Patient selection and follow up flow chart.
skeletal Class II malocclusion, systemic disorders, orthodontic, overjet
Selection criteria included skeletal Class II malocclusion, at least – Class II molar and canine relationship, Cervical Vertebrae Maturity Index (CVMI) confirming circumpubertal phase of skeletal development, average or horizontal growth pattern, no crowding in the maxillary arch, minimal crowding (<3mm) in the mandibular arch, and overjet greater than 5mm but less than 8mm. Patients with history of previous orthodontic treatment, systemic disorders, or syndromic cases were excluded from the study. Finally, 17 subjects presented with bilateral Class II molar relationship, 14 had bilateral – Class II molar, 15 had Class II molar on one side and – Class II molar on the other side. 