Correction of Class II, Division 2 malocclusions using a completely customized lingual appliance and the Herbst device.

AIM

The purpose of the present study was to examine the efficiency of correcting a Class II, Division 2 malocclusion using a completely customized lingual appliance.

MATERIALS AND METHODS

In 18 consecutively completed, Class II, Division 2 malocclusion patients, the correction of the upper incisor inclination, deep and distal bite were assessed by means of plaster casts, digital lateral cephalograms, and intraoral photographs taken at the time of debond. Furthermore, two independent calibrated examiners determined the weighted Peer Assessment Rating index (PAR Index) of the initial and end models.

RESULTS

All Class II, Division 2 patients were treated successfully: upper incisor inclination using the palatal plane as a reference improved on average from 95.4° to 111.2°. The deep bite was reduced on average from 3.6 mm to 1.7 mm. Neutral occlusion was achieved in all patients who had undergone correction of an initially pronounced distal occlusion (4.5 mm on average). An 86.2% marked improvement was observed in the weighted PAR index score from an average of 24.7 at the beginning of treatment to 2.9 at the end of treatment, with no patient classified as "worse or no different."

CONCLUSION

Class II, Division 2 malocclusions can be efficiently and reliably treated by a combination of a completely customized lingual appliance and the Herbst device.