The treatment of severe class II division 2 patients with deep overbites and gummy smiles using lingual appliances: a case series

Abstract

The treatment of Class II division 2 patients with palatally inclined upper incisors using lingual appliances is generally challenging due to difficulties in achieving upper incisor torque control. The present case series aims to describe a simple method combining lingual appliances and mini-screws for the non-surgical management of two severe Class II division 2 patients presenting with deep overbites and gummy smiles. The treatment plans involved initial bite opening and upper incisor torque recovery, followed by distalisation of the entire upper arch using mini-screw anchorage. In one case, additional anterior labial mini-screws were necessary to assist incisor intrusion and complete upper arch levelling. Favourable treatment results suggest that lingual appliances, when combined with mini-screws and pre-torqued arch wires, may offer an effective approach for the non-surgical management of severe Class II division 2 patients with deep overbites and gummy smiles.