A female patient, aged 14.0 years, with Class II dental bases (ANB 7°) and a Class II facial profile.

Fig. 7.122

Dentally, the patient showed a typical Class II division 1 malocclusion, with slightly retroclined lower incisors, and an increased overjet. Molar relationship was a full emit Class II on the right side and half a unit Class II on the left side.

Fig. 7.119

Fig. 7.128

Fig. 7.125

Occlusally, the patient was assessed as having an ovoid arch form. There was a small amount of crowding amongst the lower incisors. The radiographs confirmed that third molars were developing, and were of good size and position.

A decision was made to commence correction on a non-extraction basis, using a twin block appliance. The patient and parents were informed that consideration might need to be given to the extraction of upper second molars and lower third molars as treatment progressed.

At the start of treatment, upper and lower twin block" appliances were placed for full-time wear.

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