Kieferorthopädie, 01/2025

The diagnosis and treatment of Angle Class II, division 2 malocclusion is not standardized and is subject to controversial debate. In this paper, the relevant aspects are systematically presented and an overview of existing scientific studies is compiled. Keywords: Angle Class II, division 2 malocclusion, deep bite, mandibular retrognathia

The combination of skeletally anchored distalization and aligners offers a modern approach to treating Class II malocclusions in adults. A single-phase approach with simultaneous molar distalization and aligner staging enables precise, controlled, and efficient therapy. The presented case of a 35-year-old patient demonstrates the successful application of a custom-made distalizer. By integrating mini-implants and aligner technology, the sagittal overjet, anterior crowding, and midline deviation were corrected without tooth extractions. Skeletal anchorage enhanced treatment stability and reduced dependency on patient compliance. Keywords: Class II malocclusion, distalization, skeletal anchorage, aligners, mini-implants, benesliders, distalizers, orthodontic treatment in adults

An Angle Class II, division 2 malocclusion can be treated in various ways in clinical practice. The key features of distal occlusion and deep bite can be addressed simultaneously or sequentially, with different therapeutic options available. This case report presents the treatment with an aligner system and maxillomandibular elastics. Keywords: Angle Class II, division 2 malocclusion, deep bite, overbite, distal occlusion

Various treatment concepts are available for the treatment of Angle Class II, division 2 malocclusion. Thanks to advances in digital technology, the complete workflow for fabricating your own aligners in clinical practice (ie, in-house aligners) has recently become established. This article describes the treatment of a complex case exclusively with in-house aligners, which were designed with a modified frog intrusion protocol and overengineering. The treatment outcome demonstrates the effectiveness of individually planned aligner therapies in adult patients with a deep bite. Keywords: in-house aligners, Angle Class II, division 2 malocclusion, frog intrusion protocol, overengineering

Direct printing of aligners is relatively new and offers a variety of advantages compared to conventional manufacturing methods. Using a case study, this article presents and discusses the possibilities and limits of the process. Keywords: Angle Class II, division 2 malocclusion, aligner, direct-printed aligner

3D virtual planning has revolutionized the preoperative preparation for orthognathic surgery. Compared to traditional 2D planning methods, 3D planning offers a more precise representation of craniofacial anatomy and improved predictability of postoperative outcomes. The integration of imaging modalities such as CBCT combined with intraoral scans enables the creation of highly accurate 3D models. These models serve as the foundation for planning surgical steps, including osteotomies and repositioning of jaw segments. A significant advantage is the ability to simultaneously account for functional and esthetic parameters, such as soft tissue prediction, occlusal plane orientation, and temporomandibular joint (TMJ) positioning. Additionally, virtual planning and 3D simulation facilitate improved communication between the surgeon, the patient, and the interdisciplinary treatment team. Despite these advancements, challenges remain, particularly in the standardization of planning protocols, costs, and the precise consideration of the biomechanical aspects of the TMJ. Nevertheless, 3D planning demonstrates significant potential to improve outcome quality and patient safety in orthognathic surgery. Keywords: dysgnathia, 3D simulation, virtual planning, combined orthodontic and oral and maxillofacial surgery, interdisciplinary treatment concept

The treatment of a pronounced Angle Class II, division 2 malocclusion poses a particular challenge, especially in adult patients. With the help of a fully customized lingual appliance, the treatment goals can be achieved efficiently and, if the response is favorable, avoid the need for surgical correction of the position of the mandible. Keywords: lingual therapy, Angle Class II, division 2 malocclusion, orthodontic treatment in adults

Aligners are an excellent appliance to use to treat a variety of malocclusions, but their efficiency in treating severe deep bite has long been questioned. Infrazygomatic crest screws are a powerful accessory that, when associated with aligners, can correct Class II malocclusion using Class I elastics. The biomechanics of distalisation using infrazygomatic crest screws causes clockwise rotation of maxillary teeth, but with efficient planning and the intrusive pressure applied by aligners, deep bite was corrected in the present patient, and the entire maxillary posterior segment was distalised en masse simultaneously. This case report describes the biomechanics of aligners coupled with infrazygomatic crest screws to perform en-masse distalisation and correct severe crowding along with deep bite. Keywords: en-masse distalisation, infrazygomatic screws, aligners, deep bite, severe crowding

Couples are an interesting topic in technical mechanics because they have the ability to rotate a rigid body about its center of gravity. In orthodontics, this can be used to rotate a tooth in place around its center of resistance. However, this only appears to make clinical sense in the context of first-order considerations. The following article addresses the relevant principles, resulting side effects, and anchorage situations. Keywords: anchorage, couple, center of resistance, rotation, loss of space, collinear forces, cantilever, transpalatal arch, space opening, R-spring