{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:59:23Z","timestamp":1784217563681,"version":"3.55.0"},"reference-count":30,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A patient with a Class II division 2 malocclusion is presented, illustrating the application of a modified double J retractor (DJR) and palatal miniscrews along with clear aligners to correct the malocclusion and normalize the incisor torque. In terms of incisor torque recovery, a nonextraction approach might be a good choice if the Class II correction could be successfully achieved with total arch distalization. When maxillary molar distalization was limited by anatomical boundaries, the treatment plan was changed to bilateral maxillary first premolar extractions, which led to even more retroclination of the maxillary incisors after space closure. Anterior interdental miniscrews were used to intrude the maxillary incisors. A modified DJR and palatal miniscrews were used to regain torque and achieve palatal root movement of the maxillary incisors. The treatment effects and biomechanical designs were evaluated for torque recovery of the retroclined maxillary incisors.<\/jats:p>","DOI":"10.2319\/071222-492.1","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T14:33:41Z","timestamp":1672151621000},"page":"357-371","source":"Crossref","is-referenced-by-count":7,"title":["Torque recovery of the maxillary incisors with a modified double J retractor in a Class II division 2 case treated with clear aligners"],"prefix":"10.2319","volume":"93","author":[{"given":"Johnny J. L.","family":"Liaw","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra K.","family":"Tai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-93-3-357-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"428","article-title":"Moments with the edgewise appliance: incisor torque control","volume":"103","author":"Isaacson","year":"1993","unstructured":"Isaacson\n              RJ,\n            \n            \n              Lindauer\n              SJ,\n            \n            \n              Rubenstein\n              LK.\n            \n          \n          Moments with the edgewise appliance: incisor torque control.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1993;103:428\u2013438."},{"key":"i0003-3219-93-3-357-b02","series-title":"AJO-DO Clin Companion","first-page":"152","article-title":"Use of temporary skeletal anchorage devices for intrusive root movement of maxillary incisors in adult patients with Class II division 2 malocclusion","volume":"2","author":"Lee","year":"2022","unstructured":"Lee\n              GH,\n            \n            \n              Park\n              JH,\n            \n            \n              Moon\n              D,\n            \n            \n              Lee\n              SM.\n            \n          \n          Use of temporary skeletal anchorage devices for intrusive root movement of maxillary incisors in adult patients with Class II division 2 malocclusion.\n\t\t\t\t\tAJO-DO Clin Companion.\n\t\t\t\t\t2022;2:152\u2013166."},{"key":"i0003-3219-93-3-357-b03","series-title":"Angle Orthod","first-page":"715","article-title":"Bidimensional techniques for stronger anterior torque control in extraction cases: a combined clinical and typodont study","volume":"82","author":"Li","year":"2012","unstructured":"Li\n              Y,\n            \n            \n              Tang\n              N,\n            \n            \n              Xu\n              Z,\n            \n            \n              Feng\n              X,\n            \n            \n              Yang\n              L,\n            \n            \n              Zhao\n              Z.\n            \n          \n          Bidimensional techniques for stronger anterior torque control in extraction cases: a combined clinical and typodont study.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2012;82:715\u2013722."},{"key":"i0003-3219-93-3-357-b04","series-title":"Angle Orthod","first-page":"679","article-title":"Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign","volume":"89","author":"Dai","year":"2019","unstructured":"Dai\n              FF,\n            \n            \n              Xu\n              TM,\n            \n            \n              Shu\n              G.\n            \n          \n          Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2019;89:679\u2013687."},{"key":"i0003-3219-93-3-357-b05","series-title":"Angle Orthod","first-page":"1023","article-title":"Locating the center of resistance of maxillary anterior teeth retracted by double J retractor with palatal miniscrews","volume":"80","author":"Jang","year":"2010","unstructured":"Jang\n              HJ,\n            \n            \n              Roh\n              WJ,\n            \n            \n              Joo\n              BH,\n            \n            \n              Park\n              KH,\n            \n            \n              Kim\n              SJ,\n            \n            \n              Park\n              YG.\n            \n          \n          Locating the center of resistance of maxillary anterior teeth retracted by double J retractor with palatal miniscrews.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2010;80:1023\u20131028."},{"key":"i0003-3219-93-3-357-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"351","article-title":"Orthodontic-surgical correction of a Class II, division 2 malocclusion","volume":"110","author":"Eliades","year":"1996","unstructured":"Eliades\n              T,\n            \n            \n              Hegdvedt\n              AK.