PMC4792063_01
(a-c) Pretreatment extraoral photos
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F1
On clinical examination; extraorally, she exhibited convex profile, normal nasolabial angle, recessive chin, decreased lower anterior facial height, hypodivergent growth pattern, brachy face, and increased gingival display [Figure 1a-c].
(a-e) Pretreatment intraoral photos
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F2
Class II molar relation, deep traumatic bite, and lingually displaced lower right lateral incisor [Figure 2a-e]. Cephalometric examination [Figure 3 and [Table 1]] showed a Class II skeletal pattern (SNA, 76 ; SNB, 71 ;
Pretreatment lateral cephalograph
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F3
(a-c) Intraoral photos after leveling and aligning. Molars were in Class II relationship with 6 mm anterior overjet
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F4
Once the proper axial inclination of the teeth was achieved, 6 mm of overjet was evident in the anterior region with Class II molar relation bilaterally with no self-correction of overjet [Figure 4a-c]. 0.021 x 0.025'' stainless steel upper and lower archwires were placed with lingual crown torque in the anterior section of the lower archwire to counter buccal flaring of lower anterior teeth.
(a-d) Jasper Jumper hooked from upper first molar headgear tube to lower archwire in between canine and first premolar (d - Reprinted with permission from American Orthodontics, 1714 Cambridge Avenue, Sheboygan, WI 53082-1048, USA)
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F5
Avenue, Sheboygan, WI 53082-1048, USA) fixed functional appliance was placed from headgear tube of upper first molar and hooked to the lower archwire in between first premolar and canine, on either side [Figure 5a-d]. A transpalatal arch was placed on the upper first molars to counter the buccal flaring of the molars.
(a-c) Posttreatment intraoral photos after debanding
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F6
A good Class I molar relationship was achieved along with Class I canine relationship with normal overjet and overbite [Figure 6a-c].