DISCUSSION
malocclusion, overbite, mesial displacement, L6-GoMe, overjet, Maxillary incisors, mandibular incisors
SECONDARY, ROOT RESORPTION
Successful orthodontic treatment is not just about establishing a static as well as dynamic occlusal relationship, but also to achieve an esthetic soft tissue profile.In the present study, there was a possibility of treatment outcome being influenced by associated growth. To overcome this, use of untreated Class II controls was advocated by Stahl et al.Ideally, the subjects of a trial should demonstrate no difference in characteristics prior to the treatment, as phenotypic differences may influence the response to growth and treatment mechanics.Severity of sagittal molar relationship directly influences the amount of retraction in Class II cases; hence, considering it during a trial was proposed in a systematic review.Soft tissue response secondary to aging and treatment assists clinician in planning the best suited treatment for the patient. Bishara et alChange in lip projection of Group PE (UL-E line, -2.91mm; LL-E line, -0.68mm) and Group FF (UL-E line, -1.50mm; LL-E line, 0.45mm) were in partial agreement with Janson et alLee et alGroup PE demonstrated statistically significant change of nasolabial angle (3.14±2.05, Improvement of facial esthetics is usually the primary objective of patients undergoing treatment for skeletal Class II malocclusion.Clinical significance of the statistically significant findings of the present study could not be differentiated, due to the dichotomy in available literature. Cozza et alWith regard to the skeletal changes, both treatment mechanics had a retrusive effect on the maxillary sagittal growth, resulting in the remodeling of point ‘A’, but the differences were not significant.Compared to the premolar extraction treatment, functional fixed therapy demonstrated slightly larger sagittal growth of the mandible, but posttreatment differences were not statistically significant. Although improvement of maxillomandibular skeletal relationship was greater with functional treatment, compared to premolar extraction treatment, the differences were not significant. Similar changes were referred by a previous study.Effects of both treatment modalities on the vertical plane did not differ significantly among treatment groups. However, functional fixed treatment resulted in clockwise rotation of both jaws, whereas counter-clockwise mandibular rotation was observed in the subjects who underwent premolar extractions. Similar changes were reported by previous studies.With regard to the dentoalveolar changes, highly significant differences were observed between the two treatment strategies. Group FF had significant distal displacement of maxillary molar, whereas Group PE demonstrated mild mesial displacement, which is in agreement with the findings of Kizinger et al.Effect on maxillary molar along the vertical plane was not significantly different between the groups. Findings of the present study regarding functional fixed treatment were in accordance with previously published studies.Groups PE and FF presented statistically significant difference for L6-VP and L6-GoMe at the posttreatment stage. A difference in sagittal positioning was consequent to protraction of mandibular molar to the extraction space. Maxillary incisors were significantly retroclined in Group FF (U1-ANS PNS, -5.73Despite cinching and lingual crown torque in the lower archwire during the functional phase, unfavorable labial movement of the mandibular incisors could only be minimized. Compared to Group PE (IMPA - 2.05Both treatment modalities reduced the overjet and the overbite to normal limits, with almost similar proportional correction. In Group PE, overall change of overjet and overbite was -4.23mm and -2.64mm, respectively; whereas Group FF demonstrated reduction of -4.73mm and -3.27mm, respectively. Similar changes were reported by Janson et al.Treatment duration is one of the major factors influencing satisfaction among patients undergoing orthodontic treatment.Mini-implants were used in Group PE in order to optimize the maxillary anterior teeth retraction and mandibular molar protraction. A recent systematic reviewHighly promising overall success rate of mini-implants (86.5%) was reported by a meta-analysis.ForsusNone of the participants asked to be removed from the study, reflecting acceptance of both treatment modalities. Premolar extraction treatment has limitations in terms of increased risk of root resorption,