Class II, division 1, case with multiple treatment challenges.

This is a case report of a 23-year-old black woman with a skeletal Class II Division 1 malocclusion and an anterior open bite. The maxillary central incisor root was severely dilacerated, a maxillary lateral incisor and canine were transposed, a maxillary canine was impacted near the orbital rim, and a mandibular second premolar was congenitally missing. Selective extractions and attention to detail provided outstanding occlusal function and improved facial esthetics.