{"id":14235,"date":"2025-12-09T10:16:45","date_gmt":"2025-12-09T18:16:45","guid":{"rendered":"https:\/\/sandbox-education.angelaligner.com\/comprehensive-treatment-of-a-class-ii-div-2-malocclusion\/"},"modified":"2026-04-30T13:25:42","modified_gmt":"2026-04-30T20:25:42","slug":"comprehensive-treatment-of-a-class-ii-div-2-malocclusion","status":"publish","type":"post","link":"https:\/\/www.angelaligner.com\/en-au\/comprehensive-treatment-of-a-class-ii-div-2-malocclusion\/","title":{"rendered":"Comprehensive Treatment of a Class II, Div. 2 Malocclusion"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text css=&#8221;&#8221;]<\/p>\n<h5 style=\"text-align: center;\">Severe Crowding, Unilateral Posterior Crossbite and 1st. Premolar extraction <\/h5>\n<hr>\n<p>[\/vc_column_text][vc_column_text css=&#8221;&#8221;]<strong>Treatment Summary<\/strong><\/p>\n<p>This case, led by Dr. James M. Crouse, presents the treatment of a 16-year-old female patient with Severe Crowding, Unilateral Posterior Crossbite and 1st. Premolar extraction. Using the Angel Aligner Select system with angelButtons<sup>TM<\/sup> for Severe Crowding, Unilateral Posterior Crossbite with CL II elastics and extraction of maxillary left 1 premolar. In just 12 visits over 17 months with 69 aligners, the approach greatly reduced crowding, especially at frontal canines, improved smile arc and reduction of gummy smile.[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1755630390579{padding-top: 10px !important;padding-bottom: 20px !important;background-color: #D8D8D8 !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text css=&#8221;&#8221;]<\/p>\n<h3>Patient introduction<\/h3>\n<p><strong>Age:<\/strong> 16 years old<br \/>\n<strong>Gender:<\/strong> Female<br \/>\n<strong>Treatment time:<\/strong> 17 months<br \/>\n<strong>Number of aligners:<\/strong> 69<br \/>\n<strong>Chief complaint:<\/strong> The patient had Severe Crowding, Unilateral Posterior Crossbite and 1st. Premolar extraction <\/p>\n<p><strong>Section:<\/strong> Class II division 2 malocclusion<br \/>\n<strong>Product:<\/strong> Select<br \/>\n<strong>Malocclusion:<\/strong> CL II Div. 2 SUBDIV L, +2\/+5, 6mm overbite, 3mm overjet, 16mm maxillary arch length deficiency, 5mm mandibular arch length deficiency, 2.3, 2.4, 2.5 are in crossbite with 3.2, 3.3 and 3.4, 3.7 is impacted, extraction of maxillary left 1<sup>st<\/sup> premolar needed.<br \/>\n<strong>Protocols and features:<\/strong> angelButton with CL ll elastics[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text css=&#8221;&#8221;]<\/p>\n<h5 style=\"text-align: center;\">Before &amp; After<\/h5>\n<h5 style=\"text-align: center;\">Class II div 1 malocclusion<\/h5>\n<p>[\/vc_column_text][vc_empty_space height=&#8221;20px&#8221;][vc_column_text css=&#8221;&#8221;]\n\t\t\t\n\t<style type=\"text\/css\">\n\t\t.slider-info-7701.bafg-slider-info .bafg-slider-title {\n\t\t\t\t\t\t\tfont-size:\n\t\t\t\t\t18px\t\t\t\t;\n\t\t\t\n\t\t\t\t\t\t\tcolor:\n\t\t\t\t\t#1e73be\t\t\t\t;\n\t\t\t\n\t\t\t\t\t\t\ttext-align:\n\t\t\t\t\tleft\t\t\t\t;\n\t\t\t\t\t}\n\n\t\t.slider-info-7701.bafg-slider-info .bafg-slider-description {\n\t\t\t\n\t\t\t\n\t\t\t\t\t}\n\t\t\n\t\t\n\t\t.slider-info-7701.bafg-slider-info .bafg_slider_readmore_button {\n\t\t\t\n\t\t\t\t\t\t\tcolor:\n\t\t\t\t\t#1e73be\t\t\t\t;\n\t\t\t\n\t\t\t\n\t\t\t\n\t\t\t\n\t\t\ttext-align: center;\n\n\t\t\t\n\t\t\t\n\t\t\t\n\t\t\t\n\t\t\t\t\t}\n\n\t\t.slider-info-7701.bafg-slider-info .bafg_slider_readmore_button:hover {\n\n\t\t\t\n\t\t\t\n\t\t\t\t\t}\n\t<\/style>\n\t\n\t\t\t<div class=\"bafg-twentytwenty-container slider-7701  \"\n\t\t\t\tbafg-orientation=\"horizontal\" bafg-default-offset=\"0.5\"\n\t\t\t\tbafg-before-label=\"Before\"\n\t\t\t\tbafg-after-label=\"After\" bafg-overlay=\"1\"\n\t\t\t\tbafg-move-slider-on-hover=\"\"\n\t\t\t\tbafg-click-to-move=\"\">\n\n\t\t\t\t\t\t\t\t<img