Main Instructor Tzu-Ying Wu
Department / Institution Orthodontic section, Department of Stomatology, Veterans General Hospital, Taipei, Taiwan
Classification Case report
First molars are the earliest permanent teeth that erupt into occlusion and are prone to expose to caries and periodontal problems. In case with early missing of maxillary molar and with maxillary sinus pneumatization, space closure could also be a treatment plan.
This is a 24 years old female case with class III skeletal pattern (ANB=-1.5) due to maxillary retrognathism, anterior cross-bite, retroclined upper incisors with missing teeth (#23, 26, 46). Upper dental midline was shifted to left for 3.5 mm due to early missing tooth 23. Tooth 36 with large apical radiolucency and maxillary sinus pneumatization was noted.
Our treatment goal was to correct upper dental midline and anterior crossbite. On the other hand, the patient asked to close all of the extraction space and solve the problem of poor prognostic tooth #36. Therefore, we extracted #14 for crowding relief and midline correction. After anterior crossbite and dental midline was corrected, interdental screw were used to protract #24-27 and substitute #23-26. In the lower arch, tooth #36 and #46 extraction space were closed reciprocally. After treatment, the treatment goal was achieved, and the profile was improved.
Posterior teeth protraction may be accomplished under proper diagnosis and orthodontic mechanics planning, in this case, the protraction were achieve at quadrant two even with maxillary sinus pneumatization. Besides, the occlusal plane was maintained under these asymmetric teeth movement situation, the detailed mechanics will be illustrated in this case report.
Protraction of Maxillary Single Side Teeth for Substitution of Missing Canine and 1st Molar- A Case Report