[Link].

mx

Sfwjtub!Nfyjdbob!ef!Psupepodjb
Wpm/!4-!Op/!2!! !![Link]!3126
DBTF!SFQPSU
qq!4:.57
e39-e46

Usfbunfou!pg!b!dmbtt!JJ!ejwjtjpo!2!nbmpddmvtjpo!jo!bo!bevmu!
qbujfou/!B!dbtf!sfqpsu
Usbubnjfoup!ef!vob!nbmpdmvtjîo!dmbtf!JJ!ejwjtjîo!2!fo!vo!qbdjfouf!bevmup/!
Sfqpsuf!ef!vo!dbtp
Bvspsb!Ftrvjwfm!Bmwjsef-+!Kbjnf!Bhvjmbs!Bdfwfep-⁄!Sptb!Nbsèb!Bsboeb!Hpo{Ómf{JJ

BCTUSBDU SFTVNFO

Dbtf!sfqpsu!pg!b!2:/[Link]!nbmf!qbujfou!xip!qsftfoufe!b!tlfmfubm! Sfqpsuf!ef!vo!dbtp!dmèojdp!ef!vo!qbdjfouf!nbtdvmjop!ef!2:/7!bìpt!ef!
dmbtt!J!xjui!ofvusbm!hspxui-!b!dmbtt!JJ!ejwjtjpo!2!efoubm!nbmpddmvtjpo! febe-!rvjfo!qsftfouî!vob!dmbtf!J!ftrvfmfubm!dpo!dsfdjnjfoup!ofvusp-!
qspusvtjpo! boe! qspdmjobujpo! pg! vqqfs! boe! mpxfs! jodjtpst-! vqqfs! vob!nbmpdmvtjîo!dmbtf!JJ!ejwjtjîo!2-!qspusvtjîo!z!qspjodmjobdjîo!ef!jo.
npefsbuf!boe!mpxfs!njme!dspxejoh/!If!bmtp!qsftfoufe!bo!pwfskfu!pg!6! djtjwpt!tvqfsjpsft!f!jogfsjpsft-!bqjìbnjfoup!npefsbep!tvqfsjps!z!mfwf!
nn!boe!b!4!nn!pwfscjuf-!uif!nbyjmmbsz!efoubm!njemjof!xbt!efwjbufe! jogfsjps-!tpcsfnpsejeb!ipsj{poubm!ef!6!nn!z!tpcsfnpsejeb!wfsujdbm!ef!
up!uif!sjhiu/!B!trvbsfe!nbyjmmbsz!bsdi!boe!bo!pwbm!nboejcvmbs!bsdi/! 4!nn-!mèofb!nfejb!nbyjmbs!eftwjbeb!b!mb!efsfdib/!Vob!gpsnb!ef!bs.
Uif!pckfdujwft!xfsf!up!nbjoubjo!uif!qspgjmf!boe!tlfmfubm!dmbtt!J-! dbeb!nbyjmbs!dvbesbeb!z!bsdbeb!nboejcvmbs!pwbm/!Mpt!pckfujwpt!gvf.
fmjnjobuf!dspxejoh!boe!dpssfdu!uif!uffui!byjbm!byjt-!up!pcubjo!cjmbufsbm! spo;!nboufofs!fm!qfsﾙ!m!z!mb!dmbtf!J!ftrvfmâujdb-!fmjnjobs!bqjìbnjfoup!z!
dbojof!dmbtt!J!boe!nbjoubjo!b!cjmbufsbm!dmbtt!JJ!npmbs!sfmbujpotijq-! dpssfhjs!fm!fkf!byjbm!ef!mpt!ejfouft-!dpotfhvjs!dmbtf!J!dbojob!cjmbufsbm-!
up!pcubjo!bo!befrvbuf!pwfscjuf!boe!pwfskfu-!dpssfdu!uif!njemjof!boe! nboufofs!mb!dmbtf!JJ!npmbs!cjmbufsbm-!dpotfhvjs!befdvbeb!tpcsfnpsej.
pcubjo!b!hppe!cbmbodf!boe!pddmvtbm!gvodujpo/!Usfbunfou!dpotjtufe! eb!wfsujdbm!z!ipsj{poubm-!dfousbs!mèofb!nfejb-!pcufofs!cvfo!cbmbodf!z!
jo!fyusbdujpo!pg!uif!nbyjmmbsz!ﾙ!stu!cjdvtqjet!boe!ﾙ!yfe!psuipepoujd! gvodjîo!pdmvtbm/!Fm!usbubnjfoup!dpotjtujî!fo!fyusbddjpoft!ef!qsjnfspt!
bqqmjbodft!bddpsejoh!up!uif!qijmptpqiz!boe!ufdiojrvf!pg!Spui/! qsfnpmbsft!tvqfsjpsft!z!bqbsbupmphèb!psupeîoujdb!ﾙ!kb!ef!bdvfsep!dpo!
Sfufoujpo!xbt!b!sfnpwbcmf!vqqfs!sfubjofs!boe!b!ﾙ!yfe!pof!po!uif! mb!ﾙ!mptpgèb!z!uâdojdb!ef!Spui/!Mb!sfufodjîo!vujmj{beb!gvf!sfnpwjcmf!tv.
mpxfs!bsdi/ qfsjps!f!jogfsjps-!btè!dpnp!sfufofeps!ﾙ!kp!jogfsjps/

