Fixed orthodontics in a Class II Division 2 young adult with Brodie's occlusion and three-dimensional anomalies using a Herbst appliance and miniscrew: A case report

Abstract

In this case report, we described the successful treatment of a 17-year-old male with Class II Division 2 and a Brodie occlusion, with bilateral scissor bite, maxillomandibular transverse discrepancy, deep overbite and Class II molar relationship, using a fixed Herbst appliance. The treatment was carried out in two phases. In the first phase, the Herbst appliance was used to advance the mandible, correcting the sagittal relationship while simultaneously improving transverse and vertical discrepancies, with minimal reliance on patient compliance. In the second phase, fixed appliances combined with temporary anchorage devices (TADs) were employed to refine tooth alignment, coordinate the arches, and achieve a stable occlusion. Following treatment, all objectives were achieved, including complete correction of the bilateral scissors-bite, normalization of overjet and overbite, coordinated arch forms, and bilateral Class I molar relationships. The patient's facial profile and smile aesthetics were notably improved. Stability was confirmed after a 3-year retention period. This case highlights the effectiveness of Herbst therapy followed by TAD-assisted orthodontics in achieving functional correction, aesthetic enhancement, and long-term stability in patients with Brodie bite and complex three-dimensional discrepancies.