The class II malocclusion: differential diagnosis and clinical application of activators, extraoral traction, and fixed appliances.

The importance of an exact differential diagnosis of the Class II malocclusion and its indications for treatment with activators, extraoral forces, and fixed appliances has been shown. Four schematized malocclusions with their cephalometric characteristics and their individualized orthopedic therapeutics have been presented. Special attention has been given to the subsequent fixed mechanotherapy showing the limited need for fixed appliances. This approach is attractive, for it reduces considerably the stress imposed on the patient and the orthodontist, it bypasses the iatrogenic hazards entailed in extensive and prolonged mechanotherapy, and it consistently increases chances for long-term stability.