Class II division 2 nonextraction treatment using skeletal anchorage – a case report

Introduction
Molar distalisation is one of the most common nonextraction therapeutic protocols used for class II treatment. Microimplants seem to be the most optimum solution for noncompliant patients.

Aim
This case report aims to present a nonextraction treatment protocol in a 25-year-old female patient with class II division 2, using skeletal anchorage for en-masse distalisation.

Material and methods
A 25-year-old female presented at an orthodontic office to improve her smile aesthetics. She was diagnosed with class II division 2 and dental defects.

Case report
The patient was treated with a fixed orthodontic appliance in the upper and lower arch. The en-masse distalisation of the upper dentition was achieved using microimplants. Two microimplants were placed in the maxilla, mesially to first molars from the vestibular aspect, at the beginning of the treatment. They were used to control the position of upper canines and incisors during torque correction to protect from the class II increase. On the other hand, two other orthodontic microimplants were inserted into the maxilla from the palatal aspect, distally to first upper molars. Those microimplants with screws on the vestibular aspect were used for en-masse distalisation during class II correction.

Summary
The presented treatment protocol allowed achieving satisfactory outcomes, both in terms of aesthetics and function. Moreover, the applied biomechanics is simple and does not require using complex additional appliances that would require cooperation with a dental laboratory.