This article describes the management of a case with severe Class II skeletal discrepancy treated with growth modification therapy. As the patient was in cervical vertebral maturation (CVM) stage 3, it was planned to make use of the remaining growth for correction of skeletal discrepancy and so treatment was initiated with a modified twin block with acrylic teeth incorporated in the anterior upper and lower appliance so as to motivate the patient.
This promoted the growth of the mandible, restrained maxilla in antero-posterior direction followed by alignment and leveling of the dentition with fixed appliance.
