A novel approach for treatment of mandibular deficiency with vertical growth pattern.

This case illustrates the treatment of a 10.5-year-old girl with Class II Division I malocclusion and mandibular deficiency combined with vertical growth pattern. The patient was treated by a modified R-Appliance and extraction of upper and lower first bicuspids. Modified R-Appliance was used for 18 months followed by 17 months of Posterior bite plate, after which favorable correction of the malocclusion was observed. The SNB angle increased by 5 degrees and the IMPA decreased by 11 degrees. This case demonstrates that modified R-Appliance can be a suitable method for treatment of mandibular deficient cases with verticalgrowth pattern.