Abstract
Extraction has traditionally been necessary to correct bimaxillary and lip protrusion with proclined maxillary and mandibular incisors. However, non-extraction treatment using temporary skeletal anchorage devices (TSADs) is now an option for severe overjet or full-step Class II malocclusions. It is possible to treat bimaxillary protrusion with non-extraction, but for successful non-extraction treatment in bimaxillary patients, the amount of total arch distalization of the mandibular dentition is crucial.For maximum total mandibular arch distalization in protrusion patients, it is recommended to extrude and distalize the molars simultaneously, which results in more posterior movement of the mandibular dentition without gingival impingement. Therefore, this paper presents efficient biomechanics, a strategy, and the anatomy of the retromolar area for total arch distalization using TSADs to improve facial profile without extracting premolars in Class II maxillary and bimaxillary protrusion patients.
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