Correction of a severe Class II Division 1 malocclusion with bilateral buccal crossbite.

The patient was a 9 years and 2 months old female from the Dominican Republic whose chief complaint was, “My front teeth stick out.” The patient’s medical history was noncontributory, and she denied any known drug allergies. Her dental history revealed preventive dental visits at 6-month intervals and a fractured incisal edge (maxillary left central incisor). The patient’s mother reported the presence of both a lip-biting and nail-biting habit. There was a familial resemblance in facial appearance and malocclusion. The cause was diagnosed as a combination of environmental and hereditary factors (Figs 1-4).