Orthodontic treatment of Class II malocclusion with miniscrew implants

Abstract

Orthodontic treatment of patients with Class II malocclusion who show poor compliance with conventional treatment modalities such as extraoral headgear, functional orthopedic appliances, or conventional fixed appliances with intermaxillary elastics, can be challenging. Noncompliance approaches can be used, but they often pose anchorage problems. This article describes the orthodontic treatment of a girl, aged 11.5 years, with a Class II malocclusion, a deep bite, and increased overjet. Initially, an intraoral miniscrew implant supported distalization system (MISDS) was used to distalize the maxillary first molars. Temporary stationary anchorage was provided by 2 miniscrew implants that were placed paramedian in the anterior region of the palate. After distalization, the system was modified slightly by a chair-side procedure and then used to provide the desired stationary anchorage for subsequent anterior tooth retraction in conjunction with conventional full fixed orthodontic appliances. After 18 months of treatment, a Class I molar relationship was achieved, and the deep bite, overjet, posterior intercuspation, and facial esthetics were improved. Biomechanical considerations, clinical efficacy, and the advantages and potential complications of MISDS treatment are discussed. This case report illustrates the use of MISDS to distalize the maxillary molars and retract the anterior teeth, providing noncompliance, nonextraction, and efficient approach for the orthodontic treatment of patients with Class II malocclusion, which is initially invisible.