AJODO CC 2023: Class II Malocclusion with 14mm OJ Treated with U7 Extractions and Bone Screws｜CC754

The full article is available for free downloaded before Jan 18, 2024 at: A 15-year-old male presented with flared maxillary central incisors. He was diagnosed with a skeletal Class I relationship (SNA, 84.5°; SNB, 80.5°; ANB, 4.0°), which was associated with a full-cusp Class II molar relationship. Dental analysis revealed flared maxillary central incisors (U1-NA, 12.0 mm; U1-SN, 128.0°) with an excessive overjet of 14.0 mm. Facial convexity was within normal limits; however, lips were markedly protrusive (upper and lower lips were 4.0 and 5.0 mm to the E-line). The discrepancy index was 22. For treatment, maxillary second molars were extracted to provide space for retracting the whole maxillary dentition to correct the Class II malocclusion. Skeletal anchorage was provided by two bone screws (bilateral infrazygomatic crest bone screws). Maxillary anterior bite turbos and Class II elastics were applied for overbite and overjet reduction. Nineteen months of active treatment resulted in a satisfactory facial profile and dental alignment. Bilateral Class I canine and molar relationships were achieved. The excessive overjet was reduced to 1.0 mm, whereas the impinging overbite was reduced to 4.0 mm. Protrusive lips were treated from 4.0 and 5.0 mm to 2.0 and 2.0 mm to the E-line, for upper and lower lips, respectively. A full-cusp Class II malocclusion with 14.0 mm of overjet, flared maxillary central incisors, 100% overbite, and periodontal impingement was treated with extraction of both maxillary second molars followed by retraction of the entire maxillary dentition with bilateral infrazygomatic crest anchorage. Anterior bite turbos and Class II elastics resulted in a pleasing facial profile without orthognathic surgery while preserving as much of the dentition as possible. (Am J Orthod Dentofacial Orthop Clin Companion 2023; in press)