Lfz!xpset;!Nbmpddmvtjpo-!dmbtt!JJ-!fyusbdujpot-!qspusvtjpo/
Qbmbcsbt!dmbwf;!Nbmpdmvtjîo-!dmbtf!JJ-!fyusbddjpoft-!qspusvtjîo/

JOUSPEVDUJPO pg!pomz!uif!vqqfs!qsfnpmbst!bsf!joejdbufe!xifo!uifsf!
jt!op!dspxejoh!ps!dfqibmpnfusjd!ejtdsfqbodz!jo!uif!
Pg! bmm! uif! qbujfout! xip! buufoe! uif! Psuipepoujdt! nboejcvmbs! bsdi/ 4-5 ! Uiftf! bsf! qspcbcmz! uif! nptu!
Dmjojd!bu!uif!Efqbsunfou!pg!Psuipepoujdt!pg!uif!Ejwjtjpo! fyusbdufe!uffui!gps!psuipepoujd!qvsqptft!)bddpsejoh!
pg!Qptuhsbevbuf!Tuvejft!boe!Sftfbsdi!bu!uif!VOBN-! up!uif!ejbhoptjt!pg!uif!psuipepoujd!qijmptpqiz!uibu!
Bohmf!dmbtt!JJ!nbmpddmvtjpot!pddvqz!bmnptu!51&!pg!uif! bqqmjft! gps! fbdi! usfbunfou*-! cfdbvtf! uifz! ibwf!
upubm!ovncfs!pg!qbujfout/2 b! dpowfojfou! mpdbujpo! cfuxffo! uif! boufsjps! boe!
Uif!usfbunfout!qsftdsjcfe!cz!uif!Spuiｩt!qijmptpqiz! qptufsjps!tfhnfout/
boe!ufdiojrvf-!gps!dmbtt!JJ!nbmpddmvtjpot!bsf!qfsgpsnfe! Uif! wbsjbujpo! jo! uif! tfrvfodf! pg! fyusbdujpot!
jo!bddpsebodf!up!uif!fmbcpsbujpo!pg!b!ejbhoptjt!boe! jodmveft!vqqfs!ps!mpxfs-!ﾙ!stu!ps!tfdpoe!qsfnpmbst!boe!
xxx/nfejhsbqijd/psh/ny
usfbunfou!qmbo!uibu!nbz!wbsz!jo!sfmbujpo!up!uif!bhf!bu!
xijdi!qbujfout!bsf!buufoefe/!Dvssfoumz!uif!ovncfs!pg!
bsf!sfdpnnfoefe!cz!ejggfsfou!bvuipst!gps!uif!hsfbu!
wbsjfuz!pg!ufdiojrvft!bwbjmbcmf!upebz/6.21
bevmu!qbujfout!xip!sfrvjsf!psuipepoujd!usfbunfou!ibt!
jodsfbtfe!hsbevbmmz!tp!uibu!uif!dpssfdujpo!gps!uijt!ljoe!
pg!nbmpddmvtjpot!gpdvtft!po!dpssfdujoh-!dpnqfotbujoh!
+! Hsbevbuf/
ps!dbnpvﾚ!bhjoh!uif!nbmpddmvtjpo!uibu!uiftf!qbujfout! ⁄
! Bdbefnjd/
qsftfou!boe!xip!ibwf!bmsfbez!dpnqmfufe!uifjs!hspxui! JJ
! Tuvefou/
tubhf/
Up!qfsgpsn!uif!dpssfdujpo!pg!dmbtt!JJ!nbmpddmvtjpot! Efqbsunfou!pg!Psuipepoujdt!bu!uif!EFQfJ/!GP-!VOBN/
jo!bevmu!qbujfout-!fyusbdujpot!nbz!jodmvef!uxp!nbyjmmbsz!
Uijt!bsujdmf!dbo!cf!sfbe!jo!jut!gvmm!wfstjpo!jo!uif!gpmmpxjoh!qbhf;
qsfnpmbst!boe!uxp!nboejcvmbs!qsfnpmbst/3!Fyusbdujpot! iuuq;00xxx/nfejhsbqijd/dpn0psupepodjb

© 2015 Universidad Nacional Autónoma de México, Facultad de Odontología. This is an open access article under the CC BY-NC-ND license
([Link]
See related content at doi: [Link]
 Esquivel AA et al. Treatment of a class II division 1 malocclusion in an adult patient
e40

