Mini-implant anchorage for a skeletal class II malocclusion with missing mandibular incisors: a case report.

This case report describes the treatment of an adult female with a severe Class II malocclusion and congenitally missing mandibular incisors. It was decided to extract the maxillary first premolars and use mini-implants for en masse retraction of the maxillary anterior teeth. More than 13 mm of maxillary incisor retraction was obtained, with little change in the mandibular incisor inclination. The patient's facial esthetics showed dramatic improvement. The upper and lower lips were retracted by 6 mm and 7 mm, respectively. This helped reduce the mentalis strain and improve chin projection. In the mandibular arch, the canines were reshaped to substitute for lateral incisors and the first premolars were used as canines. After 25 months of retention, the results have been maintained. In this report, mini-implants proved to be an effective alternative to orthognathic surgery.