Non-surgical Treatment of a Late Adolescent Patient with Skeletal Class II Malocclusion Using Clear Aligners: A Case Report

Lindsay J. Robertson1, Tarek El-Bialy2, *
1 University of Alberta Orthodontic, Edmonton, Alberta, Canada
2 Professor of Orthodontics and Biomedical Engineering, University of Alberta Orthodontic graduate program, Edmonton, Alberta, Canada

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© 2022 Robertson and El-Bialy

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Professor of Orthodontics and Biomedical Engineering, Faculty of Medicine and Dentistry, 7-020D Katz Group Centre for Pharmacy and Health Research, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Tel: 780-492-2751; E-mail:



There are a variety of treatment modalities for orthodontic treatment of patients with skeletal Class II malocclusions in late adolescence. These treatment modalities may include surgical intervention, camouflage treatment, functional appliances, extraction of teeth, and/or Class II elastics mechanics. Most Class II mechanics produce retroclination of the upper incisors and proclination of lower incisors. These dentoalveolar effects limit the possibility for forward mandibular projection/growth, hence minimizing skeletal improvement.

Case Presentation:

To present a unique case report that was treated with a new perspective in maximizing skeletal improvement in a late adolescent male with skeletal Class II malocclusion and deep overbite.

A 15-year-old male presented with a skeletal Class II pattern due to mandibular retrognathism was treated with non-extraction, non-surgical technique using clear aligners in two phases. Phase 1 was designed to decompensate the compensated inclination of his anterior teeth, and phase II was planned to correct his skeletal and dental Class II malocclusion/mal relation. Results: Maxillary incisors decompensation of the inclination of the upper and lower incisors and posterior teeth intrusion allowed forward mandibular projection that led to skeletal and dental correction of his malocclusion and improvement of his chin forward projection.


This case report shows successful treatment of a Class II malocclusion in alate adolescent male. This method could perhaps be used for similar cases, avoiding the need to extract teeth or include surgical intervention.

Keywords: Clear aligners, Class II malocclusion, Late adolescent, Non surgical treatment, Mandibular advancement, Profile improvement.