Pacific Coast Society of Orthodontists Bulletin Summer 2020 - 40

Special Section: Class II Correction

Let's Talk About That

Class II Correction

Dr. Patrick Turley
PCSO Bulletin Section Editor

In anticipation of the Summer 2020 special issue
on Class II treatment, I found myself in a quandary. I usually select one orthodontist to describe
their approach to the featured topic. However,
treating Class II today seems a bit like the Wild
West, with an almost "anything goes" mentality.
There are so many different approaches to treating Class II malocclusion that a single interviewee
would not suffice. Hence, I have decided to reach
out to a number of orthodontists to describe their
treatment approaches to this common group of
patients.
We are going to discuss what I think are the most
common methods used today: the Herbst, MARA,
twin block, Forsus, Carrier Motion, Invisalign,
and headgear. For the sake of space, half of
these discussions will be published in this issue
with the others appearing in the Winter 2021
issue. Each orthodontist was asked to picture a
white female patient with a 6 mm overjet, 50%
overbite, retruded mandible with normal midface
and convex profile (a typical Class II patient), and
upper/lower alignment within normal limits, as is
the anteroposterior (A-P) position of the incisors.
She is 12 and her second primary molars have presented. The following questions were provided to
form the basis of each orthodontist's discussion.
1.	 When would the ideal time be to start treatment using your appliance?
2.	 Would you use a one-phase or two-phase
treatment?
3.	 Which appliance would you use? Please be
specific, including any teeth to be bracketed.
4.	 What are the benefits or advantages of using
your appliance over other approaches to Class
II treatment?
5.	 How long does active treatment typically
take?
6.	 What is done at each appointment during this
treatment?
7.	 What will your occlusal treatment goal be?
8.	 If using two-phase treatment, how do you
retain between phases?

40	

9.	 If using two phases, how do you approach
Phase 2? What appliances and auxiliaries do
you use?
10.	 What type of retention do you employ at the
end of treatment?
11.	 What are the shortcomings or possible complications of the appliance you are using, and
how do you handle them?
The following are responses from our selected
PCSO members: Dr. Jason Pair discussing the
MARA appliance, Dr. Bill Dischinger discussing the
Herbst, Dr. John Pobanz discussing Forsus, and Dr.
Christine Mills discussing the twin block. Part 2 of
the Will and Larry Andrews interview will appear
in the fall 2020 issue and discussions on the Carriere Motion, Invisalign, and cervical headgear will
appear in the first issue of 2021. I hope you enjoy
these interviews.
Dr. Jason Pair discusses the MARA appliance
	
Dr. Pair attended the
University of California,
San Francisco (UCSF) for
dental school and the
University of California,
Los Angeles (UCLA) for his
certificate in orthodontics.
Dr. Pair practices in
Northridge, Valencia, and
Calabasas, California, and
has been a clinical instructor at the UCLA Orthodontic Program for more than 12 years.
1. When would the ideal time be to start treatment using your appliance? I like to place a MARA
either late in the mixed dentition or just when
the patient transitions to permanent dentition so
I don't miss a growth spurt. Of course, timing is
more based on a patient's skeletal maturity, but
if they are an early bloomer skeletally (this can be
assessed through handwrist films, cervical vertebral maturation stages II and III, menarche, and/
or body weight and height) with some primary
molars still present, I will place the MARA at that

PCSO Bulletin    Summer 2020



Pacific Coast Society of Orthodontists Bulletin Summer 2020

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