Level of evidence: Low to moderate
Suitable for ages: 12+ 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
- Posterior maxillary dental intrusion
- Mandible autorotation forward and upward
- Class II dental correction
- Increase anterior overbite
Appliances
- Fixed appliances with TADS – molar intrusion (Buchang et al. 2002 & 2011, Lee and Park 2008)
- Clear aligners with TADS – molar intrusion (clear aligners alone without TADS have been to be unpredictable for true molar intrusion) (Robertson 2019, Hamilton 2020)
- Headgears – maxillary restraint types, cervical pull etc. (however compliance was a significant limitation to molar intrusion and autorotation) (Gkantidis et al. 2011)
