for the postponement or avoidance of implant placement, helps preserve the quality and quantity of space and bone, serves as a maintainer of bone and keratinized tissues, and, in optimal cases, authorizes certain orthodontic movements. The objective of this article is to propose an autotransplantation protocol in the form of a management diagram. The management diagram was developed based on literature and our clinical experience. The key clinical considerations are patient selection, 3D printing of replicas of the tooth to be transplanted using Cone Beam imaging (with elongated apices and gripping rod), preservation of periodontal tissues, minimizing extra-alveolar time (preferably through a two-step procedure or preliminary avulsion and site preparation), positioning the tooth in infraocclusion, and ensuring flexible and not overly prolonged support. À retention period of approximately four weeks is generally sufficient before resuming orthodontic movements. Dental transplantation has greatly benefited from advances in 3D printing technology.
Tooth autotransplantation is an ancient yet little-known technique, despite its high success rate. The aim of this article is to present a series of clinical cases. Patients were treated by the same oral surgeon, either solo or with four-handed dentistry, in collaboration with various orthodontists or dental surgeons in private practice or in hospital settings. Only photographs of cases with more than one year of follow-up are presented. The complete series included 12 cases, 7 of which have a follow-up period exceeding one year. The patients were aged between 13 and 34 years. Most of the teeth involved were immature (4 out of 7 cases before Nolla stage 10). The length of follow-up varied, with some cases monitored for up to 3 and a half years. The main indication was replacement of a decayed tooth with a third molar. Three cases involved different situations: impossibility to perform traction as a first-line treatment (due to a severely dystopic tooth) or as a second-line option (due to ankylosis and resorption). One tooth was lost due to excessive milling of the neo-alveolus and active retention. The fallback solution in this case was implant placement. One tooth remained in slight infraocclusion. Although the routine preservation of third molars should not be standard practice, the wide range of indications (caries, teeth refractory to traction, etc.) calls for a careful assessment of the pros and cons of extracting third molars and consideration of their usefulness, for example for autotransplantation.
Involving dentists in the field of professional insurance is a complex subject, touching on both the legal aspects of therapeutic management and professional ethics. Providing a better understanding of the medical risks faced by orthodontists helps to enhance the safety of their day-to-day practice. The aim of this article is to present the claims experience of orthodontic practitioners. The annual claims experience of dental surgeons was analyzed. All data on claims and their evolution from one year to the next were studied. The number of procedures is presented, along with their breakdown into civil, ordinal and criminal procedures, and the dental disciplines involved. In 2023, 1,980 claims were submitted by dentists, giving a claims ratio of 6.5%, compared with 6% in 2022. Unlike other medical professions, the vast majority of claims are settled out of court. In dentofacial orthopedics, it's the indication and implementation of treatment that comes top of the list of complaints, ahead of relapse. The contentious aspect of claims is due, in the vast majority of cases, to poor communication between patient and practitioner, hence the importance of providing patients with appropriate information as part of the care contract. Following a review of the typology of medical accidents specific to the profession, the legal obligations incumbent on both dental surgeons and their patients are discussed. Rigorous clinical practice by the practitioner, combined with compliance with legal obligations and appropriate, responsive clinical and relational follow-up, enhances a relationship of trust with the patient and helps to avoid subsequent blaming.
Professional recommendations on the indications for avulsions of 3rd molars recommend case-by-case decisions on germectomies. However, an overly restrictive interpretation of these recommendations has led to excessive conservation of 3rd molars. Late avulsion of these teeth entails considerably higher risks for the patient, compared with extraction between the ages of 16 and 20. The aim of this article is to illustrate, through a series of cases, the risks associated, on the one hand, with excessive retention of 3rd molars and, on the other hand, with the surgical complications associated with their avulsion too late. Fifteen cases are detailed: infections, pericoronary cyst with suborbital extension, bucco-sinusal communication, tuberosity and mandibular fracture, neuro-sensory disorders. Before the age of 15, the root formation of poorly formed and deeply impacted 3rd molars is incomplete and they are often deeply impacted, making their avulsion difficult and the post-operative after-effects significant for patients. Beyond the age of 25, the risk of paresthesia and fracture of the mandible increases significantly, and becomes problematic after the age of 30. The period between 16 and 20 years of age represents a "window" where surgical risk and post-operative consequences are minimal. Avulsion of the 3rd molars may sometimes be indicated to prevent surgical difficulties and complications in the event of ultrasonic avulsion. Beyond the age of 25, or even 30, the benefit/risk ratio must be assessed particularly rigorously, even if this means considering therapeutic abstention (accompanied by appropriate monitoring) when possible.
