Patients with skeletal ClassⅡ hyperdivergent patterns often present with mandibular retrognathism, increased lower facial height, and excessive vertical dimension of occlusion, resulting in an unaesthetic facial profile and a higher incidence of temporomandibular disorder (TMD). Conventional treatments such as camouflage orthodontics with extraction or single-jaw surgery often struggle to achieve a balance between improving facial aesthetics and functional outcomes. In recent years, a treatment approach centered on counterclockwise rotation (CCR) of the mandible has gained attention. By adjusting the occlusal plane and mandibular position, this approach not only improves mandibular retrognathism and optimizes facial proportions but also helps reduce joint loading and alleviate TMD symptoms to some extent. This article systematically discusses the role of CCR in skeletal ClassⅡ hyperdivergent cases from perspectives such as biomechanical foundations, orthodontic and orthognathic treatment strategies, joint functional adaptation, and clinical applications, while also offering insights into its stability and future research directions.
