Mandibular Mini-Implant-Supported Multiloop Edgewise Archwire Therapy for Skeletal Class II Malocclusion: A Comparative Cohort Study.

Skeletal Class II malocclusion with deep overbite can be treated using multiloop edgewise archwire (MEAW) therapy combined with Class II elastics. However, conventional dental anchorage may cause undesirable dentoalveolar effects, particularly mandibular incisor proclination. This study compared immediate post-treatment cephalometric and patient-reported outcomes of MEAW therapy using mandibular mini-implant-supported modified Class II elastics versus conventional long Class II elastics. This non-randomized bidirectional cohort study included 20 patients (10 per group) who underwent cephalometric assessment before and after treatment and completed a study-specific questionnaire. Between-group differences were primarily evaluated using analysis of covariance (ANCOVA), adjusting for pretreatment measurements. Bonferroni and false discovery rate (FDR) corrections were applied to account for multiple comparisons. All patients achieved the predefined clinical finishing criteria. After baseline adjustment and Bonferroni correction, significant between-group differences remained only for mandibular incisor inclination, with adjusted differences of +29.35° for FMIA (95% CI, 19.37-39.33; p < 0.001) and -25.28° for IMPA (95% CI, -35.88 to -14.68; p < 0.001). Differences in vertical and sagittal skeletal measurements were not statistically significant after adjustment, while doctor behavior and treatment knowledge differed significantly between groups after FDR correction. These preliminary findings suggest that mini-implant-supported MEAW therapy may improve mandibular incisor control, although larger controlled studies are needed to establish its long-term benefits.