Introduction:Aligners are presented as an aesthetic and simple solution capable of treating a wide range of malocclusions. However, they require numerous auxiliaries that are often complex to implement and unesthetic attachments to compensate for their inability in reproducing the simulated movements. Objectives:The aim of this article is to review the advantages and limitations of aligners by proposing an aesthetic, rational, and standardized solution. Material and Methods:The scientific data shows the movements for which aligners are less effective. The article illustrates through a clinical case how it is possible to combine the 2D lingual appliance and aligners to compensate for the shortcomings of each and optimize their strengths during their use. Results:When the treatment plan defines the movements to be performed, the choice of the appliance becomes clinically and logically evident according to the ongoing therapeutic sequence. Conclusion:Aligners offer advantages that make them indispensable in the orthodontist's therapeutic arsenal, but they are not sufficient on their own.
Introduction:The integration of digital tools in surgical planning has transformed the collaboration between orthodontists and maxillofacial surgeons, enabling optimized communication between practitioners as well as rapid and nearly unlimited rehearsal and adjustments. Materials and Methods:A virtual surgical planning protocol based on the "occlusal block" concept is described, structured into two complementary phases. The first phase, led by the orthodontist, involves defining the target occlusion using digital models. This "orthodontic occlusal block" is then transferred to the operating room via a final splint, ensuring faithful reproduction of the planned objectives. The second phase, carried out by the surgeon, consists of a three-dimensional evaluation of the occlusion within the overall facial context. This step accounts for facial harmony, functional constraints, and bone interferences. If this analysis indicates the need for bimaxillary surgery, the transfer is carried out using an intermediate splint. Results:In the three clinical cases presented, the authors observed a postoperative occlusion that accurately matched the jointly performed simulation. Orthodontic finishing was achieved quickly. Conclusion:This integrative approach, combining virtual planning and computer-assisted manufacturing, improves the accuracy of results, reduces complications, and enhances communication between practitioners.
Introduction:Class II subdivision malocclusions are common and challenging to treat due to their asymmetry. The range of orthodontic correction devices is expanding toward systems that may offer more comfort for patients but often lack scientific evidence supporting their efficacy. The objective of this study was to evaluate, for the first time, the effect of a Class II correction device, the Carriere Motion (CM) combined with palatal canine bite turbos, in adult patients with Class II subdivision malocclusion. Material and Methods:This retrospective study included all adult patients with Class II subdivision malocclusion who underwent orthodontic treatment with the CM appliance combined with palatal canine bite turbos and had a complete orthodontic record. Measurements were taken from dental casts before (T0) and after (T1) CM use, as well as cephalometric analyses were performed before (T0) and after (T2) completing orthodontic treatment. Statistical analyses were conducted to assess both dentoalveolar and skeletal effects of treatment with CM. Results:Fourteen patients (26 ± 2.83 years; 72% women) were eligible for inclusion. Between T0 and T1, a significant correction of Class II molar and canine relationships (p < 0.01), a significant reduction in overjet (T0: 4.19 mm vs. T1: 2.94 mm, p < 0.01), and a significant alignment of midlines were observed. Moreover, significant distal rotations of the CM-supported canines and molars were noted at T1. Additionally, CM-supporting canines showed significant extrusion (p < 0.01) compared to non-supporting canines, though this was clinically negligible (additional extrusion of 1 mm on average). SNA, SNB, and ANB angle values showed no significant changes between T0 and T2. Conclusion:Within the conditions and limitations of this study, the effect of the CM - combined with the addition of retro-palatal canine bite - on the correction of Class II subdivision malocclusions appears to be dentoalveolar. The canine supporting the CM exhibited minimal extrusion.
