Non-surgical Orthodontic Correction of Class II Division II Malocclusion with Severe Deep Bite: A Case Report

Aim and background: Class II division II malocclusion presents a complex orthodontic challenge characterised by deep overbite, retroclined maxillary incisors, and often a reduced vertical skeletal pattern.Management requires careful biomechanical planning to correct the traumatic overbite while maintaining facial harmony.This case report describes the non-extraction management of an adolescent patient with severe deep bite and skeletal class II characteristics.Case description: A 15-year-old female presented with dissatisfaction regarding her smile due to excessive incisor overlap.Clinical and cephalometric evaluation revealed a class II division II malocclusion on a class I skeletal base, with a brachycephalic growth pattern, reduced lower facial height, a 100% deep bite, retroclined maxillary and mandibular incisors, and an increased interincisal angle (168.89°).Treatment was performed using comprehensive fixed appliance therapy with a non-extraction approach, focusing on controlled levelling of the curve of Spee, gradual incisor proclination, and vertical dimension control.Post-treatment records demonstrated a marked reduction in the deep bite, normalisation of incisor inclinations, a reduction in the interincisal angle to 132°, and improvement in occlusal and soft-tissue relationships without periodontal complications. Conclusion:In non-growing or late-growing patients, successful non-extraction treatment of class II division II malocclusion can be achieved through careful management of torque and vertical dimension.Clinical significance: This case highlights the importance of thorough diagnosis and customised biomechanics in managing deep-bite cases to prevent iatrogenic effects such as gingival recession or root resorption.