Class II treatment with the Runner in adolescent patients: Combining Twin Block efficiency with aligner aesthetics

Background: This case report describes the treatment of an 11-year-old boy with hypodivergent skeletal Class II, complete molar and canine Class II on the right and edge-to-edge relationship on the left, centered midlines, deep bite, and large over jet. Methods: The patient was treated with a Runner appliance, a series of clear aligners with embedded resin blocks that advance the mandible. This functional appliance was designed on the basis of the construction bite provided by the orthodontist and enables simultaneous incisor alignment to be achieved thanks to pre-programming during the digital setup. Results: After 12 months of treatment, executed by means of six pairs of aligners, the skeletal Class II was reduced, bilateral molar and canine Class I had been achieved, the bite had been opened, the over jet reduced, and the centered midlines preserved. The patient's profile was improved, the upper and lower incisors were well aligned, and adequate expansion had been achieved in the upper lateral sectors, as planned during setup. This result was made possible by the full compliance of the patient, who, thanks to the aesthetics and streamlined design of the Runner aligners, wore them for 22 h/day throughout the entire course of treatment. Conclusions: In this case, the Runner appliance was used with success for correcting Class II malocclusion in a young patient, with improvements in the patient's profile, alignment of the upper and lower incisors, and adequate expansion in the upper lateral sectors.