Antero-posterior lingual sliding retraction system for orthodontic correction of hyperdivergent Class II protrusion

Abstract

BackgroundThis report introduces a lingual bonded retraction system (Kinematics of Lingual Bar on Non-Paralleling Technique, KILBON) for efficient sliding mechanics combined with vertical control of the anterior and posterior teeth, which is suitable for Class II hyperdivergent patients.MethodsDesign and biomechanics of the KILBON System were described. Two adults with hyperdivergent class II malocclusion were treated with the KILBON system and temporary skeletal anchorage devices (TSADs) on the palate. The first patient was treated with conventional KILBON system on the upper arch and detailed with lingual appliances. The second patient showed the modified design of the KILBON when applied to a low palatal vault.ResultsA large amount of intrusion and retraction of the anterior teeth and simultaneous intrusion of the posterior segment were achieved in short treatment time. Concomitant counterclockwise rotation of the mandible improved the esthetic profile. Periodontal support without dehiscence or bone loss was confirmed on anterior region in spite of large amount of retraction.ConclusionsThis report presented a lingual retraction system that provides simple and effective vertical and sagittal control of both anterior and posterior teeth. The biomechanics are dependable for correcting a dentoalveolar protrusion in a patient with Class II hyperdivergent skeletal pattern.

Displacement pattern of the anterior segment using antero-posterior lingual retractor combined with a palatal plate

“… 5 16 The location of the lever arm and tube, and tube angulation can be designed for each patient's problem list using the three-dimensional-computeraided design/computer-aided manufacturing method. 10 An adjustment of the tube position affects the amount of intrusion, independent of the height difference between the lever arm and the TSAD. To learn more about planning the three-dimensional effects of anterior segment retraction and positional change of point-A requires further cone-beam computed tomography research.…”

“…The antero-posterior lingual retractor (APLR) is a modified design in which the posterior segment sliding mechanics is added to the CLR ( Figure 1D-1F ). 9 10 This posterior sliding feature is expected to control canine movement and direct the translation of the anterior segment. The posterior teeth are splinted with buccal meshes to minimize any movement of these teeth.…”

“…The guide wires direct the anterior segment retraction course and prevent unwanted canine movement. 10 …”

“…A key strategy of lingual biocreative therapy is multipurpose biomechanics. 7 8 9 10 With the APLR, the posterior teeth are used for anchorage control, vector control, and vertical control. The guide bar and the posterior teeth can be intruded together by friction within the appliance.…”

“…The guide bar and the posterior teeth can be intruded together by friction within the appliance. 9 10 Friction occurs at the junction of the guide wires and the tubes as the retraction continues. It works by binding the guide wires and tube as one unit.…”