Lower-Molar Distalization with Mini-Implant Anchorage in Asymmetrical Class II Cases

About half of all Class II malocclusions are asymmetrical. If the upper molar is mesially displaced, the maxillary midline will deviate toward the Class I side, and treatment will require either extraction of one upper premolar or distal molar movement on the Class II side. In 61% of asymmetrical Class II cases, however, where the lower molar is distally displaced, the maxillary midline will match the medium sagittal plane, but the mandibular midline will deviate toward the Class II side. If the profile is convex, asymmetrical extractions (two upper premolars and one lower premolar on the Class I side) are generally used for correction. Another option is to extract four premolars, but this will extend treatment time.