Treatment of Class II, Division 2 malocclusion in adults: biomechanical considerations.

Treatment of Class II malocclusion in adolescents has always relied on growth modification. The majority of treatment modalities, such as functional appliances, are directed at stopping or redirecting maxillary growth simultaneously stimulating mandibular growth. On the other hand, in adult patients with severe Class II malocclusions, generally involving extremely deficient mandibles, orthognathic surgery is often the only possible treatment. Although camouflage may be attempted by extracting premolars, the soft-tissue objectives may be impossible to meet. Even so, a recent study has shown that patient satisfaction with camouflage treatment was similar to that achieved with surgical mandibular advancement. In Class II patients with mild-to-moderate skeletal discrepancies, dental compensation may well be the treatment of choice. Common treatment procedures for such patients include flaring of incisors, interproximal tooth reduction, and extractions.