Treatment of Class II malocclusion with bialveolar protrusion by means of unusual extractions and anchorage mini-implant

Introduction: Patients with dental Class II bialveolar protrusion are generally treated by extracting the four first premolars or two first and two second premolars, and retracting the anterior teeth. This case report describes the treatment of an adult patient with bialveolar protrusion, a Class II canine and molar relationship, and lip protrusion. Methods: In this patient, the maxillary right second molar (1.7) had to be extracted due to extensive caries. To create sufficient space to retract the anterior teeth, the maxillary right posterior teeth were distalized with a maxillary posterior mini-implant (1.2~1.3 mm in diameter, 10 mm long), which was placed into the maxillary tuberosity area and allowed an en masse retraction of the maxillary anterior teeth. Results: Overall, mini-implant can provide anchorage to produce a good facial profile even without additional premolar extraction in cases of dental Class II bialveolar protrusion with the hopeless second molar. Conclusion: The total treatment period was 42 months and the results were acceptable for 34 months after debonding.