Molar distalisation with skeletal anchorage

Antonio Gracco, Lombardo Luca, Giuseppe Siciliani
Australian Orthodontic Journal 2007, 23 (2): 147-52

BACKGROUND: Distalisation of the upper molars can be used to treat a dental Class II deep bite malocclusion with a flat facial profile. It is a useful procedure when extraction treatment has been refused and providing distalisation is an appropriate solution to the patient's problem.

AIMS: To describe distalisation of the upper buccal segments using a modified distal jet appliance and miniscrew.

METHODS: Two case reports are presented. The first case was treated with a distal screw appliance: a modified distal jet appliance with a palatal miniscrew and without the premolar arms. The Nance button was anchored to the palatal bone by a miniscrew inserted through a posterior locating plate. Locating holes in the plate ensured that the miniscrew was inserted into a site with optimal bone in the posterior part of the palate. The second case was treated with a similar distal screw appliance, but in this case the locating plate was embedded in the acrylic button. The miniscrew was inserted through a prepared hole in the button and plate. The locating hole(s) ensured that a screw could be inserted into an optimal site to one side of the median palatal suture.

CONCLUSIONS: The distal screw appliance can be used to distalise upper teeth with minimal or no anchorage loss.

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