Clear aligner treatment of Class II malocclusion with deep impinging overbite

Abstract

Correcting a deep overbite in Class II Division 2 malocclusion with clear aligners is often unpredictable because of the complexity of the required movements, which include intrusion, labial movement, and proclination of the retroclined incisors. This report presents the treatment of an adult patient with a skeletal Class II base and deep impinging overbite, managed with clear aligners and anterior mini-implants. To enhance the predictability of incisor intrusion with aligners, two interdental mini-implants were placed in the anterior maxilla. The simulated treatment plan was intentionally overcorrected to achieve the desired intrusion of the maxillary and mandibular incisors. In addition, Class II elastics and sequential distalization were incorporated into the plan. Posterior bite-blocks were added to prevent posterior tooth extrusion and clockwise mandibular rotation. The treatment outcomes demonstrated intrusion of the maxillary and mandibular incisors, effective vertical control, and the achievement of Class I canine and molar relationships.