Growth modification using a modified C-palatal plate in a patient with a Class II hyperdivergent relationship with arthrogryposis multiplex congenita

A 9-year-old male patient with arthrogryposis multiplex congenita (AMC) had a history of at least 2 joint contractures in multiple areas of his body. In addition, he had a dentoskeletal Class II malocclusion and a hyperdivergent growth pattern. He was successfully treated with growth modification using a modified C-palatal plate (MCPP) with a 2-phase treatment. An MCPP was applied 3 times throughout treatment, and the patient was observed from age 10 to 20 years. In phase 1, an MCPP was placed twice to induce the headgear effect in the maxilla. In phase 2, an MCPP and fixed appliances were used in the whole dentition to improve the dental Class II relationship and functional occlusion. Phase 1 occurred over 6 years and 9 months, whereas Phase 2 occurred over 20 months. Patient with a Class II hyperdivergent AMC relationship with micrognathia have shown improved anteroposterior discrepancy in dental and skeletal structures and effective vertical control using MCPPs. Therefore, clinicians should consider the application of MCPPs as a treatment modality for patients with a Class II growth modification in AMC.