Nonsurgical Correction Using Miniscrews In An Adult Patient

In orthodontics, the skeletal Class II malocclusion in adult patient has always been a challenging work. The control of vertical and anteroposterior direction are both of significance in the treatment. Miniscrew implants are widely used in clinical practice for stable anchorage. This case report describes a 25-year-old Chinese woman, who had a convex profile with a skeletal Class II malocclusion, maxillary prognathia, mandibular retrognathia, locked occlusion and cross-bite of posterior teeth. The camouflage treatment plan included extraction of first premolars in upper and lower arch with the classic MBT straight-wire technique and miniscrew implants anchorage. We used miniscrew implants in the maxillary and mandibular buccal segments for sagittal and vertical control. The whole orthodontic treatment time was about thirty-six months, ideal overbite and overjet were achieved, a Class I molar relationship was realized, and the convex profile was improved significantly. The main symptom of the patient was the protrusion of incisors and lips, which was mainly caused by maxillary protrusion and mandibular retraction (SNA and SNB angles were close to the critical value). We chose to extract four first premolars to intrude incisors for the improvement of facial profile. In the process of the treatment, the key point is to effectively control the anchorage and the torque of the upper anterior teeth, and miniscrew implants could provide absolute anchorage. This article illustrates that the stable anchorage of miniscrew implants in adult patients with skeletal Class II malocclusion is feasible and effective.