Nonsurgical treatment of severe Class II malocclusion with anterior open bite using mini-implants and maxillary lateral incisor and mandibular first molar extractions

•The patient had a Class II skeletal malocclusion with an open bite.•Remaining vertical facial growth potential complicated the treatment planning.•Ectopic maxillary lateral incisors were extracted and mini-implants placed.•Careful complete diagnosis was the key to successful resolution of the problems.

This clinical case report presents the nonsurgical orthodontic treatment of a patient with skeletal Class II malocclusion, posterior crossbite, anterior open bite, accentuated dental discrepancies in both arches, and an odontoma. The proposed treatment involved maxillary expansion, extraction of atypical maxillary lateral incisors and mandibular first molars, and intrusion of maxillary teeth with the aid of mini-implants. The results obtained with these procedures included good tooth alignment, normal overbite and overjet, removal of the odontoma, and a harmonious smile. In complex cases, an accurate diagnosis is the key to a favorable outcome.