Oral health–related quality of life and masticatory function changes in Class II camouflage treatment: focus on maxillary premolar extraction and final posterior occlusion

Objective: To compare changes in oral health-related quality of life (OHRQoL) and subjective food intake ability (key food intake ability [KFIA]) among different Class II camouflage strategies and to assess posterior occlusal contact types in Class II molar finishing. Materials and Methods: Records from 62 patients with Class II malocclusion were categorized into nonextraction, maxillary premolar extraction (ME), and maxillomandibular premolar extraction (MME). The Oral Health Impact Profile-14 (OHIP-14) and KFIA were administered before and after treatment. The American Board of Orthodontics Discrepancy Index and Objective Grading System (OGS) were also evaluated. The primary outcomes were group × time interactions in OHIP-14 and KFIA; the secondary outcome was posterior disclusion in ME cases. Results: Baseline characteristics were similar, except for greater initial overjet and overbite in ME (P < .05). KFIA remained stable after treatment in all groups (P ≥ .05). OHIP-14 improved significantly in total score and psychological discomfort for all patients, with additional improvement in the handicap domain in the MME group; however, no significant group × time interactions were found. Baseline OHIP-14 was the only predictor of posttreatment OHRQoL (P < .001). OGS outcomes were comparable; however, digital analysis showed second-molar posterior disclusion in 10% of ME cases. Conclusions: Class II camouflage treatment improved psychosocial aspects of OHRQoL regardless of extraction pattern; in contrast, subjective masticatory function remained unchanged. Baseline OHRQoL, rather than extraction type or case complexity, predicted final OHRQoL. Posterior occlusal assessment beyond OGS criteria may be useful in ME cases.