\n            \n          \n          Orthodontic-surgical correction of a Class II, division 2 malocclusion.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1996;110:351\u2013357."},{"key":"i0003-3219-93-3-357-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"371","article-title":"Nonsurgical correction of skeletal deep overbite and Class II division 2 malocclusion in an adult patient","volume":"126","author":"Chen","year":"2004","unstructured":"Chen\n              YJ,\n            \n            \n              Yao\n              CJ,\n            \n            \n              Chang\n              HF.\n            \n          \n          Nonsurgical correction of skeletal deep overbite and Class II division 2 malocclusion in an adult patient.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2004;126:371\u2013378."},{"key":"i0003-3219-93-3-357-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"510","article-title":"Nonextraction treatment of severe class II, division 2 malocclusions: part 1","volume":"97","author":"Arvystas","year":"1990","unstructured":"Arvystas\n              MG.\n            \n          \n          Nonextraction treatment of severe class II, division 2 malocclusions: part 1.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1990;97:510\u2013521."},{"key":"i0003-3219-93-3-357-b09","series-title":"Am J Orthod Dentofacial Orthop","first-page":"74","article-title":"Nonextraction treatment of severe Class II, division 2 malocclusions: part 2","volume":"99","author":"Arvystas","year":"1991","unstructured":"Arvystas\n              MG.\n            \n          \n          Nonextraction treatment of severe Class II, division 2 malocclusions: part 2.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1991;99:74\u201384."},{"key":"i0003-3219-93-3-357-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"190","article-title":"Mandibular posterior anatomic limit for molar distalization","volume":"146","author":"Kim","year":"2014","unstructured":"Kim\n              SJ,\n            \n            \n              Choi\n              TH,\n            \n            \n              Baik\n              HS,\n            \n            \n              Park\n              YC,\n            \n            \n              Lee\n              KJ.\n            \n          \n          Mandibular posterior anatomic limit for molar distalization.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2014;146:190\u2013197."},{"key":"i0003-3219-93-3-357-b11","series-title":"Angle Orthod","first-page":"794","article-title":"Effectiveness of an anterior mini-screw in achieving incisor intrusion and palatal root torque for anterior retraction with clear aligners: a finite element study","volume":"91","author":"Liu","year":"2021","unstructured":"Liu\n              L,\n            \n            \n              Zhan\n              Q,\n            \n            \n              Zhou\n              J,\n            \n            \n              Kuang\n              Q,\n            \n            \n              Yan\n              X,\n            \n            \n              Zhang\n              X,\n            \n            et al.\n\t\t\t\t\t\n          Effectiveness of an anterior mini-screw in achieving incisor intrusion and palatal root torque for anterior retraction with clear aligners: a finite element study.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2021;91:794\u2013803."},{"key":"i0003-3219-93-3-357-b12","series-title":"Semin Orthod","first-page":"149","article-title":"A new treatment method to retract anterior teeth with the double J retractor system in Class III malocclusions","volume":"17","author":"Joo","year":"2011","unstructured":"Joo\n              BH.\n            \n          \n          A new treatment method to retract anterior teeth with the double J retractor system in Class III malocclusions.\n\t\t\t\t\tSemin Orthod.\n\t\t\t\t\t2011;17:149\u2013167."},{"key":"i0003-3219-93-3-357-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"796","article-title":"Esthetic orthodontic treatment with a double J retractor and temporary anchorage devices","volume":"141","author":"Park","year":"2012","unstructured":"Park\n              JH,\n            \n            \n              Tai\n              K,\n            \n            \n              Takagi\n              M,\n            \n            \n              Miyajima\n              K,\n            \n            \n              Kojima\n              Y,\n            \n            \n              Joo\n              B-H.\n            \n          \n          Esthetic orthodontic treatment with a double J retractor and temporary anchorage devices.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2012;141:796\u2013805."},{"key":"i0003-3219-93-3-357-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"592","article-title":"En-masse retraction of maxillary anterior teeth with the Double J retractor and palatal miniscrews: a case report","volume":"161","author":"Liaw","year":"2022","unstructured":"Liaw\n              J,\n            \n            \n              Tai\n              S,\n            \n            \n              Huang\n              G.\n            \n          \n          En-masse retraction of maxillary anterior teeth with the Double J retractor and palatal miniscrews: a case report.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2022;161:592\u2013601."