This case report describes a complex full-step Class-II malocclusion with protrusion of maxillary incisors in an adult patient treated with lingual straight-wire appliance. The two-fold aim was to obtain an ideal occlusal relationship and improvement of smile aesthetics. This report illustrates that an appropriate treatment strategy, including anchorage control by en-masse distalisation and intermaxillary elastics, is needed to achieve the planned results, even with a completely invisible appliance. The placement of miniscrews on the palatal side provided more space for tooth distalisation, thus allowing the correction of a full-step Class-II relationship. An aesthetic buccal sectional was added in the last two months of treatment to correct the maxillary left first premolar, which exhibited a significant torque discrepancy during en-masse retraction.
Keywords: Class-II, en-masse distalisation, miniscrews, lingual appliance