Adult nonsurgical retreatment of a skeletal Class I hypodivergent, Class II subdivision malocclusion with an iatrogenic postextraction bowing pattern using buccal fixed appliances and miniscrew-supported maxillary distalization: A case report.

Orthodontic retreatment after extraction-based therapy can be complicated by iatrogenic bowing ("roller-coaster") patterns with residual spaces, posterior segment tipping, and loss of incisor torque, often accompanied by bite deepening. This case report describes nonsurgical retreatment of a 29-year-old woman with a skeletal Class I, hypodivergent pattern and a Class II left subdivision who presented with severe deep overbite, increased overjet, marked bimaxillary incisor retroclination with clinical labial root prominence of the maxillary and mandibular incisors, residual maxillary extraction spaces, and posterior segment tipping with poor buccal settling after prior premolar extractions. Buccal fixed appliances were placed with high-torque anterior brackets. Early occlusal unlocking was achieved with palatal anterior bite turbos, followed by alignment/levelling, posterior uprighting, and space management. Definitive incisor root control required near-full-size rectangular stainless steel working wires with added lingual root torque. Residual overjet and Class II subdivision correction were completed with asymmetric maxillary total-arch distalization supported by miniscrews. Active treatment time was 18 months. Posttreatment records showed closed spaces, bilateral Class I canine and molar relationships, coordinated midlines, improved intercuspation, normalized incisor inclinations, reduced incisor display, and maintained skeletal relationships, with stability documented at 1 year.