A simple method for absolute bodily retraction and intrusion of incisors using a miniscrew-supported accentuated curve of Spee archwire

Abstract

• In patients requiring premolar extraction and maxillary incisor retraction with maximum anchorage, absolute bodily retraction and intrusion of the incisors could be achieved via incisor retraction using the temporary skeletal anchorage device–supported accentuated curve of Spee archwire. • The method of ligation of the first molar to the temporary skeletal anchorage device posteriorly changed the configuration of the regular accentuated curve of Spee archwire. It prevented any undesirable molar movements while exaggerating the incisor intrusive force creating a greater moment of couple that was able to balance the moment of force resulting from the distal retracting force applied at the level of the incisor brackets, enabling absolute bodily retraction and intrusion of the incisors. This article reports the camouflage treatment of an adolescent girl presented with a Class II Division 1 malocclusion on a severe Class II skeletal base. She had 11 mm overjet, 5 mm overbite, and a gummy smile. Her treatment plan included bilateral extraction of the maxillary first premolars followed by skeletally anchored retraction and intrusion of the maxillary incisors using buccal temporary skeletal anchorage devices (TSADs). Indirect skeletal anchorage was secured using a rigid wire connecting the maxillary molars to the TSADs. Closed nickel-titanium coil springs were used to retract canines into the extraction spaces. Maxillary incisor retraction was achieved using a continuous powerchain on 0.017 × 0.025-in stainless steel accentuated curve of Spee archwire. The total treatment time was 20 months. Her facial features were greatly improved. Cephalometric superimpositions revealed absolute bodily retraction and intrusion of the maxillary incisors. TSAD-supported accentuated curve of Spee offered a simple and comfortable method for bodily retraction and intrusion of the maxillary incisors with minimal side effects.