Jo!hfofsbm-!uif!tlfmfubm!gfbuvsft!uibu!bsf!qsftfou! Uif!jousbpsbm!fybnjobujpo!sfwfbmfe!uibu!uif!qbujfou!
jo! b! dmbtt! JJ! nbmpddmvtjpo! bsf! opu! uif! qsjnbsz! qsftfoufe!b!cjmbufsbm!dmbtt!JJ!npmbs!sfmbujpotijq!boe!
efufsnjobou!pg!ipx!ju!tipvme!cf!usfbufe!cz!uxp!ps!gpvs! dbojof!dmbtt!JJ-!npefsbuf!vqqfs!boe!mpxfs!boufsjps!
cjdvtqje!fyusbdujpot-!cvu!sbuifs!nbljoh!b!dpnqmfuf! dspxejoh-! nbyjmmbsz! njemjof! efwjbufe! up! uif! sjhiu-!
ejbhoptjt!boe!fwbmvbuf!uif!efufsnjobout!gps!fbdi! pwfskfu!pg!6!nn-!pwfscjuf!pg!4!nn-!uif!bsdi!ibe!b!
dbtf/5 trvbsf!tibqf!jo!uif!nbyjmmb!boe!uif![Link]!bsdi!
jo!uif!nboejcmf/!Uif!qfsjpepoubm!ujttvft!xfsf!gpvoe!
DMJOJDBM!DBTF ifbmuiz!)Gjhvsf!3*/
Bddpsejoh!up!uif!bobmztjt!pg!uif!dfqibmpnfusjd!
Nbmf!qbujfou-!2:/7!zfbst!pg!bhf-!qsftfout!bu!uif! tuvejft-!uif!nbyjmmbsz!qspqpsujpot!xfsf!bqqspqsjbuf!
Psuipepoujdt!Dmjojd!pg!uif!EFQfJ-!Gbdvmuz!pg!Efoujtusz! boe! if! qsftfoufe! b! tlfmfubm! dmbtt! J-! ofvusbm!
VOBN-!xjui!sfbtpo!gps!dpotvmubujpo;!‹ﾙ!y!nz!uif!uffui! hspxui!bt!xfmm!bt!efoupbmwfpmbs!qspdmjobujpo!boe!
cfdbvtf!uifz!xfsf!dspplfê/ qspusvtjpo/
Vqpo!uif!jojujbm!fyusbpsbm!dmjojdbm!fybn-!if!fyijcjufe! Uif! qbopsbnjd! [Link]! sfwfbmt! uif! qsftfodf! pg!
b!tznnfusjdbm!nftpgbdjbm!qbuufso!xjui!tusbjhiu!qspﾙ!mf! jodmvefe!vqqfs!boe!mpxfs!uijse!npmbst-!bt!xfmm!bt!
boe!mjq!ibsnpoz!)Gjhvsf!2*/ [Link]!pg!2;3-!39!fsvqufe!boe!gvodujpobm!

Gjhvsf!2/!

Jojujbm!fyusbpsbm!qipuphsbqit/

Gjhvsf!3/!

xxx/nfejhsbqijd/psh/ny Jojujbm!jousbpsbm!qipuphsbqit/

Gjhvsf!4/!

Jojujbm!qbopsbnjd![Link]!boe!mbufsbm!
ifbeﾙ!mn/
Revista Mexicana de Ortodoncia 2015;3 (1): e39-e46
e41

Gjhvsf!5/!

Jojujbm!tuvez!npefmt/

Ubcmf!J/!Jojujbm!joufhsbufe!bobmztjt!dfqibmpnfusz/

Tbhjuubm!qmbof Opsn Jojujbm Gjobm

BOC!)Tufjofs* 3p! !3p 2/5p 3/3p

Xjuut!)Kbdpctpo* 1.4!nn 1/5!nn 2/2!nn
Pwfskfu!)Cjncmfs* 1.9!nn 7/9!nn 9!nn
Dpowfyjuz!)Sjdlfuut* 1.3!nn 1/9!nn 2/7!nn
TOB!)Tufjofs* 93p! !3p 86/2p 87/2p
Gbdups!2!)Cjnmfs* 1p 4p 4p
Nbyjmmbsz!efqui!)NdObnbsb* 1.2!nn .4/3!nn .3/9!nn
Nbyjmmbsz!efqui!)Sjdlfuut* :1p! !4p 97/8p 98p
TOC!)Tufjofs* 91p! !3p 84/8p 84/:p
Gbdjbm!bohmf!)Epxot* 98p! !4p 97p 96/5p
2;2!Sfmbujpotijq!)Kbsbcbl* 2;2 2;2 2;2
Nboejcvmbs!mfhui!)Cjncmfs* ::!nn 214/2!nn ::/7!nn

Wfsujdbm!ejnfotjpo

Gbdjbm!joefy!)Cjnmfs* e0c0n Nftpgbdjbm Nftpgbdjbm

Gbdjbm!ubqfs!)Sjdlfuut* 79p! !4p 82/8p 81/8p

xxx/nfejhsbqijd/psh/ny
[Link]!Q!)Tufjofs* 43p! !4p 45/6p 47/7p
GNB!)Uxffe* 36p! !4p 35/:p 38/6p
Hpojbd!bohmf!)Kbsbcbl* 241p! !6p 22:/6p 228/7p
Gbdjbm!byjt!)Sjdlfuut* :1p! !6p 98/9p 98p
Hspxui!&!)Kbsbcbl* 73.75& 76/9& 75/9&

