Fig. 3

35-year-old female patient with a Class II division 1 malocclusion, an anterior open bite and an initial ABO MGS score of 57 (a-c). After bonding of the CCLA the Class II relationship has worsened on both sides (d-f). When using MTAD, further proclination of the lower incisors during Class II correction can be avoided (g-i). At the end of fixed appliance therapy, a final ABO MGS score of 10 could be achieved. Directly after debonding, upper and lower fixed 4–4 retainers were bonded. The patient had to wear up and down elastics in the canine region at night for 6 months in order to retain the vertical correction. The result and the individual treatment plan (target set-up with a score of 6) look very similar (j-o). The lateral headfilms before and after also show a clockwise rotation of the occlusal plane with a maxillary posterior intrusion (p, q). Due to this intrusion, a slight counter-clockwise rotation of the mandible can be noted. Further proclination of the lower incisors could be prevented. For better long-term stability and further improvement of the profile a genioplasty was recommended