Class II malocclusion treatment with a customized dual force distalizer

Aron Aliaga-Del Castillo, Luciano Soldevilla, Marcelo Vinicius Valerio, Silvio Augusto Bellini-Pereira, Lorena Vilanova, Luis Ernesto Arriola-Guillén, Guilherme Janson

Research output: Contribution to journalArticlepeer-review


Intraoral distalizers associated with skeletal anchorage provide the major benefit of promoting molar distalization with minimum anchorage loss and patient cooperation. This case report presents the treatment of a 17-year-old female with Class II Division 2 malocclusion, maxillary dentoalveolar protrusion, mild mandibular retrusion, increased overjet, deepbite, and lip incompetence. The treatment plan involved initial maxillary molar distalization with a customized version of the skeletally anchored dual force distalizer (DFD). The customized DFD used smaller mini-implants and included a fixed anterior biteplane. The device applied simultaneous forces from the buccal and palatal sides directly to the molars using nickel-titanium coil springs and allowed orthodontic mechanics in the mandibular teeth. An overcorrected Class I molar relationship was obtained after 6 months. After the distalization phase, retraction mechanics began with retraction loops and using a modified transpalatal bar reinforced with the mini-implants as anchorage. Moreover, the finishing phase was performed with multiloop edgewise archwires and intermaxillary elastics to enable an individualized control of each tooth. Total treatment time comprised 2 years 4 months, and significant improvements regarding the facial and occlusal perspectives were noticed. Similarly, these favorable changes remained stable during the 2-year follow-up period. The customized version of the skeletally anchored DFD followed by fixed appliances showed effectiveness and stability in Class II malocclusion treatment.

Original languageEnglish
Pages (from-to)743-756
Number of pages14
JournalAmerican Journal of Orthodontics and Dentofacial Orthopedics
Issue number5
StatePublished - Nov 2021


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