Class II Malocclusion, mandibular repositioning therapy

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- The relationship between the occlusal plane and malocclusion- Class II: dentoalveolar and skeletal forms. Characteristic- The choice of the class II method of treatment depending on the clinical case- Сlass II treatment planning- Traditional approach to class II treatment- Indications and contraindications for the premolars extraction- Rules for the use of elastics- Mandibular reposition in the class II treatment- Retrusive guidance for class II- Leveling: simple or strategic- Class II treatment with TMD- Clinical cases.

One of the most frustrating orthodontic cases is a full Class II malocclusion. Based on the observations of developmental processes of malocclusions, full Class II subjects showed that adaptation of the mandible is not enough forward or the mandible stays in a backward position. Therefore, we should recognize that fundamental problems in full Class II cases are the retrognathic mandible, because of not enough occlusal support due to steep posterior occlusal plane. The proper treatment approach should be to control the occlusal plane, vertical dimension, arch coordination upper and lower dentition, providing retrusive guidance, and inter-coronal opening space in front teeth. It should be careful to avoid overuse of Class II elastics, which causes the elimination of space for mandibular adaptation. Class III elastics are often required for retraction and/or upright of the mandibular anterior teeth to reposition the mandible in a forward position.