Closure of anterior spacing with well-positioned incisors: Strategic molar protraction for long-term stability

Abstract

Patients with a normal inclination and properly positioned anterior teeth have a good balance of force between their lips and tongue even though they exhibit anterior spacing problems. If this balance is disrupted when the anterior teeth are retracted to close anterior spaces, there is a high probability that the anterior teeth will move forward over time, and improper spacing will reoccur. Therefore, to achieve long-term stability, the lingual movement of the anterior teeth should be minimized during space closure. The goal of anterior space closure with favorable inclination and positioning of the incisors should be to minimize retraction of the anterior teeth and promote mesial movement of the posterior teeth to maintain the stability of the anterior teeth and reduce the possibility of relapse. Using a combination of temporary skeletal anchorage devices and a transpalatal arch in the maxilla and temporary skeletal anchorage devices and nickel-titanium open-coil springs in the mandible, mesial movement of the canines and molars can be successfully achieved. • The patients had anterior spacing with favorable inclination and position of the incisors. • Space should be closed by protraction of posterior teeth for long-term stability. • Temporary skeletal anchorage devices with hole and assembly were used for molar protraction.