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Main Instructor Chung-Ting Li
Yueh Su
Yu-Kai Lian
Sheng-Yang Lee
Department / Institution Orthodontic Department of Wan-Fang Medical Center, Taipei, Taiwan
Classification Case report
Class II malocclusion is a common malocclusion treated by orthodontists. Class II patients usually have retrognathic mandibles and hyperdivergent growth pattern, which make them among the most difficult to treat orthodontically. This report describes how to manage growing class II high-angle patient with headgear and fixed appliances. 
An 11 year-old girl presented a convex profile, Angle Class II div. 1 malocclusion, skeletal class II relationship with mandible retrognathism and high mandibular plane angle. Large overjet and deep overbite followed by lip incompetence and mentalis strain. Upper 1st and lower 2nd premolars were extracted for anterior teeth retraction and lip procumbency reduction. At first, high-pull headgear was used in conjunction with transpalatal arch for anchorage control and vertical control, but later we replaced headgear with 2 TADs over bilateral IZC7 due to patient’s insufficient compliance with headgear. After 37 months, the treatment result showed harmonious profile on patient with an ideal occlusal function. 
Discussion and summary
High-pull headgear can cause restriction of horizontal and vertical maxillary growth, as well as distalization and intrusion of the maxillary molars, thus allowing mandibular forward rotation, which is beneficial for correction of the high-angle class II malocclusion. Moreover, a favorable amount of growth in mandibular ramus height can greatly facilitate the correction during therapy.
Case Report: Orthodontic Treatment for Angle’s Class II Malocclusion with A High Mandibular Plane Angle in A Growing Patient