Level of evidence: Moderate (Tulloch et al. 2004, O’Brien et al. 2009)
Suitable for ages: 12+ years old
Indications: Class II skeletal malocclusion (mandible retrognathia, maxilla prognathism), Class II dental malocclusion, normal to deep bite malocclusion
Contraindications: Dolichocephalic facial pattern, downward backward rotated mandible (for some functional appliances)
Treatment Objectives and Biomechanics
- Orthopaedic advancement of mandible forward and downward
- Restraint of maxillary growth
- Class I dental occlusion finish with ideal incisor relationships
Appliances
- Functional appliances – Clark Twin Block, Herbst, Activator, Bionator etc.
- Headgears – maxillary restraint types, cervical pull etc.
- Fixed appliances with Class II elastics
- Clear aligners with Class II mechanics
