Distalization of the entire maxillary arch in an adult

Seung-Hyun Kyung, Joo Yong Lee, Ji Won Shin, Christine Hong, Victor Dietz, Anthony A Gianelly
American Journal of Orthodontics and Dentofacial Orthopedics 2009, 135 (4): S123-32
Many appliances are available to move maxillary molars distally. First molars have routinely been moved distally with nickel-titanium coil springs and nickel-titanium wire before the eruption of the second molars. However, when first molars are moved distally after the eruption of the second molars, they tend to move slowly, and anchorage loss increases. In adults, the midpalatal area is appropriate for placing titanium miniscrews for orthodontic anchorage. This case report demonstrates the ability of midpalatal miniscrews to control anchorage while distalizing the entire maxillary dentition in an adult, with improvements in lip profile resulting from the retraction of anterior teeth followed by a good response of the lips. This report suggests that absolute anchorage can be established by placing miniscrews in the palate and that miniscrew anchorage can serve as anchorage for the distal movement of an entire arch.

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