Treatment of a Class II, division 1 vertical growth pattern with severe anterior crowding

Treatment of a skeletodental Class II vertical growth problem, combined with a severe arch length deficiency in both arches, presents a challenging orthodontic problem. This is the case report of a small-statured, 11-year, 10-month-old boy with a history of juvenile chronic arthritis and marked mandibular retrognathia who was treated with first premolar extractions in both arches. Unexpected favorable growth, with significant decrease of the mandibular plane angle over a long treatment period, provided a very satisfactory result. [This case report was presented to the American Board of Orthodontics in partial fulfillment of the requirements for the certification process.]