class=\"skip-lazy\" data-skip-lazy\t\t\t\t\tsrc=\"https:\/\/www.angelaligner.com\/wp-content\/uploads\/2025\/12\/Frontal-Before-I.B.jpg\" alt=\"class II div 2 malocclusion\">\n\t\t\t\t<img class=\"skip-lazy\" data-skip-lazy\t\t\t\t\tsrc=\"https:\/\/www.angelaligner.com\/wp-content\/uploads\/2025\/12\/Frontal-After-I.B.jpg\" alt=\"\">\n\n\t\t\t<\/div>\n\n\t\t\t\t<div class=\"bafg-slider-info-wraper\">\n\t\t<div style=\"\" class=\"slider-info-7701 bafg-slider-info\">\n\t\t\t\t\t\t\t<div class=\"bafg-slider-description\">\n\t\t\t\t\tSevere Crowding, Unilateral Posterior Crossbite and 1st. Premolar extraction\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t<\/div>\n\t\n\t\t\t<style type=\"text\/css\">\n\t\t\t\t\t\t\t\t\t\t\t<\/style>\n\t\t\t[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=&#8221;&#8221;]<\/p>\n<h4>Initial Photos and Data<\/h4>\n<p>[\/vc_column_text][vc_images_carousel images=&#8221;10713,10714,10715,10716,10717,10718,10719,10720,10721,10722&#8243; img_size=&#8221;full&#8221; speed=&#8221;3000&#8243; slides_per_view=&#8221;2&#8243; autoplay=&#8221;yes&#8221; hide_pagination_control=&#8221;yes&#8221; wrap=&#8221;yes&#8221; css=&#8221;&#8221;][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1755633215357{margin-top: 30px !important;padding-top: 20px !important;background-color: #D8D8D8 !important;}&#8221;][vc_column][vc_row_inner gap=&#8221;15&#8243;][vc_column_inner width=&#8221;2\/12&#8243;][vc_column_text css=&#8221;&#8221;]<\/p>\n<p style=\"text-align: left;\"><strong>Clinical examination and diagnosis<\/strong><\/p>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=&#8221;5\/12&#8243;][vc_column_text css=&#8221;&#8221;]CL II Div. 2 SUBDIV L, +2\/+5, 6mm overbite, 3mm overjet, 16mm maxillary arch length deficiency, 5mm mandibular arch length<br \/>\ndeficiency[\/vc_column_text][\/vc_column_inner][vc_column_inner width=&#8221;5\/12&#8243;][vc_column_text css=&#8221;&#8221;]2.3, 2.4, 2.5 are in crossbite with 3.2, 3.3 and 3.4, 3.7 is impacted, extraction of maxillary left 1 premolar needed.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner gap=&#8221;15&#8243;][vc_column_inner width=&#8221;2\/12&#8243;][vc_column_text css=&#8221;&#8221;]<\/p>\n<p style=\"text-align: left;\"><strong>Treatment plan<\/strong><\/p>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=&#8221;5\/12&#8243;][vc_column_text css=&#8221;&#8221;]Comprehensive treatment with clear aligners for an estimated 18-24 months, CL II elastics, extraction of maxillary left 1 premolar.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=&#8221;5\/12&#8243;][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=&#8221;&#8221;]<\/p>\n<h4 style=\"text-align: left;\">Treatment setup<\/h4>\n<p>[\/vc_column_text][vc_images_carousel images=&#8221;10602,10603,10604&#8243; img_size=&#8221;full&#8221; speed=&#8221;3000&#8243; slides_per_view=&#8221;2&#8243; autoplay=&#8221;yes&#8221; hide_pagination_control=&#8221;yes&#8221; wrap=&#8221;yes&#8221; css=&#8221;&#8221;][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1755633215357{margin-top: 30px !important;padding-top: 20px !important;background-color: #D8D8D8 !important;}&#8221;][vc_column][vc_row_inner gap=&#8221;15&#8243;][vc_column_inner width=&#8221;2\/12&#8243;][vc_column_text css=&#8221;&#8221;]<\/p>\n<p style=\"text-align: left;\"><strong>Treatment details<\/strong><\/p>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=&#8221;5\/12&#8243;][vc_column_text css=&#8221;&#8221;]\u2022 1<sup>st<\/sup> set of aligners &#8211; 42 aligners<br \/>\n\u2022 Delivered 1<sup>st<\/sup> 2 aligners to be changed weekly<br \/>\n\u2022 Placed attachments at stage 3 and gave patient all aligners to continue weekly changes<br \/>\n\u2022 Checked at stage 17<br \/>\n\u2022 Checked at stage 29 Scanned for refinement at stage 38, allowed patient to continue changing aligners at home<br \/>\n\u2022 1<sup>st<\/sup> refinement \u2013 17 aligners, a few new attachments, started CL II elastics on the left all the