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The clinical examination of an 11.10-year-old girl in permanent dentition showed severe crowding, chewing problems and her right maxillary lateral incisor was in palatal position. The molars were in Class II relationship on both sides. An extraction treatment was planned. Upper second premolars and lower first premolars were extracted. Lower crowding was eliminated using physiological tooth movement called "driftodontics". Slots sized 0.022 inches and self-ligating brackets were used. The patient also used a high-pull headgear for anchorage and vertical control reasons for a short period. During the correction of the lateral crossbite, a posterior bite plate was used for anterior disarticulation and anterior bite ramps were used at the last stages of the treatment to ease the correction of the curve of Spee. Class I molar and canine relationships and normal overjet and overbite achieved with good alignment of both arches and dental midlines coincided with the facial midline. The treatment results were stable after 2 years of the retention period.

Treatment of a Class II Patient with Four Premolar Extractions and Driftodontics in the Lower Jaw