Patient with class II division 1, severe proclined upper incisors with protruded upper and lower lips and lip incompetence was treated with extraction of upper first bicuspids. Final results show significant reduction of incisor proclination

Patient with class II division 1, severe proclined upper incisors, incompetence was treated with extraction of upper first bicuspids. Final results show lip competence and significant improve in facial profile

Class II division 1 malocclusion is one of the most common dental malocclusions. Patients with class II division 1 usually present with underlying skeletal discrepancy between maxilla and mandible. The lower jaw is positioned far back from the upper jaw. This results in a crowded lower arch and a retruded chin. Along with the incorrectly positioned jaw bones, the teeth are also misaligned. The lower teeth are far behind the upper teeth, the upper front teeth are significantly protruded (buck teeth). The treatment of skeletal class II division 1 depends upon the age of the patient, patient’s facial profile, growth potential, severity of malocclusion, and compliance of patient with treatment.

In growing individuals, growth modification procedures can be carried out before the cessation of active growth to correct the skeletal discrepancy using functional appliances like Herbst, MARA, Forsus or Jasper Jumper.

Shown below are class II division 1 (buck teeth) patients who have orthodontic treatment with different extraction combinations at Georgia Orthodontic Care. Patient's profile improves significantly after orthodontic treatment.

In patients where active growth is completed and malocclusion is mild to moderate, underlying skeletal discrepancy can be camouflaged by orthodontic tooth movement depending upon patient’s profile and the severity of malocclusion. Patient can be treated with extraction (2 upper bicuspids or 4 bicuspids) or without extraction by distalization of upper teeth using temporary anchorage device (TAD) or various distalized appliances.

In adult patients where the discrepancy is very severe, the best treatment approach is combined orthodontic and orthognathic surgery.

Class II Division 1