Treatment of Class II Division 2 malocclusion using temporary skeletal anchorage devices and an auxiliary intrusion arch after premolar extractions

Abstract

Intrusion and torque control of retroclined maxillary incisors are crucial for Class II Division 2 malocclusion treatment. This case report describes the orthodontic treatment of a 24-year-old female with Class II Division 2 malocclusion, a convex profile, lip protrusion, and excessive maxillary incisor exposure. Four premolars were extracted. A 0.016 × 0.022-in stainless steel archwire with long hooks, rectangular elastic thread, tip-back bends, and temporary skeletal anchorage devices was used to regain the torque of retroclined maxillary incisors. Maxillary and mandibular incisors were intruded using the anterior temporary skeletal anchorage devices and auxiliary intrusion arch. This treatment established a Class I molar relationship, restored the torque of the maxillary incisors, achieved a normal overbite and overjet, and improved both the lip-to-teeth relationship and the overall facial profile. Root resorption and palatal bone loss in the maxillary incisors were observed during space closure. Reduction in palatal bone loss was noted at the 14-month follow-up. A two year follow-up demonstrated stable treatment outcomes.