Indonesian Journal of Orthodontics Case Report
Vol. 3 No. 1 (2026): Vol 3, Issue 1, June 2026

Orthodontic Treatment Of A Skeletal Class II Subdivision Malocclusion With Severe Maxillary Crowding And Midline Discrepancy Using A Straight-Wire Appliance: A Case Report

Pepi Riyani Siregar (Hasanuddin University)
Fatmawati M (Hasanuddin University)
Baharuddin M. Ranggang (Hasanuddin University)
Eddy Heriyanto Habar (Hasanuddin University)
Ardiansyah S. Pawinru (Hasanuddin University)
Ita Purnama Alwi (Hasanuddin University)



Article Info

Publish Date
16 Sep 2026

Abstract

Abstract Background: Skeletal Class II subdivision malocclusion is a challenging asymmetric malocclusion, often associated with severe crowding, dental midline discrepancy, and dentoalveolar and soft-tissue imbalance. Achieving optimal occlusion and facial harmony requires careful management of both space and asymmetry. Objective: To report the diagnosis, treatment protocol, and outcomes of straight-wire fixed appliance therapy in a 24-year-old female with skeletal Class II subdivision malocclusion, severe maxillary crowding, and dental midline discrepancy. Case Report: A 24-year-old female presented to the Orthodontic Clinic of the Hasanuddin University Dental and Oral Hospital with protrusive and crowded teeth. Clinical examination showed dental midline deviation (maxillary 1 mm left; mandibular 0.5 mm right), overjet 3.5 mm, and overbite 2.5 mm, with a Class II subdivision canine relationship. Model analysis demonstrated a 9-mm maxillary space deficiency. Cephalometric findings indicated skeletal Class II (Class II subdivision) with incisor proclination/protrusion. Treatment was performed using straight-wire fixed appliances (Roth prescription, 0.022-inch slot) with selective extractions and staged mechanotherapy, including leveling and alignment, anterior retraction with T-loops, finishing, and fixed retainer retention. Active treatment lasted from 5 May 2023 to 19 December 2025 (approximately 32 months). Outcomes included improved facial profile, correction of crowding and midline discrepancy, and reduction of overjet to 3.0 mm.

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Journal Info

Abbrev

ijocr

Publisher

Subject

Description

The Indonesian Journal of Orthodontics Case Report focuses on detailed case reports demonstrating innovative approaches to orthodontic challenges, including complex malocclusions, dentofacial abnormalities, interdisciplinary treatments, and advanced orthodontic technologies. The journal aims to ...