In Class II division 2, the upper incisor’s torque is essential for the correction. The more retroclined the upper incisors are, the more posterior anchorage will be needed. This is the reason why, in some severe Class II division 2, a posterior microscrew is need to provide enough posterior anchorage for the correction.

Incisor torque (Class II division 2). PIR protocol.

Before correcting a Class II, the staging of movement on the incisors should be considered:

  • Procline crown (which is eqivalent to taking the root out of the cortical bone);
  • Intrusion;
  • Retrusion + lingual root torque.

DISTALISATION

  • Do not delay the movement of the incisors until the moment of their retrusion.
  • Ask technicians to align front teeth (with negative torque) from the beginning, and then retrude them.
Clincheck instruction requesting additional torque:

“I see that you have added torque to teeth ___.  After the ideal torque is obtained in Clincheck, add an additional 15 degrees. I prefer to “over-treat” torque.  All torque is to be performed in the regular (NOT over-correction) stages.” Hint: Play the Clincheck movie to see the torque. If you can see it, request over-treatment. You can also add more torque using Clincheck Pro 3D controls).

Case sample

https://www.moderndentistrymedia.com/oct_nov2022/ID-AE_12-5_Rai.pdf

Instructions for technician:

  1. Patient’s chief complaint: not happy with the retrocline dupper incisors. Please resolve. Please also level the gingival margins of the upper anterior teeth
  2. Anterior reference point: please procline UR1 by 4mm and use this to align the teeth
  3. Posterior reference point: use the mesiobuccal cusp of the upper 7s to widen the smile
  4. Overjet/overbite: please provide an overjet of 3mm
    and a positive overbite.

ELASTICS

  • from 14 and 24 palatal to 37 and 47 buccal – 1/4 and 4,5 oz