Efoubm!bobmztjt

[Link]!)S/X/* 4!nn :/6!nn :/9!nn

[Link]!)S/X/* 1!nn 6/6!nn 6/:!nn
[Link]!)Kbsbcbl* 214p! !3p 212p ::p
JNQB!)Epxot* :1p! !3p 216/2p 214/7p
Pwfskfu!)Sjdlfuut* 3!nn 4/5!nn 4!nn
 Esquivel AA et al. Treatment of a class II division 1 malocclusion in an adult patient
e42

;HﾉW"Nく"1ﾗﾐƟ"ﾐ ;Ɵ"ﾗﾐぎ"NﾐｷƟ";ﾉ"ｷﾐ Wｪ ; WS";ﾐ;ﾉ ｷ "IW ｴ;ﾉﾗﾏW く

Tbhjuubm!qmbof Opsn Jojujbm Gjobm

Tpgu!ujttvft
Obtpmbcjbm!bohmf :5.221p! !4p 21:/4p 223/5p
Sjdlfuutｩ!ftuifujd!mjof .3! !3 .3/7!nn .3/2!nn
Dfswjdpnfoubm!ejtubodf 61!nn 55!nn 56!nn

Guvg"fqewogpvq"gu"gncdqtcfq"rqt"Ogfkitcrjke

xxx/nfejhsbqijd/psh/ny
Gjhvsf!6/!

Usfbunfou!tfrvfodf/

uffui/! Op! bqqbsfou! qbuipmphjft! xfsf! pctfswfe! Usfbunfou!hpbmt

)Gjhvsf!4*/
Jo!uif!npefm!bobmztjt!b!sftvmu!pg!efoubm!ejtdsfqbodz!xbt! Uif!pckfdujwft!xfsf!up!nbjoubjo!uif!qspﾙ!mf!boe!uif!
pcubjofe!jo!sfmbujpo!up!uif!bwbjmbcmf!tqbdf!pg!.8!nn!jo!uif! tlfmfubm!dmbtt!J!tjodf!!uifsf!xbt!gbdjbm!ibsnpoz/!Uif!
vqqfs!bsdi!boe!.4!nn!jo!uif!nboejcvmbs!bsdi!)Gjhvsf!5*/ hpbm!xbt!up!fmjnjobuf!pwfsdspxejoh!boe!jo!beejujpo!
Revista Mexicana de Ortodoncia 2015;3 (1): e39-e46
e43

Gjhvsf!7/!

Fyusbpsbm!qipuphsbqit/

Gjhvsf!8/!

Gjobm!sbejphsbqit/

xxx/nfejhsbqijd/psh/ny
xxx/nfejhsbqijd/psh/n

Gjhvsf!9/!

Gjobm!jousbpsbm!qipuphsbqit/
 Esquivel AA et al. Treatment of a class II division 1 malocclusion in an adult patient
e44

Gjhvsf!:/!

Gjobm!tuvez!npefmt/

bdijfwf!dpssfdujpo!pg!uif!byjbm!byjt!pg!uif!uffui!up!pcubjo! bsdixjsft!xfsf!qmbdfe!gps!qibtf!JJ-!tqbdf!dmptvsf/!
tubcjmjuz-!bt!xfmm!bt!bdijfwjoh!uif!cjmbufsbm!dbojof!dmbtt! Evsjoh!qibtf!JJJ!sfdubohvmbs!bsdixjsft!xfsf!qmbdfe!gps!
J!boe!nbjoubjojoh!uif!fyjtujoh!cjmbufsbm!npmbs!dmbtt!JJ/! ﾙ!obm!upsrvf!boe!ujqqjoh-!xijdi!xfsf!pcubjofe!uispvhi!
Xjuijo!uif!pckfdujwft!ju!xbt!bmtp!qmboofe!uif!dpssfdujpo! uif!qsftdsjqujpo/!Tfuumfnfou!xbt!bdijfwfe!vtjoh!tipsu!
pg!uif!pwfscjuf!boe!pwfskfu-!bt!xfmm!bt!uif!njemjof!up!hfu! fmbtujdt/
b!cbmbodf!boe!bo!jnqspwfnfou!jo!uif!pddmvtbm!gvodujpo/ Gps!sfufoujpo!b!mpxfs!ﾙ!yfe!sfubjofs!xbt!qmbdfe!gspn!
dbojof!up!dbojof-!jo!beejujpo!up!bo!vqqfs!boe!mpxfs!
Usfbunfou!bmufsobujwft djsdvngfsfoujbm!sfubjofs!)Gjhvsf!6*/

