Compensatory treatment for hyperdivergent skeletal Class II using temporary anchorage device

Abstract

Introduction: The treatment of hyperdivergent skeletal Class II is one of the most challenging tasks facing orthodontists. With the advent of temporary anchorage devices, patients who were previously submitted to orthognathic surgery may be favored by a counter-clockwise rotation of the mandible, resulting from vertical control of the posterior teeth. Also, cases with increased incisor display at rest may benefit from these biomechanics in the anterior segment. Methodology and resources: This case report illustrates the successful treatment of a patient with hyperdivergent skeletal Class II malocclusion resulting in an unaesthetic smile with excessive gingival display when smiling and absence of passive lip seal. Results: The temporary anchorage device produced a suitably functional and aesthetic result, with the correction of the increased gingival exposure, passive lip sealing and improved angulation of the mandibular plane. In addition to the conventional cephalometric superimposition, three-dimensional superimposition was performed and evaluated to validate the treatment outcome. Discussion: Although it does not replace orthognathic surgery, this modality of treatment may benefit patients who are unwilling to undergo a more invasive procedure.