Successful management and stability of maxillary class II dentoalveolar protrusion with extractions of upper second and lower third molars, using en-masse distalization and vertical control with bone miniscrews: Adult case report with 7-year follow-up

Abstract

This case report describes the successful long-term management of a 19-year-old female patient presenting with a skeletal Class II pattern, mild anterior open bite, and mandibular retrognathia. The orthodontic treatment approach involved the distal movement of the maxillary and mandibular dentitions through the extraction of the maxillary second molars and mandibular third molars, combined with the use of extra-alveolar infrazygomatic crest (IZC) and buccal shelf (BS) miniscrews for anchorage. The treatment outcome achieved a stable, well-aligned dentition with ideal intercuspation and an improved facial profile. The 7-year post-treatment records demonstrated a stable occlusion and satisfactory facial aesthetics, confirming the long-term stability of this treatment approach. This case report supports that en-masse distalization of the entire dentition by extracting the upper second molars and lower third molars, coupled with bone miniscrew anchorages, can be a favourable alternative to the conventional premolar extraction approach for the correction of borderline Class II malocclusions.