Abstract
We treated a female patient with open bite and high-angle Class II Division 2 malocclusion using fully customized lingual appliances, orthodontic anchor screws (OAS), and a skeletal anchorage system (SAS). By carefully controlling torque, anchorage, and vertical skeletal and dental factors, we were able to obtain proper anterior coupling. Even after the retention phase of treatment, the occlusion was maintained, indicating that we provided proper treatment according to the properly designed treatment plan. This also indicates that cases with an extremely high level of difficulty, as in the present case with high-angle retrognathic mandible and open bite, can be treated by combining the Incognito appliance (a fully customized lingual bracket appliance) with a SAS and OAS.
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