An overview of Class II treatment

Introduction 162

The shift in emphasis from molars to incisors 162

The concept of'ideal' incisor position in treatment planning 162

Planned incisor position 162

The limitations of orthodontics 163

The surgical/non-surgical decision in Class II treatment 163

Identifying severe Class II cases 164

The four-stage treatment planning process 166

Setting a PIP for upper incisors 166 The lower incisors 166 The remaining lower teeth 167 The remaining upper teeth 167

PIP components in Class II treatment 168

A/P component 168 Torque component 169 Vertical component 169

Upper incisor movement in Class II cases 170

Mesial movement of upper incisors 170

Distal movement of upper incisors in cases with upper anterior spacing 172

Distal movement of upper incisors after upper premolar extractions 173

Distal movement of upper incisors in non-extraction cases without spacing 173

Control of upper incisor torque 174

Vertical control of incisors 177

Positioning of lower incisors in Class II cases 178

Control of the A/P position of lower incisors 178

Movement of lower incisors in the mandibular bone 179

Favorable change in mandibular length or position 180

Mandibular growth 180

Augmentation of mandibular position with functional appliances? 181

Favorable condylar repositioning of the mandible 181

Orthopedic vertical control of the maxilla? 181

Unfavorable condylar changes, causing reduced mandibular length 182

Unfavorable condylar repositioning of the mandible 183

Case LJ An adult Class II deep bile case with extraction of upper first premolars and all third molars 184

Case TC A non-extraction case, Class I skeletally and mildly Class II dentally 192

Case TS A Class II/l non-extraction twin block case 198

Case DO An adult Class II/2 which required molar extractions 206

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