Dr. Bella Shen GarnettBella Smile ↗

Case report · Fixed appliances (braces)

Spacing, Protrusion, Deep Bite and Full cusp Class II

12-year old Female presents maxillary spacing, protrusion, severe overjet, and a deep bite.

Patient
Adolescent (12–17), female
Classification
Class II div 1
Active treatment
36 months
Published
September 9, 2026
Initial Intra oral photos
Initial photos 8mm overjet
AdolescentsForsusBraces

Presentation

Chief complaint. " I want to fix my teeth"

Diagnosis. Full-cusp Class II malocclusion with severe deep overbite, 8mm overjet, maxillary spacing, mandibular retrognathia, proclined maxillary incisors, lingually inclined mandibular incisors, excessive curve of Spee, and CVM Stage 3.

Records

Initial Intraoral photosBefore — Intraoral Photos
Final Intraoral PhotosAfter — Intraoral Photos
Initial Smile photosBefore — Smile Facial Photos
Initial Smile photosAfter — Smile Facial Photos
Initial Profile Before — Profile view
Final profile photoAfter — Profile view
Initial Lateral CephBefore — Lateral Panoramic Radiograph
Final Lateral CephAfter — Lateral Panoramic Radiograph
Initial PanoBefore — Panoramic Radiograph
Final PanoAfter — Panoramic Radiograph

Measurements

MeasureNormPrePost
SNA827877
SNB807475
ANB242
Wits050
SN-MP323037
U1-SN102112105
L1-MP908496
Overjet (mm)2–382
Overbite (mm)2–342

Treatment

Objectives. Close maxillary spacing, use Forsus to posture the mandible forward and produce dentoalveolar changes to improve the Class II relationship, reduce overjet and protrusion, level and align both arches, coordinate the midlines, and improve the facial profile.

Plan. Band the upper first molars and bond 7–7. Level and align both arches, then use the Forsus appliance as the Class II corrector to advance the lower dentition and improve the Class II relationship.

Appliances and materials

  • Metal Braces — 022 MBT
  • Class II Forsus
  • Class II elastics

Outcome

We successfully leveled and aligned both arches and corrected the Class II malocclusion to a Class I relationship. Treatment was completed with an ideal 2 mm overjet and 2 mm overbite, with well-coordinated dental midlines. The mandibular incisors were well controlled and maintained in an ideal position. Favorable forward mandibular growth contributed to the Class II correction, with skeletal improvement demonstrated by the Wits appraisal and ANB angle. Her facial profile became more balanced, with improved facial esthetics both at rest and on smiling. Overall, treatment achieved a well-coordinated Class I occlusion, ideal overjet and overbite, improved skeletal relationship, and enhanced facial and smile esthetics.

Retention

  • Fixed U2-2 permanent retainer
  • Fixed L3-3 permanent retainer
  • Invisalign Vivera retainers to be worn at night

Case reports are shared with patient authorisation. Individual results vary.