{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:06:50Z","timestamp":1780067210435,"version":"3.54.0"},"reference-count":32,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This case report describes the nonsurgical management of a patient with a Class II skeletal pattern, retrognathic mandible, steep mandibular angle, maxillary vertical excess, and lip incompetence. The treatment approach involved orthodontic mechanics supported with skeletal anchorage to achieve maximal intrusion and retraction of the dentition. A novel elastic hanging rack appliance, supported by midpalatal miniscrews, was used. A maximal anchorage setup for active vertical control on both arches was illustrated. Significant improvement in the facial profile was achieved with optimal occlusion. Cephalometric analysis revealed successful incisor retraction and intrusion, as well as a forward rotation of the mandible. The treatment outcome illustrates the impact of active vertical control on orthodontic camouflage treatment for severe protrusion.<\/jats:p>","DOI":"10.2319\/041524-298.1","type":"journal-article","created":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T20:02:21Z","timestamp":1724270541000},"page":"227-239","source":"Crossref","is-referenced-by-count":3,"title":["Active vertical control with skeletal anchorage for optimizing facial profile in a severe Class II high-angle protrusion case"],"prefix":"10.2319","volume":"95","author":[{"given":"Johnny","family":"Liaw","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Huei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hou-Kun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Jane","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i1945-7103-95-2-227-b01","series-title":"Angle Orthod","first-page":"333","article-title":"Bimaxillary dentoalveolar protrusion: traits and orthodontic correction","volume":"75","author":"Bills","year":"2005","unstructured":"Bills\n              DA,\n            \n            \n              Handelman\n              CS,\n            \n            \n              BeGole\n              EA.\n            \n          \n          Bimaxillary dentoalveolar protrusion: traits and orthodontic correction. Angle Orthod. 2005;75:333\u2013339."},{"key":"i1945-7103-95-2-227-b02","series-title":"Semin Plast Surg","first-page":"32","article-title":"Bimaxillary protrusion: an overview of the surgical-orthodontic treatment","volume":"23","author":"Chu","year":"2009","unstructured":"Chu\n              YM,\n            \n            \n              Bergeron\n              L,\n            \n            \n              Chen\n              Y-R.\n            \n          \n          Bimaxillary protrusion: an overview of the surgical-orthodontic treatment. Semin Plast Surg. 2009;23:32\u201339. 20567723"},{"key":"i1945-7103-95-2-227-b03","series-title":"Am J Orthod Dentofacial Orthop Clin Companion","first-page":"245","article-title":"Treatment of a high angle protrusion case optimized with interdisciplinary approaches and TSADs","volume":"1","author":"Liaw","year":"2021","unstructured":"Liaw\n              JJ,\n            \n            \n              Park\n              JH,\n            \n            \n              Shih\n              IY,\n            \n            \n              Yang\n              SY,\n            \n            \n              Tsai\n              FF.\n            \n          \n          Treatment of a high angle protrusion case optimized with interdisciplinary approaches and TSADs. Am J Orthod Dentofacial Orthop Clin Companion. 2021;1:245\u2013258."},{"key":"i1945-7103-95-2-227-b04","series-title":"J Clin Orthod","first-page":"643","article-title":"Micro-implant anchorage for lingual treatment of a skeletal Class II malocclusion","volume":"35","author":"Lee","year":"2001","unstructured":"Lee\n              JS,\n            \n            \n              Park\n              HS,\n            \n            \n              Kyung\n              HM.\n            \n          \n          Micro-implant anchorage for lingual treatment of a skeletal Class II malocclusion. J Clin Orthod. 2001;35:643\u2013647."},{"key":"i1945-7103-95-2-227-b05","series-title":"Semin Orthod","first-page":"195","article-title":"Dentofacial asymmetry: non-surgical orthodontic treatment using extra-alveolar miniscrews","volume":"28","author":"de Almeida","year":"2022","unstructured":"de Almeida\n              MR.\n            \n          \n          Dentofacial asymmetry: non-surgical orthodontic treatment using extra-alveolar miniscrews. Semin Orthod. 2022;28:195\u2013211."