Nonsurgical Orthodontic Management of a Severe Skeletal Class II Malocclusion Using a Modified Intrusive Arch

Treating skeletal Class II malocclusion in non-growing patients remains a significant challenge in contemporary orthodontics. Treatment options range from dental camouflage, often involving extractions, to combined orthodontic–surgical approaches. In this case, orthodontic camouflage with extractions was selected to manage a severe skeletal Class II discrepancy in a 28-year-old female patient. A modified intrusive arch was employed to achieve simultaneous retraction and intrusion of the maxillary anterior teeth, effectively reducing excessive overjet. The biomechanical system of the modified intrusive arch generates an anterior intrusive force, a posterior extrusive force, and a posterior tip-back moment. The combined use of Tip-Edge Plus brackets and the modified intrusive arch provided efficient control of tooth movement, enabling successful correction without surgical intervention. This case highlights the effectiveness and biomechanical advantages of the modified intrusive arch in managing severe skeletal Class II malocclusion in adult patients.