Maxillary En-Masse Distalization for Correction of Class II Malocclusion Using Infra-Zygomatic Crest (IZC) Bone Screws: A Case Report

Animesh Gupta, Rajan K. Mahindra, Dhitika Handa, Rakesh Mohode

Abstract: Objective: To demonstrate the clinical effectiveness of infra-zygomatic crest (IZC) bone screws for en- masse distalization of the maxillary dentition in the correction of Class II malocclusion. Case Description: A 17 year old male presented with a Class II malocclusion, characterized by proclined upper incisors and increased overjet. The patient was diagnosed as having Skeletal Class II bases with maxillary excess, bilateral full cusp Cl II molar relation, average growth pattern, proclined maxillary incisors, increased overjet, deep bite and protrusive upper and lower lips. The patient desired a non-extraction, esthetic treatment plan. En-masse distalization of the maxillary dentition was achieved using infra-zygomatic crest bone screws as extra-alveolar anchorage. Treatment Progress: Two IZC screws were placed bilaterally in the posterior maxilla. A pre-adjusted edgewise appliance (0.022" slot) was used, and distalizing force was applied with closed coil springs connected to a crimpable hook anterior to the canines. Maxillary molars and anterior teeth were moved distally as a unit. Treatment duration was 20 months. Results: Class I molar and canine relationships were achieved with improved incisor inclination and smile aesthetics with a balanced soft tissue profile. No significant root resorption or screw failure was observed. Conclusion: IZC bone screws provided effective skeletal anchorage for maxillary en-masse distalization, offering a non-extraction, compliance-independent option approach for Class II correction in adults.

Keywords: Temporary Skeletal Anchorage Devices (TSADs) Infrazygomatic Crest (IZC) bone screw, En-masse distalization Zygomatic crest, Extra-alveolar (EA) implants, Class II Correction

How to Cite?: Animesh Gupta, Rajan K. Mahindra, Dhitika Handa, Rakesh Mohode, "Maxillary En-Masse Distalization for Correction of Class II Malocclusion Using Infra-Zygomatic Crest (IZC) Bone Screws: A Case Report", Volume 14 Issue 11, November 2025, International Journal of Science and Research (IJSR), Pages: 1862-1868, https://www.ijsr.net/getabstract.php?paperid=SR251127105334, DOI: https://dx.doi.org/10.21275/SR251127105334