الفهرس 
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Abstract
This randomized clinical trial was conducted to assess the correction of Class II malocclusion using two different protocols. Patients with class II malocclusion were treated with Class II elastics either applied early from the beginning of the treatment or conventionally after alignment and leveling on rigid rectangular Stainless Steel arch wires.
Twenty adult patients with Class II malocclusion were recruited for this study from the outpatient clinic of the Orthodontic Department, Faculty of Dentistry, Ain Shams University. The sample was equally divided into two groups. Early group was treated by immediate short (from the maxillary canine to the mandibular second premolar) early Class II elastics while the conventional group was treated by Class II elastics which were applied later after alignment and leveling with longer elastics extended from the maxillary canine to the mandibular first molar. Occlusal disarticulation was done for patients in both groups. All 20 patients completed the study with no dropouts.
Treatment results were assessed using lateral cephalometric radiographs, digital models, and standardized digital photographs. The records were acquired at T0 “before treatment” and T1 “after achievement of alignment and leveling with Class I relationship”. Lateral cephalometric radiographs were used to assess the effects of treatment on the skeletal, dental and soft tissues. Digital models were used to assess the dental movements in all planes of space. The standardized digital photographs were used to assess the effect of treatment on the amount of gingival display on smile. Also, treatment duration was calculated in both groups.
Both groups showed a statistically significant maxillary incisors retroclination with insignificant differences between the two groups. Mandibular incisors showed a statistically significant proclination in both groups with statistically insignificant difference between the two groups.
There was a statistically significant canine and molar distalization in both groups but the early group showed a statistically significant more distalization than the conventional group. In addition, maxillary canines and mandibular molars were significantly rotated in both groups with significantly less molar rotation observed in the early group.
Gingival display on smile showed a statistically significant increase in the maxillary lateral incisor region with a statistically insignificant difference between both groups.
Regarding treatment duration, there was a statistically significant difference between both groups as overall treatment duration including alignment, leveling, and correction of Class II was significantly lower in the early group by 7.77 ± 1.44 months.