Mandibular Advancement In Class-Ii Case: 3-Year Follow-Up

Clear aligner-based Mandibular Advancement (MA) is a reliable procedure for adolescent patients with mandibular retrognathia. This case report presents the orthodontic management and 3-year follow-up of a patient with skeletal Class II malocclusion. A 10-year-old female patient presented to our clinic with a chief complaint of retrognathic mandible. The clinical extraoral examination showed mandibular deficiency and a deep labiomental sulcus. Intraoral examination revealed Class II canine and molar relationships, severe overbite and overjet. In radiographic examination, skeletal Class II pattern with mandibular retrognathia, horizontal facial growth pattern, and proclined upper/lower incisors were observed. The patient was at her pubertal growth spurt (CVS3). During the treatment, the pre-MA phase involved intrusion of anterior teeth, extrusion of the posterior teeth, and arch coordination. The MA phase involved stepwise mandibular advancement, overjet correction, and improvement of facial profile. By the end of the treatment, we corrected overbite and overjet. Class I canine and molar occlusion and a satisfactory facial profile were achieved. These clinical results remained stable at both the 10-month and 3-year follow-up. Clear aligner MA can be customized to combine traditional two-phase orthodontic treatment. The pre-MA phase establishes occlusal conditions for mandibular advancement through bite opening and arch coordination, while the MA phase utilizes precision wings to guide the mandible in a forward position. In clinical practice, with clear aligner MA, aesthetic, functional, and stable outcomes can be achieved in growing skeletal Class II patients with mandibular retrognathia.