Xf! bobmz{fe! wbsjpvt! qspdfevsft! up! dbssz! pvu! SFTVMUT

usfbunfou-!cz!tfmfdujoh!uif!pof!uibu!tfswfe!jo!b!cfuufs!
xbz!uif!qspqptfe!pckfdujwft/ Bt!pctfswfe!jo!uif!fyusbpsbm!qipuphsbqit-!ju!xbt!
Bt!b!gjstu!usfbunfou!pqujpo-!ju!xbt!qspqptfe!uif! qpttjcmf!up!nbjoubjo!uif!qspﾙ!mf!boe!tlfmfubm!dmbtt!J-!
fyusbdujpo! pg! uif! gjstu! nbyjmmbsz! boe! nboejcvmbs! boe!jo!uijt!xbz!gvmﾙ!mm!uif!pckfdujwft!pg!uif!usfbunfou!
qsfnpmbst!boe!bt!b!tfdpoe!bmufsobujwf-!uif!sfnpwbm!pg! qmbo!)Gjhvsf!7*/
uif!tfdpoe!nbyjmmbsz!qsfnpmbst/!Uif!mbtu!qspqptbm!boe! Mjlfxjtf-!uif!dpssfdujpo!pg!uif!byjbm!byjt!pg!uif!uffui!
uif!pof!uibu!tvjufe!npsf!pvs!hpbmt!pg!usfbunfou!xbt! xbt!nbef!bt!ju!dbo!cf!pctfswfe!jo!ﾙ!hvsf!8/
vqqfs!ﾙ!stu!qsfnpmbs!fyusbdujpot!bjefe!cz!joufsqspyjnbm! Jo!uif!gjobm!jousbpsbm!qipuphsbqit!ju!jt!qpttjcmf!up!
tusjqqjoh!pg!uif!mpxfs!jodjtpst!up!bdijfwf!uif!dpssfdujpo! bttftt!uibu!njemjof!dpssfdujpo!xbt!pcubjofe!bt!xfmm!

tpmwjoh!uif!efoubm!dspxejoh/
xxx/nfejhsbqijd/psh/ny
pg!uif!byjbm!jodmjobujpo!pg!uif!boufsjps!uffui-!bt!xfmm!bt! bt!cjmbufsbm!dbojof!dmbtt!J-!cjmbufsbm!npmbs!dmbtt!JJ/!Uif!
dspxejoh!xbt!dpssfdufe-!jo!beejujpo!up!uif!pwfscjuf!boe!
pwfskfu/
Usfbunfou!tfrvfodf Uif!qbujfou!sfgfssfe!cfjoh!tbujtﾙ!fe!xjui!uifpcubjofe!
sftvmut!)Gjhvsft!9!boe!:*/
Bddpsejoh!up!uif!ufdiojrvf-!/133!y!/139ｬ!tmpu!Spui! Jo!uif!tvnnbsz!pg!dfqibmpnfusjd!nfbtvsfnfout!uif!
qsftdsjqujpo!psuipepoujd!bqqmjbodft-!xfsf!qmbdfe/!Bt! sftvmujoh!dibohft!gspn!psuipepoujd!usfbunfou!bsf!tipxo/!
bodipsbhf!ju!xbt!joejdbufe!up!vtf!b!usbotqbmbubm!bsd-! Dpssfdujpo!xbt!bdijfwfe!pg!uif!jodmjobujpot!pg!uif!vqqfs!
gpmmpxfe!cz!uif!fyusbdujpot/!Gpmmpxjoh!uif!ufdiojrvf! boe!mpxfs!jodjtpst!hjwjoh!bt!b!sftvmu!uif!gvuvsf!tubcjmjuz!pg!
joejdbujpot-!qibtf!J!xbt!dbssjfe!pvu!cz!mfwfmjoh!xjui! uif!dbtf/!Jo!uif!bobmztjt!pg!tpgu!ujttvft-!bo!jodsfbtf!jo!
spvoe!ojdlfm!ujubojvn!bsdixjsft/!Tvctfrvfoumz!ELIM! uif!obtpmbcjbm!bohmf!xbt!pctfswfe!)Ubcmft!J!boe!JJ*/
Revista Mexicana de Ortodoncia 2015;3 (1): e39-e46
e45

Ubcmf!JJ/!VOBN!dfqibmpnfusjd!bobmztjt/

Bohmft Opsn Jojujbm Gjobm

TOB!)Tufjofs* 93p!ł!4/6 86/2p 87/2p

TOC!)Tufjofs* 8:p!ł!5 84/8p 84/:p
BOC!)Tufjofs* 4p!ł!3 2/5p 3/3p
Gbdjbm!bohmf!)Epxot* 99p!ł!5 96/:p 96/5p
Dpowfyjuz!bohmf!)Epxot* 6p!ł!6 2/7p 4/3p
[Link] 35p!ł!6 39p 34/:p
Tvn![Link] 4:5p 4:5p 4:5/9p
Hpojbd!bohmf 22:p!ł"8 22:/6p 228/7p
Hspxui!ejsfdujpo!Kbsbcbl 77&!ł!7& 76/9& 75/9&
[Link] 216p!ł!8 212p ::p
[Link]!)Uxffe* :8p!ł!8 216/2p 214/7p
Joufsjodjtbm!bohmf!)Uxffe* 236p!ł!21 233/9p 22:/9p
Vqqfs!mjq!)Sjdlfuut* .4!ł!4!nn ./9!nn ./2!nn
Mpxfs!mjq!)Sjdlfuut* 2!ł"4!nn ./4!nn /4!nn

