Use of the intraosseous screw for unilateral upper molar distalization and found well balanced occlusion

Head & Face Medicine, Nov 2006

Background The aim of this study was to present a temporary anchorage device with intraosseous screw for unilateral molar distalization to make a space for the impacted premolar and to found well balanced occlusion in a case. Case presentation A 13-year-old male who have an impacted premolar is presented with skeletal Class I and dental Class 2 relationship. The screw was placed and immediately loaded to distalize the left upper first and second molar. The average distalization time to achieve an overcorrected Class I molar relationship was 3.6 months. There was no change in overjet, overbite, or mandibular plane angle measurements. Mild protrusion (0.5 mm) of the upper left central incisor was also recorded. Conclusion Immediately loaded intraosseous screw-supported anchorage unit was successful in achieving sufficient unilateral molar distalization without anchorage loss. This treatment procedure was an alternative treatment to the extraction therapy.

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Use of the intraosseous screw for unilateral upper molar distalization and found well balanced occlusion

Head & Face Medicine Use of the intraosseous screw for unilateral upper molar distalization and found well balanced occlusion Ibrahim Erhan Gelgor 2 Ali Ihya Karaman 1 Tamer Buyukyilmaz 0 0 Cukurova University, Faculty of Dentistry, Department of Orthodontics , Adana , Turkey 1 Selcuk University, Faculty of Dentistry, Department of Orthodontics , Konya , Turkey 2 Kirikkale University, Faculty of Dentistry, Department of Orthodontics , Kirikkale , Turkey Background: The aim of this study was to present a temporary anchorage device with intraosseous screw for unilateral molar distalization to make a space for the impacted premolar and to found well balanced occlusion in a case. Case presentation: A 13-year-old male who have an impacted premolar is presented with skeletal Class I and dental Class 2 relationship. The screw was placed and immediately loaded to distalize the left upper first and second molar. The average distalization time to achieve an overcorrected Class I molar relationship was 3.6 months. There was no change in overjet, overbite, or mandibular plane angle measurements. Mild protrusion (0.5 mm) of the upper left central incisor was also recorded. Conclusion: Immediately loaded intraosseous screw-supported anchorage unit was successful in achieving sufficient unilateral molar distalization without anchorage loss. This treatment procedure was an alternative treatment to the extraction therapy. - Background In the treatment of Angle Class II malocclusions, with well-aligned lower teeth and a mandible in sagitally normal position, upper anterior crowding and excessive overjet can be treated with either distalization or extraction of upper posterior teeth. Newly developed orthodontic mechanics and their ease of application enabled widespread use of nonextraction therapies[1]. Conventional extraoral appliances are usually used for supporting maxillary molar anchorage or for distalization purposes. However, patient cooperation is a serious problem that has to be dealt with and moreover, orthodontic mechanics requiring minimal patient cooperation are desirable [2,3]. A number of treatment protocols that minimize the need for patient compliance have been suggested previously [4-12]. These techniques effectively distalize the maxillary molars, however, in most of these studies anchorage loss is unavoidable characterized by maxillary incisor protrusion, an increase in overjet, and decrease in overbite [6,7,11]. In recent years, studies have been directed toward the use of osseointegrated implants [3,12-14], onplants [15], and intraosseous screws [1] as anchorage units in orthodontic patients. Use of intraosseous screws for temporary orthodontic anchorage devices is a new area of research [1,3,16]. Creekmore and Eklund [16] used a Vitallium screw for intrusion of the upper incisors. Park et al [17] successfully used maxillary microscrews for treatment of openbite malocclusion. Liou et al [18] and Park et al [19,20] carried out en masse distalization of upper and lower posterior teeth using microscrew implant anchorage. In our previous study [1], we prepared an anchorage unit for bilateral upper molar distalization by placing an intraosseous screw in twenty five cases. During the following 4.6 months, both the first and second molars were distalized into an overcorrected Class I relationship without major anchorage loss. The aim of this study was to present use of the intraosseous screw for unilateral upper molar distalization in a case. Case presentation A 13-year-old male presented skeletal Class I relationship. The patient's profile was mild convex. Vertical facial proportions were normal, and there were no significant asymmetries (Figure 1). A full complement of permanent teeth was present except left lower first molar. There was a huge caries in the lower right first molar. Upper left second premolar was impacted. In centric occlusion canine relationships were Class I, and the incisors were in teeth a teeth relation. Both the maxillary and the mandibular arches exhibited moderate teeth disorderliness. Oral hygiene was moderate (Figures 2, and 3). In pretreatment cephalometric evaluation (Figure 4, Table 1); the maxilla was normal to the cranial base (SNA 86), and in centric occlusion the mandible was normal position to the cranial base (SNB 84). The ANB (2) indicated a Class I skeletal relationship. The maxillary incisors were slightly upright, while the mandibular incisors were PFrigeturreeat2ment intraoral photographs of the patient Pretreatment intraoral photographs of the patient. somewhat protrusive. The mandibular plane was normal relative to cranial base (SN-MP 31). Treatment objectives 1. to establish Class I molar relationship. 2. to eliminate maxillary and mandibular arch disorders. 3. to erupt upper left second premolar because of the patient's rejection of surgically extraction of the impacted premolar. 4. to correct overbite, and overjet. 5. to align arches including midlin (...truncated)


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Ibrahim Gelgor, Ali Karaman, Tamer Buyukyilmaz. Use of the intraosseous screw for unilateral upper molar distalization and found well balanced occlusion, Head & Face Medicine, 2006, pp. 38, 2, DOI: 10.1186/1746-160X-2-38