This report describes the treatment of a patient with a severe skeletal Angle Class II occlusion with a 14-mm overjet, crowding, and protrusion of the mandibular anterior teeth. The Class II relationship was caused mainly by a short corpus of the mandible. A fixed functional appliance was directly anchored on mini-implants, which were inserted in the mandible. A significant amount of mandibular advancement was achieved, with no protrusion of the mandibular anterior teeth. Facial esthetics improved considerably. This is the first patient report to demonstrate that mini-implants can be applied to anchor fixed functional appliances. The rationale to use mini-implants with fixed functional appliances and the potential benefits of this procedure are discussed. World J Orthod 2010;11:369–379.

Key words: mini-implants, fixed functional appliance, skeletal Class II, glenoid fossa, remodeling