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Patient has severe teeth protrusion with incompetent lips. Treatment with 2 upper bicuspids extraction to reduce protrusion and improve patient's lip incompetency

Class II division 1 malocclusion is one of the most common dental malocclusions. Patients with class II division 1 usually present with underlying skeletal discrepancy between maxilla and mandible. The lower jaw is positioned far back from the upper jaw. This results in a crowded lower arch and a retruded chin. Along with the incorrectly positioned jaw bones, the teeth are also misaligned. The lower teeth are far behind the upper teeth, the upper front teeth are significantly protruded (buck teeth). The treatment of skeletal class II division 1 depends upon the age of the patient, patient’s facial profile, growth potential, severity of malocclusion, and compliance of patient with treatment. In patients where active growth is completed and malocclusion is mild to moderate, underlying skeletal discrepancy can be camouflaged by orthodontic tooth movement depending upon patient’s profile and the severity of malocclusion. Patient can be treated with extraction (2 upper bicuspids or 4 bicuspids) or without extraction by distalization of upper teeth using temporary anchorage device (TAD) or various distalized appliances.

Patient has severe teeth protrusion. Treatment with 2 upper bicuspids extraction to reduce dental protrusion.

Upper bicuspid extraction scheme for class II division 1