Abstract

Skeletal Class II malocclusion is a complex craniofacial condition in which dentoalveolar compensation can partially conceal the underlying skeletal discrepancy, making accurate diagnosis and treatment planning challenging. This study by Salah Bin Hafedh evaluated dentoalveolar compensation patterns among CBCT-derived skeletal Class II phenotypes in a Yemeni cohort. A retrospective secondary analysis was conducted on 120 Yemeni patients with skeletal Class II malocclusion, including 56 males and 64 females with a mean age of 23.1 ± 3.5 years. Using principal component analysis and Ward hierarchical clustering, five skeletal phenotypes were identified and compared through thirteen dentoalveolar variables derived from CBCT-based cephalometric reconstructions. Significant differences were observed among phenotypes, particularly in upper and lower incisor inclination, protrusion, and vertical positioning. The hyperdivergent phenotype demonstrated the greatest maxillary incisor  proclination and vertical position, while the most severe phenotype exhibited the smallest U1-NA linear values and the greatest L1-APg linear values. The findings highlight that skeletal Class II phenotypes possess distinct dentoalveolar compensation signatures, emphasizing the importance of integrating dentoalveolar assessment with skeletal phenotyping to improve craniofacial diagnosis and support individualized orthodontic and facial aesthetic treatment planning.