Clinical Indications

• Class II div 1
• Crowding
• Facial/dental midline descrepancy
• Increased overjet
• Narrow arches

The patient presented with a typical Class II Division 1 malocclusion, characterized by bilateral end-on Class II relationships and a mildly increased overjet. Constricted dental arches and mild anterior crowding were also observed. Furthermore, all four third molars were present and exhibited occlusal contact.

Modalities

• Distalization
• Elastics: Class II
• Intrusion
• IPR
• Leveling Curve of Spee
• Proclination
• Restorative
• Retraction

Class II elastics were incorporated to facilitate sequential distalization of the maxillary dentition, correct the bilateral end-on Class II relationships, and assist in retraction of the maxillary anterior teeth to reduce the overjet. In the mandibular arch, controlled intrusion and proclination of the anterior teeth were planned to level the curve of Spee, with the proclination also contributing to further overjet reduction. Furthermore, all four third molars were incorporated into the arch and aligned to optimize posterior occlusion, particularly because the patient had undergone premolar extractions during the previous orthodontic treatment. Finally, IPR between teeth #11 and #21, combined with adjunctive composite resin restorations, was performed to optimize the tooth morphology, and eliminate the black triangle, thereby enhancing anterior dental esthetics.

Treatment Information