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Dentoalveolar class III treatment using retromolar miniscrew anchorage.

Poletti L, Silvera AA, Ghislanzoni LT - Prog Orthod (2013)

Bottom Line: Extrusion should be prevented or minimized when treating long-faced patients with reduced overbite.In addition, there was an esthetic improvement in the profile with only a small increase of the lower anterior facial height.These results remained stable at a 12-month follow-up.

View Article: PubMed Central - PubMed

Affiliation: Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy. dottor.acca@gmail.com.

ABSTRACT
In this article, we report the successful use of miniscrews in the distalization of the lower dentition to correct an Angle class III malocclusion with lower anterior crowding in a dolichofacial adult patient. Conventional intraoral and extraoral appliances have many disadvantages, including the need for patient cooperation, potential for anchorage loss, and vertical extrusion of upper molars and lower incisors. Extrusion should be prevented or minimized when treating long-faced patients with reduced overbite. After third molar extractions, miniscrews were placed in the retromolar area. A sliding jig was applied to distalize the lower molars, while the anterior teeth were bonded and retracted secondarily to avoid round tripping. After 18 months of treatment, molar and canine class I relationship with normal overjet and overbite were achieved. In addition, there was an esthetic improvement in the profile with only a small increase of the lower anterior facial height. These results remained stable at a 12-month follow-up.

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Occlusal intraoral photographs during treatment showing progressive distalization. (A) At 2 months, (B) at 6 months, and (C) at 8 months.
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Fig4: Occlusal intraoral photographs during treatment showing progressive distalization. (A) At 2 months, (B) at 6 months, and (C) at 8 months.

Mentions: The upper and lower third molars were extracted 6 months before the start of the active treatment to allow for bone healing in the extraction area (Figure 3). Two 1.5-mm diameter miniscrews were then placed into the retromolar area (11 mm on the left and 14 mm on the right due to different soft tissue thickness). They were immediately loaded with light forces directed to the second molars. A segmented arch approach was used including both the lower molars and premolars (Figure 4A). The canines and incisors were excluded in the first distalizing phase of the treatment to avoid round tripping (proclination of the crowded incisors followed by retraction later in treatment).Figure 3


Dentoalveolar class III treatment using retromolar miniscrew anchorage.

Poletti L, Silvera AA, Ghislanzoni LT - Prog Orthod (2013)

Occlusal intraoral photographs during treatment showing progressive distalization. (A) At 2 months, (B) at 6 months, and (C) at 8 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384962&req=5

Fig4: Occlusal intraoral photographs during treatment showing progressive distalization. (A) At 2 months, (B) at 6 months, and (C) at 8 months.
Mentions: The upper and lower third molars were extracted 6 months before the start of the active treatment to allow for bone healing in the extraction area (Figure 3). Two 1.5-mm diameter miniscrews were then placed into the retromolar area (11 mm on the left and 14 mm on the right due to different soft tissue thickness). They were immediately loaded with light forces directed to the second molars. A segmented arch approach was used including both the lower molars and premolars (Figure 4A). The canines and incisors were excluded in the first distalizing phase of the treatment to avoid round tripping (proclination of the crowded incisors followed by retraction later in treatment).Figure 3

Bottom Line: Extrusion should be prevented or minimized when treating long-faced patients with reduced overbite.In addition, there was an esthetic improvement in the profile with only a small increase of the lower anterior facial height.These results remained stable at a 12-month follow-up.

View Article: PubMed Central - PubMed

Affiliation: Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy. dottor.acca@gmail.com.

ABSTRACT
In this article, we report the successful use of miniscrews in the distalization of the lower dentition to correct an Angle class III malocclusion with lower anterior crowding in a dolichofacial adult patient. Conventional intraoral and extraoral appliances have many disadvantages, including the need for patient cooperation, potential for anchorage loss, and vertical extrusion of upper molars and lower incisors. Extrusion should be prevented or minimized when treating long-faced patients with reduced overbite. After third molar extractions, miniscrews were placed in the retromolar area. A sliding jig was applied to distalize the lower molars, while the anterior teeth were bonded and retracted secondarily to avoid round tripping. After 18 months of treatment, molar and canine class I relationship with normal overjet and overbite were achieved. In addition, there was an esthetic improvement in the profile with only a small increase of the lower anterior facial height. These results remained stable at a 12-month follow-up.

Show MeSH
Related in: MedlinePlus