Molar intrusion using miniscrew palatal anchorage.

A 17-year-old female presented with the chief complaint of inability to bite properly. Clinical examination revealed a Class II, division 1 malocclusion with an anterior open bite and mild maxillary and mandibular tooth-sizearch-length discrepancies (Fig. 1, Table 1). The patient’s initial contact upon closure was between the maxillary and mandibular first molars, leading to a complex open bite involving the premolars and all the anterior teeth. In addition, there was a maxillary transverse deficiency resulting in bilateral posterior crossbites, as well as a severely rotated mandibular left second premolar. Profile analysis indicated an excessive lower anterior facial height and mandibular plane angle. Two options were discussed with the patient: comprehensive surgical-orthodontic treatment, including orthognathic surgery to impact the posterior maxilla and expand the posterior segments through a three-piece Le Fort I procedure; and orthodontic treatment involving slow maxillary expansion and correction of the anterior open bite by intrusion of the maxillary posterior segments, using palatal miniscrew anchor-