},{"key":"i1945-7103-95-2-227-b06","series-title":"Am J Orthod Dentofacial Orthop Clin Companion","article-title":"Incisor torque recovery in a transfer case with iatrogenic perforation of the labial cortical plate","author":"Liaw","year":"2024","unstructured":"Liaw\n              JJ,\n            \n            \n              Wang\n              S-H,\n            \n            \n              Tsai\n              C-Y,\n            \n            \n              Yao\n              C-C,\n            \n            \n              Chen\n              Y-J,\n            \n            \n              Huang\n              G\n            \n            et al.\n          Incisor torque recovery in a transfer case with iatrogenic perforation of the labial cortical plate. Am J Orthod Dentofacial Orthop Clin Companion. 2024. In press."},{"key":"i1945-7103-95-2-227-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"978","article-title":"Nonsurgical correction using miniscrew-assisted vertical control of a severe high angle with mandibular retrusion and gummy smile in an adult","volume":"151","author":"Wang","year":"2017","unstructured":"Wang\n              X-D,\n            \n            \n              Zhang\n              J-N,\n            \n            \n              Liu\n              D-W,\n            \n            et al.\n          Nonsurgical correction using miniscrew-assisted vertical control of a severe high angle with mandibular retrusion and gummy smile in an adult. Am J Orthod Dentofacial Orthop. 2017;151:978\u2013988."},{"key":"i1945-7103-95-2-227-b08","series-title":"Temporary Anchorage Devices in Clinical Orthodontics","first-page":"647","article-title":"Application of TADs in an adult gummy smile case with vertical maxillary excess","author":"Liaw","year":"2020","unstructured":"Liaw\n              JJ.\n            \n          \n          Application of TADs in an adult gummy smile case with vertical maxillary excess. Temporary Anchorage Devices in Clinical Orthodontics. Wiley; 2020:647\u2013660."},{"key":"i1945-7103-95-2-227-b09","series-title":"Am J Orthod","first-page":"141","article-title":"The influence of lip thickness and strain on upper lip response to incisor retraction","volume":"82","author":"Oliver","year":"1982","unstructured":"Oliver\n              BM.\n            \n          \n          The influence of lip thickness and strain on upper lip response to incisor retraction. Am J Orthod. 1982;82:141\u2013149."},{"key":"i1945-7103-95-2-227-b10","series-title":"Angle Orthod","first-page":"562","article-title":"Torque control of maxillary anterior teeth with the double J retractor and palatal miniscrews during en masse retraction: a case report","volume":"92","author":"Liaw","year":"2022","unstructured":"Liaw\n              J,\n            \n            \n              Huang\n              G,\n            \n            \n              Tsai\n              F-F,\n            \n            \n              Wang\n              S-H,\n            \n            \n              Liao\n              W.\n            \n          \n          Torque control of maxillary anterior teeth with the double J retractor and palatal miniscrews during en masse retraction: a case report. Angle Orthod. 2022;92:562\u2013572."},{"key":"i1945-7103-95-2-227-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"554","article-title":"An unusual extraction pattern for retreatment in a patient with dental protrusion and a deficient soft-tissue chin","volume":"162","author":"Liaw","year":"2022","unstructured":"Liaw\n              JJ,\n            \n            \n              Wang\n              SH,\n            \n            \n              Tsai\n              BM.\n            \n          \n          An unusual extraction pattern for retreatment in a patient with dental protrusion and a deficient soft-tissue chin. Am J Orthod Dentofacial Orthop. 2022;162:554\u2013567."},{"key":"i1945-7103-95-2-227-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"264","article-title":"Vertical control of a Class II deep bite malocclusion with the use of orthodontic mini-implants","volume":"155","author":"Jung","year":"2019","unstructured":"Jung\n              MH.\n            \n          \n          Vertical control of a Class II deep bite malocclusion with the use of orthodontic mini-implants. Am J Orthod Dentofacial Orthop. 2019;155:264\u2013275."},{"key":"i1945-7103-95-2-227-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"493","article-title":"Approximation and contact of the maxillary central incisor roots with the incisive canal after maximum retraction with temporary anchorage devices: report of 2 patients","volume":"148","author":"Chung","year":"2015","unstructured":"Chung\n              CJ,\n            \n            \n              Choi\n              YJ,\n            \n            \n              Kim\n              K-H.