Class II Malocclusion: Back or Forth?

Class II malocclusion represents one of the most frequent sagittal discrepancies in orthodontics, often involving mandibular retrognathia, maxillary protrusion, or a combination of both. The therapeutic dilemma of whether to address the discrepancy by moving the maxilla backward ("back") or advancing the mandible forward ("forth") represents a critical decision point in contemporary orthodontic treatment planning.

Traditionally, the choice between maxillary distalization and mandibular advancement has been influenced by factors such as skeletal maturity, growth potential, facial aesthetics, and anchorage availability. With the advent of digital diagnostics, skeletal anchorage systems, and individualized treatment planning protocols, the boundaries of these two strategies have changed. Despite these advances, uncertainty remains regarding which approach offers the most stable, efficient, and aesthetic outcomes, especially in borderline or non-growing patients. Moreover, long-term comparative studies remain limited, and variability in clinical decision-making is still widespread.

This Research Topic seeks to explore the current evidence and clinical reasoning behind the decision to move the maxilla “back” or the mandible “forth” in the management of Class II malocclusion. We invite original research, clinical trials, reviews, and case reports addressing:

- Skeletal and dental diagnostic criteria guiding distalization vs. advancement

- Effects of timing on treatment outcomes

- Role of skeletal anchorage in both approaches

- Biomechanical considerations and long-term stability

- 3D imaging, digital planning, and AI-assisted decision-making

- Interdisciplinary approaches, including surgical-orthodontic treatments

- Patient-centered outcomes, quality of life, and aesthetic satisfaction

By integrating diverse clinical and research perspectives, this Topic aims to provide a clearer framework for individualized Class II treatment planning. Whether the answer lies in moving back or pushing forth, we hope to foster a more biologically rational and evidence-based approach to this foundational orthodontic question.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Curriculum, Instruction, and Pedagogy
• Data Report
• Editorial
• FAIR² Data
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Curriculum, Instruction, and Pedagogy
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Policy Brief
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: class II malocclusion, mandibular advancement, maxillary distalization, orthodontic treatment planning, skeletal anchorage, digital diagnostics

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.