Treatment of a Class II Division 2 Patient with Severe Skeletal Discrepancy by Using a Custom Made TPA Proclination Spring

Sergio Paduano1, Gianrico Spagnuolo2, Giuseppe di Biase3, Iacopo Cioffi2, *
1 School of Dentistry, University “Magna Graecia” Catanzaro, Italy
2 Department of Neurosciences and Oral Sciences, University of Naples Federico II, Naples. Italy
3 Laboratorio ortodontico Giuseppe di Biase, Pomigliano d’Arco, Naples. Italy

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© Paduano et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Neuroscience, University of Naples Federico II, Via Pansini 5, I 80131 Naples, Italy; Tel: 00390817462195; Fax: 00390817462192; E-mail:


This case report describes the orthodontic treatment of a boy, aged 15.3 years, with permanent dentition, mesofacial typology, affected with a severe sagittal skeletal Class II division 2 malocclusion, due to a mandibular retrusion. His chief compliant was the position of the maxillary incisors, displaced too palatally, and an impaired facial profile. Herbst and multi-bracket straightwire fixed appliances, together with a custom made modified transpalatal arch (i.e. TPA proclination spring), were used to correct the sagittal discrepancy and to improve the attractiveness of the impaired facial profile.

Keywords: : Class II division 2, Skeletal sagittal discrepancy, functional therapy.