Limits Of Class II Correction With Lingual Orthodontics in Daily Practice


Class II Malocclusions are one of the most prevalent malocclusions in orthodontic practice. These malocclusions are often accompanied by a sagittal retrusion of the mandible and are therefore commonly treated by positioning the mandible forwards to achieve dental and skeletal changes.

Depending on the extent of the malocclusion, subject’s age, and remaining dentofacial growth potential, different treatment approaches are available for Angle Class II correction. The latter are often used in combination with extraction therapy, Class II elastics, or flexible or rigid fixed functional appliance or maxillary distalisation using miniscrews. An optimal orthodontic treatment is the one that solves the entire list of problems with minimum discomfort and risk for the patient.

With the use of completely customised lingual bracket systems and the advantages of technology, many problems that had previously been experienced during lingual orthodontic treatment have disappeared and more predictable and successful results have been achieved.
The important clinical advantages of customised lingual orthodontic systems are full torque control and predictability, which is critical for the clinical management of Class II malocclusions.

When ideal protocols are followed, the clinical management of severe malocclusions is possible and successful with lingual orthodontic treatment which provides a facilitating clinical advantage to the doctor.

In this presentation, current therapeutic strategies and ideal protocols will be described to treat Class II malocclusions in adults with a completely customised lingual appliance.

In this context, clinical utilisation methods of flexible bite jumpers and Herbst mechanics will additionally be examined through clinical cases.


Dr Didem Aktan was born in Istanbul in 1985 and received her Dental Degree from İstanbul University Faculty of Dentistry in 2008. She has completed her PhD from Istanbul University Dentistry Faculty Orthodontics Department in Turkey. She is working as an orthodontist in a dental clinic of a private complex hospital in Istanbul.

Dr Aktan, who has been intensively interested in lingual orthodontics since 2011, participated in many congresses, symposiums and certification programs both in Turkey and abroad. She is a member of the Turkish Orthodontic Society (TOD) and in 2018, she became an European Society of Lingual Orthodontics (ESLO) Active Member.

Dr Aktan is the current president of Turkish Lingual Orthodontic Society (LOD).

Dr Aktan is carrying out a clinical training program on lingual orthodontics in Istanbul, and since 2020 she lectures post-graduate lessons of Lingual Orthodontics at Yeditepe University and Bezmialem Vakıf University.

Dr Aktan has been carrying out clinical studies on lingual orthodontics in Turkey and has been carrying out joint studies with foreign clinics and associations.