Saudi Journal of Oral and Dental Research (SJODR)
Volume-10 | Issue-10 | 411-420
Case Report
Simplifying Class II Treatment with IZC-Assisted Distalization: A Clinical Case
Hatem Hammouda, Takwa Mamlouk, Rihab Zairi, Sirine Fakhfakh, Anissa Elyemni Zinelabidine
Published : Oct. 29, 2025
Abstract
Background: Class II malocclusion is one of the most common orthodontic problems and often requires comprehensive treatment strategies. Conventional correction methods typically depend on high levels of patient compliance and may involve complex mechanics or extractions. The introduction of skeletal anchorage systems, particularly infrazygomatic crest (IZC) miniscrews, has provided an effective alternative for non-compliant and non-extraction cases. Objective: This case report aims to demonstrate the effectiveness of IZC-assisted en-masse distalization in correcting a Class II malocclusion Case Presentation: A 20-year-old female presented with a skeletal Class I malocclusion, Angle Class II relationship on the right side, right posterior crossbite, maxillary midline deviation, and proclined anterior teeth. Treatment objectives included correcting the midline, establishing Class I molar and canine relationships, resolving the crossbite, and improving facial esthetics. A passive self-ligating appliance system (Genius system) was used alongside skeletal anchorage via an IZC miniscrew to achieve en-masse distalization. A sequence of NiTi and stainless-steel archwires was used for alignment and torque control. Crossbite correction was achieved using flipped brackets, bite blocks, and criss-cross elastics. En-masse distalization was carried out using an IZC miniscrew and power arms to generate controlled force vectors. Final results showed successful correction of the Class II relationship, midline alignment, ideal overjet and overbite, and improved smile esthetics. Functional occlusion with proper guidance was also achieved. Conclusion: IZC miniscrew-supported distalization provides a reliable, compliance-independent solution for Class II correction. This approach offers excellent control of tooth movement, eliminates the need for extractions in many cases, and enhances both esthetic and functional outcomes with minimal patient cooperation.