Rethinking the bioprogressive technique for Class II correction with clear aligners

The traditional bioprogressive philosophy has been reported to treat growing Class II malocclusion cases. The traditional technique involves the use of cervical headgear to extrude maxillary molars and to restrain maxillary growth while allowing forward arcial growth of the mandible. This case report utilises the same philosophy but using clear aligners. A 12-year-old girl presented with a skeletal Class II relationship due to mandibular retrognathism. The patient also presented full-step Class II, division 1 malocclusion with an increased overjet and deep overbite in addition to a spaced mandibular arch. Treatment included restraining maxillary forward growth while allowing maximum forward mandibular growth and correction of both skeletal and dental malocclusion/malrelationship using clear aligners. Detailed setup of the treatment plan using clear aligners utilising the bioprogressive philosophy is presented. Treatment was completed in 1 year. The treatment achieved improvement in skeletal and dental relationships. Critical evaluation of the case is also presented and the future management of similar cases of Class II malocclusion with a skeletal Class II relationship is discussed. Keywords: bioprogressive, Class II, clear aligner treatment, malocclusion, skeletal