Case Report
KEYWORDS: Class II malocclusion, hybrid segmental mechanics, asymmetric extraction, Nance palatal arch, IZC screws, anchorage, round tripping, biomechanics.
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.