Non-extraction camouflage on a fully cooperative full-step class II division 2 adult patient treated with en-masse distalization, class II elastics and preadjusted lingual appliance: A case report

This article describes one adult bilateral full-step class II case with severe initial upper incisors retroclination successfully treated by a completely invisible lingual appliance. A non-extraction treatment to compensate for the severe sagittal discrepancy was made possible following the excellent patient cooperation with intermaxillary elastics, combined with upper arch en-masse effective distalization with miniscrews. The application of an auxiliary torque spring was essential to increase upper incisors torque during class II mechanics. This case report shows the possibility of obtaining a full-step class II correction in an hypodivergent adult patient with a completely invisible appliance, taking advantage for the patient cooperation, for a more straightforward and faster non-extraction case resolution. It also underlines on the other hand the importance of successfully controlling incisors torque with auxiliaries in cases of severe retroclination in an adult class II malocclusion, in combination with the simultaneous distalization mechanics for monolateral full-step class II correction, by means of a completely invisible appliance.