Use of temporary skeletal anchorage devices for intrusive root movement of maxillary incisors in adult patients with Class II Division 2 malocclusion

Abstract

• In treating adult Class II Div. 2 patients, absolute intrusion of the maxillary incisors is needed. • The combined use of TSADs enabled effective intrusion of maxillary anterior teeth. • The vertical position of the maxillary anterior teeth should be decided first for esthetic display. • An adequate maxillary occlusal plane angle should be obtained according to its incisor position. Treatment of nongrowing patients with Class II Division 2 malocclusion with a severe deep overbite is one of the most difficult cases that orthodontists can experience. Appropriate biomechanics should be applied for the intrusion of maxillary anterior teeth with these patients to avoid undesirable side effects. The vertical position of the maxillary anterior teeth needs to be decided first for esthetic incisor display, and then an adequate maxillary occlusal plane angle must be obtained accordingly, both for functional and esthetic reasons. This case report presents the biomechanics and its clinical application to treat a nongrowing patient with a severe deep overbite and retroclined maxillary incisors using multiple temporary skeletal anchorage devices.