Mini-implants: mechanical resource for molars uprighting

Abstract

INTRODUCTION: The early orthodontic treatment allows correction of skeletal discrepancies by growth control, and the elimination of deleterious habits, which are risk factors for the development of malocclusions, favoring for the correction of tooth positioning later in a second treatment stage. During development of teeth and occlusion, the mandibular second molars commonly erupt in the oral cavity after all other teeth of the anterior region. In their eruptive process there may be a condition known as tooth impaction, which precludes its complete eruption and requires proper uprighting treatment. The temporary anchorage devices allow disimpaction and movement of these teeth directly to their final position, without the need of patient compliance or reaction movements in other parts of the arch. OBJECTIVE: This paper aims at describing a case report of the treatment of a patient with Angle Class II malocclusion, performed in two phases, in which mini-implants were used for uprighting the impacted mandibular second molars.

Open bite in adult patients

“…The following treatment alternatives could be considered: a) extracting teeth or distalizing the posterior mandibular teeth using skeletal anchorage [13][14][15] ; b) surgically-assisted rapid maxillary expansion (SARME) to improve the narrow maxilla 12 and conventional surgical orthodontic approach; c) bimaxillary surgery would combine Le Fort I for maxillary repositioning, counterclockwise rotation of the mandible and genioplasty [16][17][18][19] ; or d) early benefit surgery. The latter alternative was refused because it is not fully investigated [20][21][22] and because relapse after treatment of AOB is quite common.…”

Penggunaan Pir T-Loop Untuk Perbaikan I Gigi Molar Kedua Permanen Rahang Bawah

“…Pergerakan akar gigi ke arah mesial ini sedikit sulit untuk dicapai terutama ketika telah terjadi resorbsi tulang alveolar yang cukup banyak pada regio gigi yang hilang 2 . Terdapat banyak cara yang dapat digunakan untuk memperbaiki mesial tipping gigi molar, seperti penggunaan kawat lentur dengan ukuran besar, berbagai macam spring atau pir seperti helical spring, box-loop spring, T-Loop spring, dan lain-lain, penggunaan mini-implant (TAD), dan bahkan pada kasus mesial tipping dengan derajat sangat berat dapat dilakukan tindakan operasi 4,5,6 . Pir T-loop dan beberapa pir lain seperti tear drop loop, key hole loop,dan omega loop biasanya digunakan untuk retraksi anterior dengan mekanisme frictionless1.…”

Mandibular molar uprighting using orthodontic miniscrew implants: a systematic review

“…A tipped mandibular molar is a frequent situation among orthodontic patients, which usually occurs after premature loss of adjacent teeth leading to the inclination of the molars [ 1 , 2 ]. Inadequate mandibular arch length, excessive teeth size, loss of the adjacent first molar, premature eruption of the mandibular third molar, and unusually mesial eruption pathway of the second molar can also cause its partial or total impaction with a reported incidence of 0.03–0.3% of the general population and 2–3% of orthodontic patients [ 3 – 5 ].…”

“…Yet, an osseointegrated dental implant is costly, needs sufficient bone space, limiting our choices, and is very difficult to be removed after the treatment. It also requires osseointegration before orthodontic force application, increasing the treatment time [ 5 , 10 , 12 ].…”

“…Their main advantage though is their ability to move specific teeth or even the entire quadrants directly, without involving other teeth or using inter-arch mechanics. Thus, they eliminate the reaction forces usually applied on the anchor teeth, leading to unwanted tooth movement and anchorage loss [ 5 , 14 , 15 ]. Patients are also more satisfied with the more invisible treatment compared to conventional methods [ 10 ].…”