\n            \n          \n          Approximation and contact of the maxillary central incisor roots with the incisive canal after maximum retraction with temporary anchorage devices: report of 2 patients. Am J Orthod Dentofacial Orthop. 2015;148:493\u2013502."},{"key":"i1945-7103-95-2-227-b14","series-title":"Orthod Craniofac Res","first-page":"59","article-title":"Incisive canal remodelling following maximum anterior retraction reduces apical root resorption","volume":"24","author":"Chung","year":"2021","unstructured":"Chung\n              CJ,\n            \n            \n              Nguyen\n              T,\n            \n            \n              Lee\n              JH,\n            \n            \n              Kim\n              KH.\n            \n          \n          Incisive canal remodelling following maximum anterior retraction reduces apical root resorption. Orthod Craniofac Res. 2021;24Suppl 1:59\u201365."},{"key":"i1945-7103-95-2-227-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"396","article-title":"Morphologic changes of the incisive canal and its proximity to maxillary incisor roots after anterior tooth movement","volume":"161","author":"Yu","year":"2022","unstructured":"Yu\n              JH,\n            \n            \n              Nguyen\n              T,\n            \n            \n              Kim\n              YI,\n            \n            \n              Hwang\n              S,\n            \n            \n              Kim\n              KH,\n            \n            \n              Chung\n              CJ.\n            \n          \n          Morphologic changes of the incisive canal and its proximity to maxillary incisor roots after anterior tooth movement. Am J Orthod Dentofacial Orthop. 2022;161:396\u2013403."},{"issue":"1","key":"i1945-7103-95-2-227-b16","series-title":"BMC Oral Health","first-page":"164","article-title":"Stability of vertical dimension following total arch intrusion","volume":"23","author":"Kang","year":"2023","unstructured":"Kang\n              DO,\n            \n            \n              Yu\n              HS,\n            \n            \n              Choi\n              SH,\n            \n            \n              Kim\n              ST,\n            \n            \n              Jung\n              HD,\n            \n            \n              Lee\n              KJ.\n            \n          \n          Stability of vertical dimension following total arch intrusion. BMC Oral Health. 2023;23(1):164."},{"key":"i1945-7103-95-2-227-b01","series-title":"Angle Orthod","first-page":"333","article-title":"Bimaxillary dentoalveolar protrusion: traits and orthodontic correction","volume":"75","author":"Bills","year":"2005","unstructured":"Bills\n              DA,\n            \n            \n              Handelman\n              CS,\n            \n            \n              BeGole\n              EA.\n            \n          \n          Bimaxillary dentoalveolar protrusion: traits and orthodontic correction. Angle Orthod. 2005;75:333\u2013339."},{"key":"i1945-7103-95-2-227-b02","series-title":"Semin Plast Surg","first-page":"32","article-title":"Bimaxillary protrusion: an overview of the surgical-orthodontic treatment","volume":"23","author":"Chu","year":"2009","unstructured":"Chu\n              YM,\n            \n            \n              Bergeron\n              L,\n            \n            \n              Chen\n              Y-R.\n            \n          \n          Bimaxillary protrusion: an overview of the surgical-orthodontic treatment. Semin Plast Surg. 2009;23:32\u201339. 20567723"},{"key":"i1945-7103-95-2-227-b03","series-title":"Am J Orthod Dentofacial Orthop Clin Companion","first-page":"245","article-title":"Treatment of a high angle protrusion case optimized with interdisciplinary approaches and TSADs","volume":"1","author":"Liaw","year":"2021","unstructured":"Liaw\n              JJ,\n            \n            \n              Park\n              JH,\n            \n            \n              Shih\n              IY,\n            \n            \n              Yang\n              SY,\n            \n            \n              Tsai\n              FF.\n            \n          \n          Treatment of a high angle protrusion case optimized with interdisciplinary approaches and TSADs. Am J Orthod Dentofacial Orthop Clin Companion. 2021;1:245\u2013258."