Treatment of a Class II subdivision based on occlusal plane control: a clinical case

It is important to understand the morphologic features of malocclusion to construct a functional occlusion. The features of Class II subdivision malocclusions with mandibular lateral deviation make them especially difficult to correct. This article describes a Class II subdivision clinical case, treated at the first stage with the straightwire technique, which permitted alignment and leveling for 12 months. At the second stage, an occlusal plane modification and mandible repositioning with multiloop edgewise archwires (MEAW) was used for 6 months. Different MEAW activation on either side and occlusal provisional composite restorations (prematurity) in the maxillary left first and second molars became essential to increase the vertical dimension in the affected side, thereby allowing the left premolars to extrude into a Class I relationship. Short vertical elastics in the anterior area (for Class III) on the right side and on the left side (Class II) also applied different orthodontic forces. This procedure made it possible to finish the case with stable sagittal and vertical occlusion relationships between both arches.