Treatment of Class II Protrusion with Severe Crowding Using Indirect Miniscrew Anchorage

Abstract

This report describes the nonsurgical treatment of a patient with skeletal Class II protrusion and severe crowding. A 20-year-old woman presented with the chief complaint of lip protrusion and crowding. To correct the Class II relationship, severe crowding, and lip protrusion, distal movement of the maxillary first molars using indirect miniscrew anchorage and nickel-titanium coil springs, along with extraction of the first premolars and maxillary second molars, was planned. After the distal molar movement phase was complete, the maxillary first molars had moved 8.0 mm to the distal, and the first premolars, which were splinted to the miniscrews, had moved 0.5 mm to the mesial. The results show that the distal molar movement mechanics were efficient and stable. After treatment, all of the patient's chief complaints were relieved and an esthetic facial profile was obtained.