},{"key":"i0003-3219-93-3-357-b15","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","volume":"92","author":"Liaw","year":"2022","unstructured":"Liaw\n              J,\n            \n            \n              Huang\n              G,\n            \n            \n              Tsai\n              FF,\n            \n            \n              Wang\n              SH,\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.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2022;92:562\u2013572."},{"key":"i0003-3219-93-3-357-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"428","article-title":"Moments with the edgewise appliance: incisor torque control","volume":"103","author":"Isaacson","year":"1993","unstructured":"Isaacson\n              RJ,\n            \n            \n              Lindauer\n              SJ,\n            \n            \n              Rubenstein\n              LK.\n            \n          \n          Moments with the edgewise appliance: incisor torque control.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1993;103:428\u2013438."},{"key":"i0003-3219-93-3-357-b02","series-title":"AJO-DO Clin Companion","first-page":"152","article-title":"Use of temporary skeletal anchorage devices for intrusive root movement of maxillary incisors in adult patients with Class II division 2 malocclusion","volume":"2","author":"Lee","year":"2022","unstructured":"Lee\n              GH,\n            \n            \n              Park\n              JH,\n            \n            \n              Moon\n              D,\n            \n            \n              Lee\n              SM.\n            \n          \n          Use of temporary skeletal anchorage devices for intrusive root movement of maxillary incisors in adult patients with Class II division 2 malocclusion.\n\t\t\t\t\tAJO-DO Clin Companion.\n\t\t\t\t\t2022;2:152\u2013166."},{"key":"i0003-3219-93-3-357-b03","series-title":"Angle Orthod","first-page":"715","article-title":"Bidimensional techniques for stronger anterior torque control in extraction cases: a combined clinical and typodont study","volume":"82","author":"Li","year":"2012","unstructured":"Li\n              Y,\n            \n            \n              Tang\n              N,\n            \n            \n              Xu\n              Z,\n            \n            \n              Feng\n              X,\n            \n            \n              Yang\n              L,\n            \n            \n              Zhao\n              Z.\n            \n          \n          Bidimensional techniques for stronger anterior torque control in extraction cases: a combined clinical and typodont study.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2012;82:715\u2013722."},{"key":"i0003-3219-93-3-357-b04","series-title":"Angle Orthod","first-page":"679","article-title":"Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign","volume":"89","author":"Dai","year":"2019","unstructured":"Dai\n              FF,\n            \n            \n              Xu\n              TM,\n            \n            \n              Shu\n              G.\n            \n          \n          Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2019;89:679\u2013687."},{"key":"i0003-3219-93-3-357-b05","series-title":"Angle Orthod","first-page":"1023","article-title":"Locating the center of resistance of maxillary anterior teeth retracted by double J retractor with palatal miniscrews","volume":"80","author":"Jang","year":"2010","unstructured":"Jang\n              HJ,\n            \n            \n              Roh\n              WJ,\n            \n            \n              Joo\n              BH,\n            \n            \n              Park\n              KH,\n            \n            \n              Kim\n              SJ,\n            \n            \n              Park\n              YG.\n            \n          \n          Locating the center of resistance of maxillary anterior teeth retracted by double J retractor with palatal miniscrews.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2010;80:1023\u20131028."},{"key":"i0003-3219-93-3-357-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"351","article-title":"Orthodontic-surgical correction of a Class II, division 2 malocclusion","volume":"110","author":"Eliades","year":"1996","unstructured":"Eliades\n              T,\n            \n            \n              Hegdvedt\n              AK.\n            \n          \n          Orthodontic-surgical correction of a Class II, division 2 malocclusion.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1996;110:351\u2013357."},{"key":"i0003-3219-93-3-357-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"371","article-title":"Nonsurgical correction of skeletal deep overbite and Class II division 2 malocclusion in an adult patient","volume":"126","author":"Chen","year":"2004","unstructured":"Chen\n              YJ,\n            \n            \n              Yao\n              CJ,\n            \n            \n              Chang\n              HF.\n            \n          \n          Nonsurgical correction of skeletal deep overbite and Class II division 2 malocclusion in an adult patient.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2004;126:371\u2013378."},{"key":"i0003-3219-93-3-357-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"510","article-title":"Nonextraction treatment of severe class II, division 2 malocclusions: part 1","volume":"97","author":"Arvystas","year":"1990","unstructured":"Arvystas\n              MG.\n            \n          \n          Nonextraction treatment of severe class II, division 2 malocclusions: part 1.