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Main Instructor Shih-Hsuan Lin
Shih-Chieh Chen
Jeih-Fu Chen
Yu-Chuan Tseng
Department / Institution Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Classification Case report
   Sagittal discrepancy is an important issue in consideration of malocclusion. Class II jaw relation is frequently encountered, though the prevalence is lower in Orientals. Orthopedic effect may be expected by intervention of functional appliance during adolescent period. Selection of appliance is also a profound subject in consideration of jaw relation, facial pattern, and bite condition.
   This case is a report of 12-year-old female patient who requested for evaluation of her crowding dentition. Clinical examination revealed Class II molar relationship with anterior crowding and deep overbite. Radiographic examination indicated skeletal Class II jaw relation, orthodivergent facial pattern, and retroclined upper incisors.
   High-pull headgear and full mouth fixed edgewise appliances were selected in our treatment plan. At the beginning, fixed appliances were bonded for initial alignment. Then the patient was required to wear headgear at least 14 hours a day including nighttime sleep. By 22.5 months of treatment, distalization of upper molars and growth of mandible could be observed.
   In growing cases of Class II, restraining growth of maxilla and letting mandible to grow are expected by extraoral force. Concerning the malocclusion of Class II division 2, the retroclined upper incisors and deep overbite should be corrected to prevent limitation on growth of mandible. This case report will present the mechanism and the pre- and post-treatment changes.
A Growing Patient with Class II Division 2 Malocclusion Treated with High-pull Headgear and Fixed Edgewise Appliance