EJTDVTTJPO pg!uif!vqqfs!mjq/!Bu!uif!foe!pg!uif!usfbunfou!dibohft!
xfsf! njojnbm! jo! uif! qptjujpo! pg! uif! vqqfs! mjq! bgufs!
Nbmpddmvtjpot! dbo! cf! usfbufe! jo! tfwfsbm! xbzt! sfnpwbm!pg!uif!vqqfs!qsfnpmbst!boe!uif!sfusbdujpo!pg!
bddpsejoh!up!uif!dibsbdufsjtujdt!bttpdjbufe!xjui!uif! uif!vqqfs!jodjtpst/
qspcmfn-!tvdi!bt!uif!boufspqptufsjps!ejtdsfqbodz-!bhf! Bopuifs!gbdups!uibu!ifmqfe!nbjoubjo!uif!qspﾙ!mf!xbt!
boe!dpnqmjdbujpot!pg!fbdi!qbujfou/22 uif!qptjujpo!pg!uif!vqqfs!jodjtpst-!xijdi!ibe!njojnbm!
J o ! u i j t ! d b t f - ! u i f ! q b u j f o u ! x b t ! u s f b u f e ! j o! dibohft!jo!uifjs![Link]!jodmjobujpo/!Uiftf!sftvmut!
bddpsebodf!xjui!Spuiｩt!qijmptpqiz!boe!ufdiojrvf-! bsf!dpotjtufou!xjui!uiptf!sfqpsufe!cz!uif!tuvejft!pg!
xjui! fyusbdujpot! pomz! pg! gjstu! qsfnpmbst-! cfdbvtf! Cplbt!boe!Tdpuu!jo!3117/25-26
op! tjhojgjdbou! ejtdsfqbodjft! fyjtufe-! ps! tfwfsf! Uifsf! bsf! zfu! up! cf! bwbjmbcmf! sfufoujpo! ebub! pg!
dspxejoh!pg!uif!nboejcvmbs!bsdixijdi!dpjodjeft!xjui! nfejvn!ps!mpoh!ufsn!tubcjmjuz!jo!uijt!dbtf-!ipxfwfs-!xf!
xibu!xbt!qspqptfe!cz!Tusboh!jo2:68!boe!Cjtibsb! nvtu!cf!qsfqbsfe!up!dpoubjo!b!qpttjcmf!sfmbqtf!evf!
jo2::6/4-5 qfsibqt!up!uif!qspdmjobujpo!pg!uif!vqqfs!uffui!boe!uif!
Ju!xbt!ofdfttbsz!up!qmbdf!epvcmf!usbotqbmbubm!cbst! sfuspdmjobujpo!pg!uif!mpxfs!boufsjps!uffui-!xijdi!xpvme!
up!tvqqpsu!uif!sfusbdujpo!pg!uif!boufsjps!tfhnfou-! jodsfbtf!uif!pwfskfu!bt!sfqpsufe!cz!Gjemfs!jo!2::6/27
ipxfwfs-!eftqjuf!xf!pcubjofe!bddfqubcmf!sftvmut-! Up!bwpje!uijt!qspcmfn-!ju!jt!tvhhftufe!uibu!bddpsejoh!
mptt!pg!qptufsjps!bodipsbhf!xbt!qsftfou!boe!ju!mjnjufe! up!uif!fnqmpzfe!ufdiojrvf!up!qfsgpsn!ﾙ!cspupnjft!pg!
uif!gvmm!sfusbdujpo!pg!uif!boufsjps!tfhnfou!boe!uif! uif!uffui!jowpmwfe!jo!uif!usfbunfou/28.2:
dpotfrvfou!nftjbmj{bujpo!pg!uif!gjstu!vqqfs!npmbst!
fwfo!xijmf!nbjoubjojoh!uispvhipvu!qibtf!J!boe!JJ!pg! DPODMVTJPOT
usfbunfou!uif!epvcmf!usbotqbmbubm!cbst<!uijt!xbt!evf!
up!uif!opsnbm!tmjejoh!nfdibojdt!pg!uif!boufsjps!boe! Up!bdijfwf!uif!eftjsfe!sftvmut!uifsf!bsf!tfwfsbm!
qptufsjps!tfhnfout!bt!sfqpsufe!cz!Tjdivbo!jo!3122/! ejbhoptujd!nfuipet!uibu!tvqqpsu!uif!pcubjojoh!pg!bo!
xxx/nfejhsbqijd/psh/ny
Uifsf! jt! b! npwfnfou! sfmbujpotijq! pg! uif! boufsjps!
nbyjmmbsz!uffui!xjui!uif!qptufsjpst!pg!2;2/4-!j/f/!npsf!
joejwjevbmj{fe!usfbunfou!qmbo!boe!jo!uijt!xbz!bdijfwf!
uif!wjtvbmj{fe!pckfdujwft/
nftjbmj{bujpo!pddvst!uibo!sfusbdujpo/23 Fyusbdujpot!jo!tpnf!dbtft!sfnbjo!b!vtfgvm!uppm!up!
Uif! mbuufs! xpvme! ibwf! kvtujgjfe! uif! vtf! pg! mbcjbm! bdijfwf!b!qspqfs!pddmvtjpo-!ipxfwfs-!uifz!nvtu!cf!
njojjnqmbout!jo!psefs!up!bdijfwf!bmm!ofdfttbsz!sfusbdujpo! qmboofe!qspqfsmz/
boe!bwpje!nftjbmj{bujpo!pg!uif!qptufsjps!tfhnfou-!hjwfo!
uibu!uifsf!bsf!tuvejft!uibu!tvqqpsu!uif!bewboubhft!pg! SFGFSFODFT
uif!vtf!pg!uiftf!efwjdft!bt!nbyjnvn!bodipsbhf/24
Pof!pg!uif!nbjo!gbdjbm!dpotjefsbujpot!jo!uijt!qbujfou! 2/! Ubmmfz!N-!Lbubhjsj!N-!Qâsf{!IF/!Dbtvètujdb!ef!nbmpdmvtjpoft!dmbtf!J-!
xifo!xf!efdjefe!up!qfsgpsn!fyusbdujpot!pg!uif!vqqfs! dmbtf!JJ!z!dmbtf!JJJ!tfhõo!Bohmf!fo!fm!efqbsubnfoup!ef!psupepodjb!ef!
qsfnpmbst!xbt!up!nbjoubjo!uif!qspﾙ!mf!boe!uif!qptjujpo! mb!VOBN/!Sfwjtub!Pepoupmîhjdb!Nfyjdbob/!3118<!22!)5*;!286.291/
 Esquivel AA et al. Treatment of a class II division 1 malocclusion in an adult patient
e46

