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Anchorage management of a hiperdivergent Class II division 1 malocclusion with severe crowding using orthodontic miniscrew


Objective: Hyperdivergent Class II division 1 malocclusion with severe crowding generally requires premolars extraction to create space for crowding correction, anterior retraction, and facial profile improvement. The purpose of this case report is to demonstrate the anchorage management of a hyperdivergent Class II division 1 malocclusion with severe crowding using orthodontic miniscrew as skeletal anchorage.Method: This case was treated by extraction of the upper and lower first premolars, using a conventional orthodontic appliance MBT system and orthodontic miniscrew as skeletal anchorage. Result: Correction of severe crowding, protrusive incisors, and improvement of the facial profile were obtained in 26 months of treatment.Conclusion: Anchorage management with orthodontic miniscrew was effective in correcting severe crowding, protrusive incisors, and convex facial profile of a hyperdivergent Class II division 1 malocclusion


  1. Joshi. Skeletal Malocclusion: A Developmental Disorder With a Life-Long Morbidity. J Clin Med Res. 2014;6(6):399-408.
  2. Yao C, Lai H, Chang Z, Chen I, Chen Y. Comparison of treatment outcomes between skeletal anchorage and extraoral anchorage in adults with maxillary dentoalveolar protrusion. Am J Orthod Dentofac Orthop. 2008;134:615-624.
  3. Del Santo M. Treatment of adult patient with hyperdivergent retrognathic phenotype and anterior open bite: Report of a case with non-surgical orthodontic approach. Dental Press J Orthod. 2020;25(4):75-84.
  4. Mitchell L. Introduction to Orthodontics. 4th ed. Oxford: Oxford University Press; 2013.p.113-125.
  5. Ribeiro G, Jacob H. Understanding the basis of space closure in Orthodontics for a more efficient orthodontic treatment. Dent Press J Orthod. 2016;21(2):115-125.
  6. Alharbi F, Almuzian M, Bearn D. Anchorage effectiveness of orthodontic miniscrews compared to headgear and transpalatal arches: a systematic review and meta-analysis. Acta Odontol Scand. 2019;77(2):88-98.
  7. Becker K, Pliska A, Busch C, Wilmes B, Wolf M, Drescher D. Efficacy of orthodontic mini implants for en masse retraction in the maxilla: a systematic review and meta-analysis. Int J Implant Dent. 2018;4(1).
  8. Antoszewska-Smith J, Sarul M, ?yczek J, Konopka T, Kawala B. Effectiveness of orthodontic miniscrew implants in anchorage reinforcement during en-masse retraction: A systematic review and meta-analysis. Am J Orthod Dentofac Orthop. 2017;151(3):440-455.
  9. Lee J, Miyazawa K, Tabuchi M, Sato T, Kawaguchi M, Goto S. Effectiveness of en-masse retraction using midpalatal miniscrews and a modified transpalatal arch: Treatment duration and dentoskeletal changes. Korean J Orthod. 2014;44:88-95.
  10. Holberg C, Winterhalder P, Holberg N, Rudzki-Janson I, Wichelhaus A. Direct versus indirect loading of orthodontic miniscrew implants-an FEM analysis. Clin Oral Investig. 2013;17(1821-7).
  11. Barthélemi S, Desoutter A, Souaré F, Cuisinier F. Effectiveness of anchorage with temporary anchorage devices during anterior maxillary tooth retraction: A randomized clinical trial. Korean J Orthod. 2019;49(5):279.
  12. Liu Y, Yang Z jin, Zhou J, et al. Comparison of Anchorage Efficiency of Orthodontic Mini-implant and Conventional Anchorage Reinforcement in Patients Requiring Maximum Orthodontic Anchorage: A Systematic Review and Meta-analysis. J Evid Based Dent Pract. 2020;20(2):101401.
  13. Zhang L, Lin Y, Guo R, Huang Y, Xu B, Li W. Comparison of Direct and Indirect Mini-implant Anchorage in Adults with Maxillary Protrusion: A Randomized Controlled Trial. Indian J Pharm Sci. 2019;81(4 spl issue1):13-20.
  14. Baumgaertel S. Temporary skeletal anchorage devices: The case for miniscrews. Am J Orthod Dentofac Orthop. 2014;145(5):558-564.
  15. Ozkan S, Bayram M. Comparison of direct and indirect skeletal anchorage systems combined with 2 canine retraction techniques. Am J Orthod Dentofac Orthop. 2016;150(5):763-770.
  16. Kojima Y, Kawamura J, Fukui H. Finite element analysis of the effect of force directions on tooth movement in extraction space closure with miniscrew sliding mechanics. Am J Orthod Dentofac Orthop. 2012;142:501-508.
  17. Su H, Han B, Li S, Na B, Ma W, Xu TM. Factors predisposing to maxillary anchorage loss: A retrospective study of 1403 cases. PLoS One. 2014;9(10):1-8.
  18. Cobourne M, DiBiase A. Handbook of Orthodontics. 2nd ed. London: Elsevier; 2015.p.1-30.
  19. Jang W, Choi YJ, Hwang S, Chung CJ, Kim KH. Anchorage loss assessment of the indirect anchor tooth during adjunctive orthodontic treatment. Am J Orthod Dentofac Orthop. 2019;155(3):347-354.
  20. Scheyer E, Sanz M, Dibart S. Periodontal soft tissue non-root coverage procedures: A consensus report from the AAP Regeneration Workshop. J Periodontol. 2015;86(suppl):S73–S76.
  21. Ulfah N, Augustina E. Perawatan resesi gingiva dengan bedah dan non-bedah. J Dentomaxillofacial Sci. 2010;9(1):29-33.

How to Cite

Putri, A. S., & Anggani, H. S. (2021). Anchorage management of a hiperdivergent Class II division 1 malocclusion with severe crowding using orthodontic miniscrew. Journal of Dentomaxillofacial Science, 5(2).




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Adisty Setyari Putri
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Haru Setyo Anggani
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