},{"key":"i1945-7103-95-2-227-b04","series-title":"J Clin Orthod","first-page":"643","article-title":"Micro-implant anchorage for lingual treatment of a skeletal Class II malocclusion","volume":"35","author":"Lee","year":"2001","unstructured":"Lee\n              JS,\n            \n            \n              Park\n              HS,\n            \n            \n              Kyung\n              HM.\n            \n          \n          Micro-implant anchorage for lingual treatment of a skeletal Class II malocclusion. J Clin Orthod. 2001;35:643\u2013647."},{"key":"i1945-7103-95-2-227-b05","series-title":"Semin Orthod","first-page":"195","article-title":"Dentofacial asymmetry: non-surgical orthodontic treatment using extra-alveolar miniscrews","volume":"28","author":"de Almeida","year":"2022","unstructured":"de Almeida\n              MR.\n            \n          \n          Dentofacial asymmetry: non-surgical orthodontic treatment using extra-alveolar miniscrews. Semin Orthod. 2022;28:195\u2013211."},{"key":"i1945-7103-95-2-227-b06","series-title":"Am J Orthod Dentofacial Orthop Clin Companion","article-title":"Incisor torque recovery in a transfer case with iatrogenic perforation of the labial cortical plate","author":"Liaw","year":"2024","unstructured":"Liaw\n              JJ,\n            \n            \n              Wang\n              S-H,\n            \n            \n              Tsai\n              C-Y,\n            \n            \n              Yao\n              C-C,\n            \n            \n              Chen\n              Y-J,\n            \n            \n              Huang\n              G\n            \n            et al.\n          Incisor torque recovery in a transfer case with iatrogenic perforation of the labial cortical plate. Am J Orthod Dentofacial Orthop Clin Companion. 2024. In press."},{"key":"i1945-7103-95-2-227-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"978","article-title":"Nonsurgical correction using miniscrew-assisted vertical control of a severe high angle with mandibular retrusion and gummy smile in an adult","volume":"151","author":"Wang","year":"2017","unstructured":"Wang\n              X-D,\n            \n            \n              Zhang\n              J-N,\n            \n            \n              Liu\n              D-W,\n            \n            et al.\n          Nonsurgical correction using miniscrew-assisted vertical control of a severe high angle with mandibular retrusion and gummy smile in an adult. Am J Orthod Dentofacial Orthop. 2017;151:978\u2013988."},{"key":"i1945-7103-95-2-227-b08","series-title":"Temporary Anchorage Devices in Clinical Orthodontics","first-page":"647","article-title":"Application of TADs in an adult gummy smile case with vertical maxillary excess","author":"Liaw","year":"2020","unstructured":"Liaw\n              JJ.\n            \n          \n          Application of TADs in an adult gummy smile case with vertical maxillary excess. Temporary Anchorage Devices in Clinical Orthodontics. Wiley; 2020:647\u2013660."},{"key":"i1945-7103-95-2-227-b09","series-title":"Am J Orthod","first-page":"141","article-title":"The influence of lip thickness and strain on upper lip response to incisor retraction","volume":"82","author":"Oliver","year":"1982","unstructured":"Oliver\n              BM.\n            \n          \n          The influence of lip thickness and strain on upper lip response to incisor retraction. Am J Orthod. 1982;82:141\u2013149."},{"key":"i1945-7103-95-2-227-b10","series-title":"Angle Orthod","first-page":"562","article-title":"Torque control of maxillary anterior teeth with the double J retractor and palatal miniscrews during en masse retraction: a case report","volume":"92","author":"Liaw","year":"2022","unstructured":"Liaw\n              J,\n            \n            \n              Huang\n              G,\n            \n            \n              Tsai\n              F-F,\n            \n            \n              Wang\n              S-H,\n            \n            \n              Liao\n              W.\n            \n          \n          Torque control of maxillary anterior teeth with the double J retractor and palatal miniscrews during en masse retraction: a case report. Angle Orthod. 2022;92:562\u2013572."},{"key":"i1945-7103-95-2-227-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"554","article-title":"An unusual extraction pattern for retreatment in a patient with dental protrusion and a deficient soft-tissue chin","volume":"162","author":"Liaw","year":"2022","unstructured":"Liaw\n              JJ,\n            \n            \n              Wang\n              SH,\n            \n            \n              Tsai\n              BM.