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Class II patients usually present with underlying skeletal discrepancy between maxilla and mandible. The lower jaw is positioned far back from the upper jaw. Unlike class II division 1 (buck teeth), Class II division 2 malocclusion is characterized by the upright and retroclined position of upper central incisors in conjunction with excess vertical overbite and an excessive interincisal angle. The treatment of skeletal class II division 2 is similar to those of class II division 1. It 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.

Class II div 2 patient treated with extraction inconjunction with class II appliance. Patient's profile significantly improves

Class II div 2 extraction mechanics using TAD