Invisible treatment with lingual appliance for the correction of an adult class II subdivision with asymmetrical Wilson and Spee curves: A case report

This article describes a class II subdivision malocclusion successfully treated by an invisible lingual appliance. The combination of en-masse distalization by interradicular palatal mini-screws and inner unilateral class II auxiliaries, first by intermaxillary elastic, later by a class II coil spring, resulted in a dento-alveolar correction, allowing one to maintain the appliance completely invisible. At the same time, the inclination of buccal sectors was normalized by a correct torque expression with set-up overcorrections, resulting in a significant improvement of the buccal corridors. This case report demonstrates the possibility of successfully solving class II division 2 subdivision malocclusion in adult patients without surgery by means of a completely invisible appliance. It also demonstrates that correct levelling and torque expression, for the correction of asymmetrical Spee and Wilson curves, are achievable with an accurate set-up planning. On the other hand, it underlines the necessity of mini-screws, auxiliaries and set-up overcorrections in order to obtain the best results.

Automated summary

This article describes the successful treatment of a class II subdivision malocclusion using an invisible lingual appliance. The combination of interradicular palatal mini-screws and inner unilateral class II auxiliaries resulted in a dento-alveolar correction, allowing for a completely invisible appliance. Additionally, proper torque expression and set-up overcorrections normalized the inclination of buccal sectors and significantly improved the buccal corridors. This case report demonstrates that class II division 2 subdivision malocclusion in adult patients can be successfully treated without surgery using a completely invisible appliance, while highlighting the importance of mini-screws, auxiliaries, and set-up overcorrections for optimal results.