Management of Skeletal Class II in a Growing Patient Using a Headgear and a Fixed Functional Appliance, with a Three-Year Follow-up : An Indian Board of Orthodontics Case Report

Abstract

This case was submitted to the Indian Board of Orthodontics under category II for phase III examination, in December 2018. SP, a 13-year-old female patient, presented with the chief complaint of forwardly placed upper front teeth. On clinical examination, she was found to have class II division 1 malocclusion with an increased overjet and overbite, a class II skeletal pattern due to a prognathic maxilla and a retrognathic mandible with positive visual treatment objective (VTO), moderate crowding in the upper and lower arches, retained deciduous 54 and 55, an exaggerated Curve of Spee, and a midline discrepancy of 6 mm. The treatment objectives were to correct the skeletal pattern and molar and canine relation. The patient was treated with fixed mechanotherapy, along with a headgear and a fixed functional appliance (Forsus). At the end of the treatment, she showed improvement in the skeletal pattern, good posterior occlusion, and an improved overjet and overbite. A bonded fixed retainer in the lower arch and a Begg’s wraparound retainer in the upper arch were used. Occlusion remained stable 3 years after the treatment.