{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:37:27Z","timestamp":1787027847656,"version":"build-2736575974"},"reference-count":53,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:00:00Z","timestamp":1745625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: This cephalometric study aimed to evaluate the effects of clear aligner therapy in growing individuals with Class II malocclusion, comparing two functional approaches: the use of Class II elastics or the Mandibular Advancement (MA). Methods: Cephalometric data from 39 patients with Class II malocclusion treated using clear aligners either combined with Class II elastics (EL group; n = 18) or Mandibular Advancement (MA group; n = 21) were analyzed and compared with an untreated control group (UC2; n = 15). Results: Both treatment groups (EL and MA) showed a significant reduction in the ANB angle compared to the control (MA: \u22121.5\u00b0; EL: \u22122.2\u00b0; UC2: +0.2\u00b0). An increase in mandibular length, as measured by Co\u2013Gn, was observed in both the EL and MA groups (+5.5 mm and +8.3 mm, respectively) relative to the control group. Soft tissue analysis of the Pg\u2013TVL distance from T1 to T2 revealed the most substantial forward displacement of the chin in the MA group (MA: +2.0 \u00b1 3.7 mm; EL: +0.5 \u00b1 0.7 mm; UC2: \u22121.6 \u00b1 3.3 mm). Vertically, the MA group exhibited a more marked decrease in the palatal-mandibular plane angle than the other groups. Both treatment modalities significantly reduced overjet and overbite from T1 to T2. Conclusions: The EL and MA appliances effectively advanced the mandible, leading to significant improvements in the sagittal relationship, overjet, and overbite while maintaining stable vertical control. Additionally, the MA group exhibited a more pronounced forward movement of the soft tissue chin.<\/jats:p>","DOI":"10.3390\/children12050562","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T03:50:43Z","timestamp":1746071443000},"page":"562","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Orthodontic Management of Class II Malocclusion with Clear Aligners: Mandibular Advancement vs. Class II Elastics"],"prefix":"10.3390","volume":"12","author":[{"given":"Elisabetta","family":"Cretella Lombardo","sequence":"first","affiliation":[{"name":"Department of Health Science, UniCamillus-Saint Camillus International Medical University, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Lugli","sequence":"additional","affiliation":[{"name":"Department of Health Science, UniCamillus-Saint Camillus International Medical University, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9292-3248","authenticated-orcid":false,"given":"Roberta","family":"Lione","sequence":"additional","affiliation":[{"name":"Department of Health Science, UniCamillus-Saint Camillus International Medical University, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizio","family":"Bollero","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2663-8291","authenticated-orcid":false,"given":"Paola","family":"Cozza","sequence":"additional","affiliation":[{"name":"Department of Health Science, UniCamillus-Saint Camillus International Medical University, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6720-1606","authenticated-orcid":false,"given":"Chiara","family":"Pavoni","sequence":"additional","affiliation":[{"name":"Department of Health Science, UniCamillus-Saint Camillus International Medical University, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"950","DOI":"10.2319\/110205-385","article-title":"Prediction of individual mandibular changes induced by functional jaws orthopedics followed by fixed appliances in class II patients","volume":"76","author":"Franchi","year":"2006","journal-title":"Angle Orthod."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"599.e1","DOI":"10.1016\/j.ajodo.2005.11.010","article-title":"Mandibular changes produced by functional appliances in class II malocclusion: A systematic review","volume":"129","author":"Cozza","year":"2006","journal-title":"Am. 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