\n            \n          \n          An unusual extraction pattern for retreatment in a patient with dental protrusion and a deficient soft-tissue chin. Am J Orthod Dentofacial Orthop. 2022;162:554\u2013567."},{"key":"i1945-7103-95-2-227-b12","series-title":"Am J Orthod Dentofacial Orthop","first-page":"264","article-title":"Vertical control of a Class II deep bite malocclusion with the use of orthodontic mini-implants","volume":"155","author":"Jung","year":"2019","unstructured":"Jung\n              MH.\n            \n          \n          Vertical control of a Class II deep bite malocclusion with the use of orthodontic mini-implants. Am J Orthod Dentofacial Orthop. 2019;155:264\u2013275."},{"key":"i1945-7103-95-2-227-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"493","article-title":"Approximation and contact of the maxillary central incisor roots with the incisive canal after maximum retraction with temporary anchorage devices: report of 2 patients","volume":"148","author":"Chung","year":"2015","unstructured":"Chung\n              CJ,\n            \n            \n              Choi\n              YJ,\n            \n            \n              Kim\n              K-H.\n            \n          \n          Approximation and contact of the maxillary central incisor roots with the incisive canal after maximum retraction with temporary anchorage devices: report of 2 patients. Am J Orthod Dentofacial Orthop. 2015;148:493\u2013502."},{"key":"i1945-7103-95-2-227-b14","series-title":"Orthod Craniofac Res","first-page":"59","article-title":"Incisive canal remodelling following maximum anterior retraction reduces apical root resorption","volume":"24","author":"Chung","year":"2021","unstructured":"Chung\n              CJ,\n            \n            \n              Nguyen\n              T,\n            \n            \n              Lee\n              JH,\n            \n            \n              Kim\n              KH.\n            \n          \n          Incisive canal remodelling following maximum anterior retraction reduces apical root resorption. Orthod Craniofac Res. 2021;24Suppl 1:59\u201365."},{"key":"i1945-7103-95-2-227-b15","series-title":"Am J Orthod Dentofacial Orthop","first-page":"396","article-title":"Morphologic changes of the incisive canal and its proximity to maxillary incisor roots after anterior tooth movement","volume":"161","author":"Yu","year":"2022","unstructured":"Yu\n              JH,\n            \n            \n              Nguyen\n              T,\n            \n            \n              Kim\n              YI,\n            \n            \n              Hwang\n              S,\n            \n            \n              Kim\n              KH,\n            \n            \n              Chung\n              CJ.\n            \n          \n          Morphologic changes of the incisive canal and its proximity to maxillary incisor roots after anterior tooth movement. Am J Orthod Dentofacial Orthop. 2022;161:396\u2013403."},{"issue":"1","key":"i1945-7103-95-2-227-b16","series-title":"BMC Oral Health","first-page":"164","article-title":"Stability of vertical dimension following total arch intrusion","volume":"23","author":"Kang","year":"2023","unstructured":"Kang\n              DO,\n            \n            \n              Yu\n              HS,\n            \n            \n              Choi\n              SH,\n            \n            \n              Kim\n              ST,\n            \n            \n              Jung\n              HD,\n            \n            \n              Lee\n              KJ.\n            \n          \n          Stability of vertical dimension following total arch intrusion. BMC Oral Health. 2023;23(1):164."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/95\/2\/article-p227.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/angle-orthodontist\/article-pdf\/doi\/10.2319\/041524-298.1\/3488913\/i1945-7103-95-2-227.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/95\/2\/article-p227.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/95\/2\/article-p227.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:45:03Z","timestamp":1780065903000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/95\/2\/article-p227.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":32,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.2319\/041524-298.1","relation":{},"ISSN":["1945-7103","0003-3219"],"issn-type":[{"value":"1945-7103","type":"electronic"},{"value":"0003-3219","type":"print"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}