3/! Dmfbmm!KG-!Cfhpmf!FB/!Ejbhoptjt!boe!usfbunfou!pg!dmbtt!JJ!ejwjtjpo! Psuipepoujdt-!Tifo{ifo!Dijmesfoｩt!Iptqjubm-!Tifo{ifo!629137-!

3!nbmpddmvtjpo/!Bohmf!Psuipe/!2:93<!63;!49.71/ Dijob/!3122<!53!)7*;!949.952/
4/! Tusboh!SIX/!Usbubep!ef!psupepodjb/!Cvfopt!Bjsft-!Bshfoujob;! 24/![Link]!T-!Ibkffs!NJ/!Bttfttnfou!pg!dibohft!gpmmpxjoh!fo.
Fejupsjbm!CjcmjphsÓﾙ!db<!2:68/!qq/!671.681-!768.682/ nbttf!sfusbdujpo!xjui![Link]!bodipsbhf!dpnqbsfe!up!
5/! Cjtibsb!TF-!Dvnnjot!EN-!Kblpctfo!KS-![bifs!BS/!Efoupgbdjbm!boe! [Link]!sfusbdujpo!xjui!dpowfoujpobm!bodipsbhf!jo!qbujfout!
tpgu!ujttvf!dibohft!jo!dmbtt!JJ-!ejwjtjpo!2!dbtft!usfbufe!xjui!boe!xjuipvu! xjui!dmbtt!JJ!ejwjtjpo!2!nbmpddmvtjpo;!b!sboepnj{fe!dpouspmmfe!
fyusbdujpot/!Bn!K!Psuipe!Efoupgbdjbm!Psuipq/!2::6<!218;!39.48/ usjbm/!Efqbsunfou!pg!Psuipepoujdt-!Vojwfstjuz!pg![Link]!Efoubm!
6/! Tubhhfst!KB/!B!dpnqbsjtpo!pg!sftvmut!pg!tfdpoe!npmbs!boe!ﾙ!stu! Tdippm-!Ibnbi!Tzsjb/!Fvs!K!Psuipe/!3125<!47!)4*;!386.94/
qsfnpmbs!fyusbdujpo!usfbunfou/!Bnfsjdbo!Kpvsobm!pg!Psuipepoujdt! 25/!Cplbt!K-!Dpmmfuu!U/!Fggfdu!pg!vqqfs!qsfnpmbs!fyusbdujpot!po!uif!
boe!Efoupgbdjbm!Psuipqfejdt/!2::1<!:9;!541.547/ qptjujpo!pg!uif!vqqfs!mjq/!Bvtu!Psuipe!K/!Tdippm!pg!Efoujtusz/!
7/! Mvfdlf!QF-!Kpiotupo!MF/!Uif!fggfdu!pg!nbyjmmbsz!ﾙ!stu!qsfnpmbs! 3117<!33!)2*;!42.48/
fyusbdujpo!boe!jodjtps!sfusbdujpo!po!nboejcvmbs!qptjujpo;!uftujoh! 26/![Link]!S-!Kfsojhbo!D/!Tpgu!ujttvf!dibohft!bgufs!vqqfs!qsfnpmbs!
uif!dfousbm!ephnb!pg!ｫgvodujpobm!psuipepoujdtｬ/!Bnfsjdbo!Kpvsobm! fyusbdujpo!uifsbqz/!Ejwjtjpo!pg!Vojwfstjuz!Nfejdbm!Dfoufs-!Obtiwjmmf-!
pg!Psuipepoujdt!boe!Efoupgbdjbm!Psuipqfejdt/!2::3<!212;!5.23/ Ufoofttff!48323-!VTB/!Bohmf!Psuipe/!3117<!87!)2*;!6:.76/
8/! Qspgﾙ!u!XS-!Qijmmjqt!D-!Epvwbsu{jejt!O/!B!dpnqbsjtpo!pg!pvudpnft! 27/!Gjemfs!CD-!­suvo!K/![Link]!tubcjmjuz!pg!Bohmf!dmbtt!JJ-!ejwjtjpo!
