Level of evidence: Moderate
Suitable for ages: 16+ years old
Indications: Class II skeletal malocclusion (mandible retrognathia, maxilla prognathism), dolichocephalic facial pattern, downward backward rotated mandible, vertical maxillary excess, Class II dental malocclusion, anterior open bite
Contraindications: Brachyfacial growth pattern, forward and upward rotated mandible, deep bite
Treatment Objectives and Biomechanics
- Decompensate upper and lower incisors
- Surgical impaction of the maxilla
- Autorotation of the mandible +/- mandibular advancement surgery
- Ideal facial pattern and dental finish
Appliances and surgery
- Fixed appliances
- Maxilla impaction surgery (Proffit et al. 1991 & 2007, Milhalik et al. 2003)
- +/- mandibular advancement surgery