Maxillary molar distalization with first class appliance

Abstract

Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation.

Figure 1

Pretreatment facial photographs.

Figure 2

Pretreatment intraoral photographs.

Figure 3

Pretreatment lateral cephalogram and orthopantomogram.

Figure 4

Occlusal photograph with first class appliance.

Figure 5

Postdistalization occlusal photograph.

Figure 6

Converted to retention appliance.

Figure 7

Predistalization and postdistalization radiographs.

Figure 8

Intraoral photographs after levelling and alignment.

Figure 9

Extraoral photographs after levelling and alignment.