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Growth modulation therapy in skeletal class II malocclusion
  1. Shahir Backer1 and
  2. Kevin Joseph Nirayath2
  1. 1Carewell Dental Clinic, Kannur, Kerala, India
  2. 2Department of Orthodontics and Dentofacial Orthopedics, Yenepoya Dental College, Mangalore, Karnataka, India
  1. Correspondence to Dr Kevin Joseph Nirayath; iamkevinjoseph{at}


A male child in his early adolescence was referred to the orthodontist to correct the proclined maxillary anterior teeth. Investigations concluded an excess maxilla, deficient mandible and remaining growth potential. The patient was treated with Twin Block functional appliance in combination with a high-pull headgear and later fixed pre-adjusted edgewise appliance to detail the occlusion. The total treatment duration was 18 months. The positive motivation and compliance exhibited by the patient were important.

  • Dentistry and oral medicine
  • Medical education
  • Mouth

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content—SB and KJN. The following author gave final approval of the manuscript—SB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.