{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:05:00Z","timestamp":1780070700958,"version":"3.54.0"},"reference-count":80,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To evaluate the changes in apical base sagittal relationship in Class II treatment with and without premolar extractions.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Materials and Methods:<\/jats:bold>\n                    Controlled studies evaluating ANB angle changes after Class II Division 1 malocclusion treatment with or without premolar extractions were considered. Electronic databases (PubMed, Embase, Web of Science, Scopus, The Cochrane Library, Lilacs, and Google Scholar) without limitations regarding publication year or language were searched. Risk of bias was assessed with Risk Of Bias in Non-randomized Studies\u2014of Interventions tool of the Cochrane Collaboration. Mean difference (MD) and 95% confidence interval (CI) were calculated from the random-effects meta-analysis. Subgroup and sensitivity analyses were also performed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Twenty-five studies satisfied the inclusion criteria and were included in the qualitative synthesis. Eleven nonextraction and only one extraction Class II treatment studies presented untreated Class II control group. Therefore, meta-analysis was performed only for the nonextraction protocol. In treated Class II nonextraction patients, the average of the various effects was a reduction in the ANB angle of 1.56\u00b0 (95% CI: 1.03, 2.09,\n                    <jats:italic>P<\/jats:italic>\n                    &lt; .001) compared with untreated Class II subjects. Class II malocclusions treated with two maxillary-premolar extractions and four-premolar extractions produced estimated mean reductions in ANB of \u22121.88\u00b0 and \u22122.55\u00b0, respectively. However, there is a lack of low-risk-of-bias studies.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    According to the existing low quality evidence\n                    <jats:bold>,<\/jats:bold>\n                    the apical base sagittal relationship in nonextraction, two-maxillary and four-premolar extractions Class II treatments decreases \u22121.56\u00b0, 1.88\u00b0 and 2.55\u00b0, respectively. Further studies are necessary to obtain more robust information.\n                  <\/jats:p>","DOI":"10.2319\/030716-198.1","type":"journal-article","created":{"date-parts":[[2016,9,6]],"date-time":"2016-09-06T09:43:21Z","timestamp":1473155001000},"page":"338-355","source":"Crossref","is-referenced-by-count":12,"title":["Changes in apical base sagittal relationship in Class II malocclusion treatment with and without premolar extractions: A systematic review and meta-analysis"],"prefix":"10.2319","volume":"87","author":[{"given":"Guilherme","family":"Janson","sequence":"first","affiliation":[{"name":"Professor and Head, Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Aliaga-Del Castillo","sequence":"additional","affiliation":[{"name":"Graduate Student, Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Niederberger","sequence":"additional","affiliation":[{"name":"Graduate Student, Department of Orthodontics, Bauru Dental School, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-87-2-338-b01","series-title":"Am J Orthod","first-page":"729","article-title":"Cephalometrics for you and me","volume":"39","author":"Steiner \n              CC.","year":"1953","unstructured":"Steiner \n              CC. \n            \n          \n          Cephalometrics for you and me. 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Angle Orthod. 2001;71:90\u2013102."},{"key":"i0003-3219-87-2-338-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"501","article-title":"Effect of timing on the outcomes of 1-phase nonextraction therapy of Class II malocclusion","volume":"136","author":"Baccetti \n              T,","year":"2009","unstructured":"Baccetti \n              T, \n            \n            \n              Franchi \n              L, \n            \n            \n              Kim \n              LH. \n            \n          \n          Effect of timing on the outcomes of 1-phase nonextraction therapy of Class II malocclusion. Am J Orthod Dentofacial Orthop. 2009;136:501\u2013509."},{"key":"i0003-3219-87-2-338-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"833","article-title":"Effects of the pendulum appliance, cervical headgear, and 2 premolar extractions followed by fixed appliances in patients with Class II malocclusion","volume":"136","author":"de Almeida-Pedrin \n              RR,","year":"2009","unstructured":"de Almeida-Pedrin \n              RR, \n            \n            \n              Henriques \n              JFC, \n            \n            \n              de Almeida \n              RR, \n            \n            \n              de Almeida \n              MR, \n            \n            \n              McNamara \n              JA\n              Jr. \n            \n          \n          Effects of the pendulum appliance, cervical headgear, and 2 premolar extractions followed by fixed appliances in patients with Class II malocclusion. 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Am J Orthod Dentofacial Orthop. 2007;132:54\u201362."},{"key":"i0003-3219-87-2-338-b34","series-title":"Am J Orthod Dentofacial Orthop","first-page":"310","article-title":"The effect of cervical headgear on patients with high or low mandibular plane angles and the \u201cmyth\u201d of posterior mandibular rotation","volume":"126","author":"Haralabakis \n              NB,","year":"2004","unstructured":"Haralabakis \n              NB, \n            \n            \n              Sifakakis \n              IB. \n            \n          \n          The effect of cervical headgear on patients with high or low mandibular plane angles and the \u201cmyth\u201d of posterior mandibular rotation. Am J Orthod Dentofacial Orthop. 2004;126:310\u2013317."},{"key":"i0003-3219-87-2-338-b35","series-title":"Angle Orthod","first-page":"594","article-title":"Caffer Dde C, Henriques JF, de Freitas MR, Neves LS. Stability of Class II, Division 1 treatment with the headgear-activator combination followed by the edgewise appliance","volume":"74","author":"Janson \n              G,","year":"2004","unstructured":"Janson \n              G, \n            \n          \n          Caffer Dde C, Henriques JF, de Freitas MR, Neves LS. Stability of Class II, Division 1 treatment with the headgear-activator combination followed by the edgewise appliance. Angle Orthod. 2004;74:594\u2013604."},{"key":"i0003-3219-87-2-338-b36","series-title":"Am J Orthod Dentofacial Orthop","first-page":"531","article-title":"Effects of cervical headgear and edgewise appliances on growing patients","volume":"119","year":"2001","unstructured":"Schiavon Gandini MREA, Gandini LG Jr, Da Rosa Martins JC, Del Santo M Jr. Effects of cervical headgear and edgewise appliances on growing patients. Am J Orthod Dentofacial Orthop. 2001;119:531\u2013538."},{"key":"i0003-3219-87-2-338-b37","series-title":"Angle Orthod","first-page":"208","article-title":"Long-term profile changes associated with successfully treated extraction and nonextraction Class II Division 1 malocclusions","volume":"70","author":"Zierhut \n              EC,","year":"2000","unstructured":"Zierhut \n              EC, \n            \n            \n              Joondeph \n              DR, \n            \n            \n              Artun \n              J, \n            \n            \n              Little \n              RM. \n            \n          \n          Long-term profile changes associated with successfully treated extraction and nonextraction Class II Division 1 malocclusions. 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Angle Orthod. 2015;85:480\u2013492."},{"key":"i0003-3219-87-2-338-b39","series-title":"Am J Orthod Dentofacial Orthop","first-page":"47","article-title":"Early orthodontic treatment for Class II malocclusion reduces the chance of incisal trauma: results of a Cochrane systematic review","volume":"148","author":"Thiruvenkatachari \n              B,","year":"2015","unstructured":"Thiruvenkatachari \n              B, \n            \n            \n              Harrison \n              J, \n            \n            \n              Worthington \n              H, \n            \n            \n              O'Brien \n              K. \n            \n          \n          Early orthodontic treatment for Class II malocclusion reduces the chance of incisal trauma: results of a Cochrane systematic review. 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