A two stage non extraction treatment of class II division 1 malocclusion using split-activator and fixed appliance – A case report

Class II malocclusions are one of the most common problems in orthodontic treatment. There are a variety of effective and simple treatments to correct them, such as headgear and functional appliances. Functional appliances are commonly used for the treatment of class II malocclusions with mandibular deficiency. The success of treatment with a functional appliance relies on the patient’s cooperation and favourable mandibular growth. Treatment with a functional appliance usually lasts for 9–12 months and requires a proper retention time to ensure complete musculoskeletal adaptation.A second stage of treatment with a full-fixed appliance is often required to achieve proper alignment and good interdigitation of the dentition. In the present case, a prepubertal twelve year female with a class II malocclusion and retrusive mandible was treated first with an activator for 17 months. The activator successfully resolved the problem of the retrusive mandible with favourable mandibular growth. This was followed by 10 months of fixed orthodontic treatment to finalize the occlusion without extractions. This two phase treatment yielded a pleasing profile and good occlusion in this patient.