This case report describes the application of fixed functional appliance in the treatment of an adult female having Class II division 2 malocclusion with retroclination of upper incisors. Fixed functional appliance was used to correct the overjet after the uprighting of upper incisors. Fixed functional appliance was fitted on a rigid rectangular arch wire. Application of fixed functional appliance achieved a good Class I molar relationship along with Class I canine relationship with normal overjet and overbite. Fixed functional appliance is effective in the treatment of Class II malocclusions, even in adult patients, and can serve as an alternate choice of treatment instead of orthognathic surgery. This is a case; wherein, fixed functional appliance was successfully used to relieve deep bite and overjet that was ensued after leveling and aligning. We demonstrate that fixed functional appliance can act as a “noncompliant corrector” and use of Class II elastics can be avoided.

One of the major challenges of fixed clinical orthodontics is the correction of deep overbite. Mini screw implants are ideally suited for absolute intrusion because they make it possible to apply light continuous forces of known magnitudes without producing any reciprocal reactionary effect on posterior teeth. The purpose of this FEM study was to evaluate and compare the stresses generated in maxillary anterior region during absolute en masse intrusion of six maxillary teeth using mini-implants at strategic locations. Materials and methods: Finite element model was generated using FEM software ANSYS and, on the same model, two different analyses were carried out for two groups with different points of force application as Group I consisted of two bilateral implants for en masse intrusion of maxillary anteriors and Group II consisted of a single mid implant. Results: Soft and hard bones showed significantly high stress distribution in Group I as compared to Group II. The total tooth deformation was found to be more with single point of force application which produced oblique force vectors. Conclusion: Stresses on the teeth are higher and distributed more evenly, when the point of force application is bilateral rather than a single source. Bilateral implants generate less stresses which are evenly distributed with minimum detrimental effect on the teeth during absolute intrusion.

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Background: Class II malocclusion is one of the most common problems around the globe affecting around one-third of the patients who come for orthodontic treatment Management of class II malocclusion in adolescent patients by growth modulation is one of the most debated topics in orthodontics. Noncompliance has been a major concern for orthodontists. Case Report: This case report describes the management of class II malocclusion in an 18 year old female patient using "Forsus" fixed functional appliance system to correct her class II malocclusion. The patient was well beyond her growing years, hence the fixed functional appliance bought more of dento-alveolar changes rather than much of skeletal changes. This appliance has several advantages, as it is an operator handled device and the patient cannot remove it. It acts on the teeth and jaws for 24 hours a day, patient compliance is not a problem, and hence treatment duration is shorter. Conclusion: The profile changes and treatment results were demonstrated. This case report illustrates that, fixed functional appliances have a significant role in the management of class II malocclusion by not only promoting growth modulation, but also encouraging dento-alveolar changes once growth has completed. Both growth modulation and dento-alveolar correction minimizes the necessity of extraction of permanent teeth and probably orthognathic surgery. With proper case selection and good patient cooperation, we can obtain a significant result with the Forsus Fixed appliance. Clinical significance: Fixed functional appliances have a significant role in the management of class II malocclusion. It eliminates the massive compliance needed in removable fixed appliance therapy. Nonetheless, the growth modulation minimizes the necessity of extraction of permanent teeth and probably orthognathic surgery.