Treatment of hyperdivergent Class II open bite in a periodontally compromised patient

• Miniscrew-anchored posterior intrusion enables mandibular counterclockwise rotation. • Miniscrews provide vertical and sagittal control to correct a high-angle pattern. • This approach offers long-term stability in periodontally compromised patients. The orthodontic treatment of periodontally compromised patients requires a multidisciplinary approach to ensure stability and long-term success. This case report presents a 59-year-old female with hyperdivergent Class II malocclusion, severe open bite, and mandibular retrusion who was treated using miniscrew-anchored molar intrusion as a camouflage approach. Orthodontic miniscrews were placed in the maxillary posterior segments to provide skeletal anchorage for molar intrusion, facilitating counterclockwise mandibular rotation and improving lower facial esthetics. After 2 years of retention, the patient maintained a well-aligned dentition, proper occlusion, and a balanced profile. This case report demonstrates that miniscrew-anchored posterior intrusion can effectively manage hyperdivergent Class II malocclusion and open bite in periodontally compromised patients, providing stable long-term outcomes.