Advancing Mandibular Growth and Aesthetic Harmony in Post-pubertal Class-II Malocclusion, a Non Extraction Treatment with AdvanSync™ 2: A Case Report

Abstract

Skeletal Class-II malocclusion is a prevalent type of malocclusion characterised by either a retrognathic mandible, a prognathic maxilla, or both. The present orthodontic case study describes a 15-year-old female patient with a Class II malocclusion and a retrognathic mandible, accompanied by rotated teeth, increased overjet and overbite. The patient presented with a pronounced mentolabial sulcus, a steep nasolabial angle and a convex facial profile. Cephalometric examination revealed a Class II skeletal base and limited growth potential, indicated by Cervical Vertebral Maturation Index (CVMI) Stage V. The treatment employed a non extraction, non surgical strategy using 0.022-inch McLaughlin, Bennett, and Trevisi (MBT) self-ligating brackets and the AdvanSync™ 2 hybrid Fixed Functional Appliance (FFA). This approach improved the mandible and arch alignment to correct skeletal and dental discrepancies. Treatment resulted in the establishment of a Class I canine and molar relationship, correction of rotations and expansion of the dental arches. Cephalometric analysis revealed a decrease in the A point, Nasion, B point (ANB) angle, an increase in the Sella-Nasion-B (SNB) angle and an increased mandibular length, reflecting significant skeletal advancement. The case demonstrates the effectiveness of the AdvanSync™ 2 appliance in post-pubertal patients when growth is no longer a significant factor in treatment. It underscores the value of integrating FFAs with self-ligating systems to achieve predictable and efficient skeletal and dental corrections, emphasising patient comfort and non surgical intervention in managing skeletal Class-II malocclusions.