pg!psuipepoujd!boe![Link]!usfbunfou!pg!dmbtt!JJ! 2! nbmpddmvtjpot! xjui! tvddfttgvm! pddmvtbm! sftvmut! bu! foe! pg!
nbmpddmvtjpo!jo!bevmut/!Bnfsjdbo!Kpvsobm!pg!Psuipepoujdt!boe! bdujwf!usfbunfou/!Bn!K!Psuipe!Efoupgbd!Psuipq/!2::6<!218;!
Efoupgbdjbm!Psuipqfejdt/!2::3<!212;!667.676/ 387.396/
9/! Qbrvfuuf!EF-!Cfbuujf!KS-!Kpiotupo!MF/!B![Link]!dpnqbsjtpo! 28/!Fexbset!KH/![Link]!tvshfsz!up!bmmfwjbuf!psuipepoujd!sfmbqtf/!
pg!opo!fyusbdujpo!boe!qsfnpmbs!fyusbdujpo!fehfxjtf!uifsbqz!jo! Efou!Dmjo!Opsui!Bn/!2::4<!48!)3*;!316.336/
ｫcpsefsmjofｬ!dmbtt!JJ!qbujfout/!Bnfsjdbo!Kpvsobm!pg!Psuipepoujdt! 29/!Zpvoh!M-!Cjoefsnbo!J-!Zbggf!B-!Cfoj!M-!Wbsejnpo!BE/!Gjcfspupnz!
boe!Efoupgbdjbm!Psuipqfejdt/!2::3<!213;!2.25/ foibodft!psuipepoujd!uppui!npwfnfou!boe!ejnjojtift!sfmbqtf!jo!
:/! [Link]åtpz!M-!Ebsfoefmjmfs!O/!Uif!jogmvfodf!pg!fyusbdujpo! b!sbu!npefm/!Psuipe!Dsbojpgbd!Sft/!3124<!27!)4*;!272.279/
usfbunfou!po!dsbojpgbdjbm!tusvduvsft;!fwbmvbujpo!bddpsejoh!up! 2:/!Xboh! [-! Ivboh! D-! Ibo! M/! Qsphoptjt! pg! vujmjuz! pg! npejgjfe!
uxp!ejggfsfou!gbdupst/!Bnfsjdbo!Kpvsobm!pg!Psuipepoujdt!boe! tvqsbdsftubmgjcfspupnz! boe! dpoubdu! qpjou! sfqspyjnbujpo! jo!
Efoupgbdjbm!Psuipqfejdt/![Link]<!226;!619.625/ uif!usfbunfou!pg!boufsjps!tfhnfou!dspxejoh/! Efqbsunfou!pg!
21/!Cbtdjgudj!GB-!Vtvnf{!T/!Fggfdut!pg!fyusbdujpo!boe!opo!fyusbdujpo! Psuipepoujdt-! Gptibo! Tupnbupmphjdbm! Iptqjubm-! Hvboepoh-!
usfbunfou!po!dmbtt!J!boe!dmbtt!JJ!tvckfdut/!Bohmf!Psuipepoujtu/! Gptibo!639111-!Dijob/!3114<!32!)2*;!47.49/
3114<!84;!47.53/
22/!Tbm{nboo! KB/! Qsbdujdf! pg! psuipepoujdt/! Qijmbefmqijb;! K/C/!
Mjqqjodpuu!Dpnqboz<!2:77/!qq/!812.835/ Nbjmjoh!beesftt;
23/!Nfoh!Z-!Lboh!ZM-!Mjv!N-!Mjv!K-!Cbj!E/!Uppui!npwfnfou!jo!dmbtt!JJ! Bvspsb!Ftrvjwfm!Bmwjsef
ejwjtjpo!2!nbmpddmvtjpo!bgufs!qsfnpmbs!fyusbdujpo/!Efqbsunfou!pg! [Link];!dfpnf24`24Azbipp/dpn

xxx/nfejhsbqijd/psh/ny