PDF: Treatment of a Class II Division 2 Malocclusion in a Teenage Patient: Clinical Case Report

This article describes the orthodontic treatment of an adolescent patient presenting a class II skeletal, convex profile, mesofacial biotype, upper dental midline deviated 1 mm to the left, Class I bilateral molar, canine distoclusion of ½ right unit and left canine relationship non-determinable because piece 23 is in ectopic position, proinclination and inferior protrusion. 

The treatment plan was to distalize the maxillary molars and create enough space to incorporate pieces 13, 23 in the dental arch, a pendulum appliance supported with two orthodontic mini implants were used. The active treatment lasted 18 months and at the end of it, all the objectives were fulfilled, resulting in facial balance. The pendulum appliance is a good alternative for a Class II dental correction, it produces distalization of the maxillary molars in an optimal treatment time.

Class II malocclusions can be corrected in various ways, such as reorientation of maxillary growth, distal movement of the maxillary dentition, mesial movement of the mandibular dentition and increase or reorientation of mandibular growth

When the treatment plan for the patient is considered, the question arises: Do we need to remove the teeth or create necessary space without extractions? Before this question, when it is chosen to create the necessary space without extractions, the professional must find alternatives to obtain the necessary space to correct the malocclusion. A considerable decrease in the percentage of extractions as part of the orthodontic treatment has been observed in recent years, since with these extractions, stability at the end of the treatment is not necessarily obtained.

Molar distalization is a treatment option that aims to create additional space within the arch, being of great value in cases where there is a normal mandibular relationship, minimal bonetooth discrepancy, Class II molar relationship, and it is desired to avoid extractions of permanent teeth, in the end one obtains a Class I molar relationship and the necessary space in the lateral segments of the canines or premolars. In this way, anterosuperior crowding is resolved by moving the molars to distal in the initial stages of treatment.