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Early management of a patient with skeletal class II

Dennis D’Aprile, Soroosh Rahimy, Hristina Arnautska, Zornica Vulcheva


Introduction: The upside of early orthodontic treatment is the ability to take advantage of the period when a child`s jaws are still developing. It has been estimated that as many as 70% of children have a malocclusion. The most common malocclusion is skeletal class II characterized with normal position of the upper jaw and retrognathic mandible. Skeletal malformations are often seen in dentistry. If left untreated, they can lead to severe problems during the course of a patient`s life. The aim of the follow­ing case report is to present the early management of a patient with skeletal class II.

Materials and Methods: This report describes the treatment of an 8-year old girl in the Department of Orthodontics, Faculty of Dental Medicine, Medical University of Varna. Diagnostic data was gath­ered from anamnesis, cephalometric analysis based on lateral cephalogram, orthopantomography and orthodontic study model analysis. Extra- and intra- oral photographs were taken before treat­ment.

Results: Severe constriction of both jaws, mesialisation of all posterior teeth on the right in the upper jaw, dental class II, laterodeviation and deep bite were established. According to lateral cephalometric analysis, the patient has a retrognathic mandible, retroclination of upper incisors and hypodivergent growth pattern. Because of the severe constriction, the first phase of the treatment begins with ex­pansion of upper and lower dental arches. At the second phase, after arch alignment, a functional ap­pliance for mesialisation of the lower jaw will be used to achieve normal occlusion between both jaws.

Conclusion: Properly formed dental arches are necessary to achieve normal anteroposterior relation­ship between upper and lower jaw. Because of this, a standard lingual plate will be used. Good results are to be expected if the patient is cooperative.


skeletal class II; overbite; deep bite; overjet; laterodeviation; lingual plate



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