time[\/vc_column_text][\/vc_column_inner][vc_column_inner width=&#8221;5\/12&#8243;][vc_column_text css=&#8221;&#8221;]\u2022 Checked at stage 11<br \/>\n\u2022 Scanned for refinement at stage 17, wear last aligner at night until aligners come in, continue with CL II elastics<br \/>\n\u2022 2<sup>nd<\/sup>refinement \u2013 11 aligners, no new attachments, resume full time wear of aligners and CL II elastics<br \/>\n\u2022 Checked at stage 8 Deband &#8211; Removed attachments at stage 10, did not use #11 due to patient losing it waiting on removal of all 3 molars and exposure of mandibular left second molar[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=&#8221;&#8221;]<\/p>\n<h4 style=\"text-align: left;\">Treatment progress<\/h4>\n<p>[\/vc_column_text][vc_images_carousel images=&#8221;10723,10724,10725,10726,10727,10728,10729,10730,10731,10732,10733,10734&#8243; img_size=&#8221;full&#8221; speed=&#8221;3000&#8243; slides_per_view=&#8221;2&#8243; autoplay=&#8221;yes&#8221; hide_pagination_control=&#8221;yes&#8221; wrap=&#8221;yes&#8221; css=&#8221;&#8221;][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space][vc_column_text css=&#8221;&#8221;]<\/p>\n<h5 style=\"text-align: center;\">Download the full case to see the treatment results, the conclusion and get more details on the solution<\/h5>\n<p>[\/vc_column_text][vc_empty_space][vc_row_inner css=&#8221;.vc_custom_1755667099092{padding: 20px !important;border: 1px solid #1E73BE !important;}&#8221;][vc_column_inner][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space][vc_single_image image=&#8221;10511&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221; css=&#8221;&#8221;][vc_column_text css=&#8221;&#8221;]<\/p>\n<h4 style=\"text-align: center;\">Dr. James M. Crouse<\/h4>\n<p>[\/vc_column_text][vc_column_text css=&#8221;&#8221;]Dr. James M. Crouse, a native of Salisbury, MD, graduated magna cum laude in 1985 from the University of Maryland School of Dentistry.<\/p>\n<p>After completing a general practice residency at Barksdale AFB hospital, he served three years in the United Kingdom before pursuing orthodontic training at Emory University in 1991. He then served as an orthodontic consultant at Spangdahlem Air Base in Germany until 1994 before returning home to practice with Dr. Alfred Beattie, where he continued after Dr. Beattie retired in 1995. <\/p>\n<p>\u2022 President of Eastern Shore Dental Society 1997-98<br \/>\n\u2022 Diplomate, American Board of Orthodontics 2003<br \/>\n\u2022 14 cases published in the Invisalign case galleries 2010, 2012, 2014, 2016, and 2018<br \/>\n\u2022 Invisalign Summit Shoot Out semi-finalist in the class II\/class III category 2016<br \/>\n\u2022 Has treated over 3000 aligner cases<br \/>\n\u2022 Volunteer faculty for the NYU Langone Pediatric dental program since 2014[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>This case, led by Dr. James M. Crouse, presents the treatment of a 13-year-old female patient with a Comprehensive Correction of a Crowded Class II Div. 1 Malocclusion. Using the Angel Aligner Select system with angelButtons for CL ll elastics, the treatment corrected significant Arch Length Deficiency and Facially Blocked Maxillary Canines. In just 11 visits over 17 months with 64 aligners, the approach delivered precise control, greatly enhanced facial refinement, and a dramatically improved smile.   <\/p>\n","protected":false},"author":2,"featured_media":10735,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[275],"tags":[235,227,236,225],"class_list":["post-14235","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-en-au","tag-angelbutton","tag-class-ii","tag-elastics","tag-malocclusion"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Comprehensive Treatment of a Class II, Div. 2 Malocclusion - angelaligner.com<\/title>\n<meta name=\"description\" content=\"This case, led by Dr. James M. 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