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1990;97:510\u2013521."},{"key":"i0003-3219-93-3-357-b09","series-title":"Am J Orthod Dentofacial Orthop","first-page":"74","article-title":"Nonextraction treatment of severe Class II, division 2 malocclusions: part 2","volume":"99","author":"Arvystas","year":"1991","unstructured":"Arvystas\n              MG.\n            \n          \n          Nonextraction treatment of severe Class II, division 2 malocclusions: part 2.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1991;99:74\u201384."},{"key":"i0003-3219-93-3-357-b10","series-title":"Am J Orthod Dentofacial Orthop","first-page":"190","article-title":"Mandibular posterior anatomic limit for molar distalization","volume":"146","author":"Kim","year":"2014","unstructured":"Kim\n              SJ,\n            \n            \n              Choi\n              TH,\n            \n            \n              Baik\n              HS,\n            \n            \n              Park\n              YC,\n            \n            \n              Lee\n              KJ.\n            \n          \n          Mandibular posterior anatomic limit for molar distalization.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2014;146:190\u2013197."},{"key":"i0003-3219-93-3-357-b11","series-title":"Angle Orthod","first-page":"794","article-title":"Effectiveness of an anterior mini-screw in achieving incisor intrusion and palatal root torque for anterior retraction with clear aligners: a finite element study","volume":"91","author":"Liu","year":"2021","unstructured":"Liu\n              L,\n            \n            \n              Zhan\n              Q,\n            \n            \n              Zhou\n              J,\n            \n            \n              Kuang\n              Q,\n            \n            \n              Yan\n              X,\n            \n            \n              Zhang\n              X,\n            \n            et al.\n\t\t\t\t\t\n          Effectiveness of an anterior mini-screw in achieving incisor intrusion and palatal root torque for anterior retraction with clear aligners: a finite element study.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2021;91:794\u2013803."},{"key":"i0003-3219-93-3-357-b12","series-title":"Semin Orthod","first-page":"149","article-title":"A new treatment method to retract anterior teeth with the double J retractor system in Class III malocclusions","volume":"17","author":"Joo","year":"2011","unstructured":"Joo\n              BH.\n            \n          \n          A new treatment method to retract anterior teeth with the double J retractor system in Class III malocclusions.\n\t\t\t\t\tSemin Orthod.\n\t\t\t\t\t2011;17:149\u2013167."},{"key":"i0003-3219-93-3-357-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"796","article-title":"Esthetic orthodontic treatment with a double J retractor and temporary anchorage devices","volume":"141","author":"Park","year":"2012","unstructured":"Park\n              JH,\n            \n            \n              Tai\n              K,\n            \n            \n              Takagi\n              M,\n            \n            \n              Miyajima\n              K,\n            \n            \n              Kojima\n              Y,\n            \n            \n              Joo\n              B-H.\n            \n          \n          Esthetic orthodontic treatment with a double J retractor and temporary anchorage devices.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2012;141:796\u2013805."},{"key":"i0003-3219-93-3-357-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"592","article-title":"En-masse retraction of maxillary anterior teeth with the Double J retractor and palatal miniscrews: a case report","volume":"161","author":"Liaw","year":"2022","unstructured":"Liaw\n              J,\n            \n            \n              Tai\n              S,\n            \n            \n              Huang\n              G.\n            \n          \n          En-masse retraction of maxillary anterior teeth with the Double J retractor and palatal miniscrews: a case report.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2022;161:592\u2013601."},{"key":"i0003-3219-93-3-357-b15","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","volume":"92","author":"Liaw","year":"2022","unstructured":"Liaw\n              J,\n            \n            \n              Huang\n              G,\n            \n            \n              Tsai\n              FF,\n            \n            \n              Wang\n              SH,\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.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2022;92:562\u2013572."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/93\/3\/article-p357.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/angle-orthodontist\/article-pdf\/93\/3\/357\/3206744\/i0003-3219-93-3-357.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/93\/3\/article-p357.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/93\/3\/article-p357.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:29:13Z","timestamp":1780064953000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/93\/3\/article-p357.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":30,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.2319\/071222-492.1","relation":{},"ISSN":["1945-7103","0003-3219"],"issn-type":[{"value":"1945-7103","type":"electronic"},{"value":"0003-3219","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}