Case Report

Year : 2025 | Volume : 16 | Issue : 3 | Page : 1-16

Anchorage-Driven Management of Vertical Class II Malocclusion: Role Of Hybrid Segmental Mechanics in Preventing Round-Tripping

Harsh Ashok Mishra1, Waseem Khan1, Parag Vishnu Gangurde2, Shashank Udaykumar3, Diksha Vinod Wali3 

1-Associate Professor, 2-Professor, 3-Postgraduate Resident, Department of Orthodontics and Dentofacial Orthopaedics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Bharati Vidyapeeth (DU) University, Pune.

Address for Correspondence:

Dr. Harsh Ashok Mishra

Associate Professor, Department of Orthodontics and Dentofacial Orthopaedics,

Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai,

Bharati Vidyapeeth (DU) University, Pune

Email: dr.mishraharsh@gmail.com

ABSTRACT  

This case report describes the orthodontic management of a 25-year-old male presenting with a skeletal Class II maxillomandibular relationship, vertical growth pattern, and Class II subdivision molar relationships. Clinically, the patient exhibited a Class I molar relationship on the left and an end-on molar relationship on the right, with crowding, retroclined maxillary and mandibular incisors, and highly positioned maxillary canines. An asymmetric extraction protocol—removal of teeth 14, 24, 34, and 42—was implemented to optimize the space distribution while maintaining facial balance and occlusal harmony.

Hybrid segmental mechanics were employed, incorporating anchorage control via a Nance palatal arch, segmental canine retraction using T-loop mechanics, molar distalization with a sliding jig, and Class II elastics. This was later supplemented by the infrazygomatic crest (IZC) skeletal anchorage on the right side. This approach minimizes the risk of round-tripping, enhances biomechanical precision, and avoids excessive incisor proclination or anchorage loss.

Post-treatment records revealed well-aligned dentition, stable bilateral Class I molar and canine relationships, and improved overjet, overbite, and facial esthetics. This case highlights the effectiveness of combining hybrid segmental mechanics with skeletal anchorage in managing asymmetric extractions and achieving esthetically and functionally favorable orthodontic outcomes.
KEYWORDS: Class II malocclusion, hybrid segmental mechanics, asymmetric extraction, Nance palatal arch, IZC screws, anchorage, round tripping, biomechanics.

FUNDING

Nil

CONFLICT OF INTEREST

Nil
How to cite this article: Harsh Ashok Mishra, Waseem Khan, Parag Vishnu Gangurde, Shashank Udaykumar, Diksha Vinod Wali. Anchorage-Driven Management of Vertical Class II Malocclusion: Role Of Hybrid Segmental Mechanics in Preventing Round-Tripping. Int J Orthod Rehabil 2025; 16(3): 1-16.

Original Research

Year : 2024 | Volume : 15 | Issue : 1 | Page : 39-50

Impact of irregular appointment interval on Orthodontic treatment amid COVID-19 Pandemic- A Cross sectional Observational Study.

Meera Madgavkar1, Harsh Ashok Mishra2, Raj Kumar Maurya3, Hitesh Ramdas Sawant4, Alok Ranjan4, Parag Gangurde5

1-Intern, 2-Associate Professor, 4-AssistantProfessor, 5-Professor & Head, Department of Orthodontics and Dentofacial Orthopaedics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Bharati Vidyapeeth (DU) University, Pune, 3-Associate Professor, Government Field Hospital, India.

Address for Correspondence:

Dr. Harsh Ashok Mishra, Associate Professor, Department of Orthodontics and Dentofacial Orthopaedics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai. Bharati Vidyapeeth (DU) University, Pune.

Email: dr.mishraharsh@gmail.com

Phone No: 8451840579

Abstract

Introduction: The COVID-19 pandemic situation has affected all professions including orthodontics. The present study proposed determination of impact of irregular appointments on Orthodontic treatment amid COVID-19 pandemic.

Materials and Methods: The cross-sectional observational study design enrolled 134 patients over period of 2 weeks were recorded such as treatment start date, total number of appointments scheduled and frequency of missed appointments after 24 March 2020, Stage of Orthodontic treatment on or before 24 March 2020 i.e., Alignment & levelling b) Space closure c) Finishing and Detailing d) Retention.

Results: The distribution of malocclusion based on Angle Molar criteria showed prevalence of 53.73 % Class I, 37.32 % Class II and 8.95% Class III. The malocclusions were treated predominantly by extraction in 57.46 % and non-extraction in 42.44 % patients. The total treatment duration revealed that more than 51 % patients’ treatment lasted beyond 24 months but finished before 36 months. Similarly, 35.82 % patients’ treatment duration was less than 12 months. It was found that more than 47 % were in Stage I, 28.36 % were in stage II, 18.66 % in stage III and lastly 5.97 % were in stage IV.

Conclusion: Orthodontic emergencies and un-schedule appointments had prevalence of Class I, followed by Class II and Class III with extraction treatment therapy. Majority patients treated with fixed mechanotherapy followed by Clear aligners and Retainers. More than half of the patients had increased treatment duration due to irregular follow up.

SOURCE OF FUNDING

STS 2022 reference ID: 2022-07984

CONFLICT OF INTEREST

The authors have no conflict of interest to declare.

How to Cite this Article: Madgaonkar, M. M., Mishra, D. H., Maurya, D. R. K., Sawant, D. H., Ranjan, D. A., & Gangurde, D. P. (2024). Impact of irregular appointment interval on Orthodontic treatment amid COVID-19 Pandemic- A Cross-sectional Observational Study.: Original Research. International Journal of Orthodontic Rehabilitation, 15(1), 39–50. https://doi.org/10.56501/intjorthodrehabil.v15i1.973.