Objective: Successfull orthopedic/orthodontic treatment of high angle CIass II malocclussion could be performed either with extra oral force by restraining the growth of maxilla and/or functional appliances by enhancing the growth of mandibula or selective removal of permanent teeth depending upon the source of the problem and are often difficult to treat. The aim of this article is to describe a nonsurgical approach to the treatment of a high-angle Class II malocclusion in a growing patient.
Methods: A 13.5-year-old girl with Class II division 1 malocclusion with a high mandibular plane angle, short upper lip, severe gummy smile and convex profile was treated in two phases. In the first phase, bonded RPE with anteriorly bonded buttons was applied for 4 months and during retention period Class II elastics were worn from the buttons bonded on the buccal surface of the mandibular first molars along with 0,75 mm thick essix appliance covering full mandibular arch. Skeletal correction was achieved in 3,5 months. The second phase was performed with fixed straight wire appliances to level and align the dental arches and sleeping high pull headgear. Total treatment time was 12 months.
Results: Correction of the high-angle skeletal Class II malocclusion was obtained by restricting forward growth of the maxilla and by a favorable amount of growth of the mandible with minimal dental changes and without mandibular clockwise rotation.
Conclusion: In growing patients, satisfactory correction of the severe dentoskeletal disharmony is possible with a new approach and less treatment time.