Nonsurgical Treatment of an Adult Patient with Bilateral Scissors-bite and Class II Division 2 Malocclusion

Nonsurgical Treatment of an Adult Patient with Bilateral Scissors-bite and Class II Division 2 Malocclusion

This report illustrates a 20 years old female presented a Class II division 2 malocclusion with deep overbite, gummy smile, canted maxillary anterior occlusal plane, low mandibular plane angle and bilateral scissors-bite. Angle's Class II division 2 malocclusion needs to be treated by correcting the inclination of maxillary incisors and lower lip posture. Selective bonding of maxillary anterior teeth and molars were performed to level the occlusal plane and gingival line, thus creating a consonant smile arc. Disocclusion was necessary by using a removable bite plate. Maxillary second premolars and second molars, lower third molars were extracted. The aim was to intrude the elongated maxillary molars and upright the mandibular molars. The treatment of bilateral scissors-bite is more efficient with the help of temporary anchorage devices (TADs). Four titanium bone screws were therefore inserted at maxillary and mandibular posterior regions to intrude and upright the molars even without patient's compliance. At the end of treatment, a harmonized smile and stable occlusion were accomplished. After one-year retention period, the treatment results still maintained well.