Intrusion of Overerupted Upper First Molar Using Two Orthodontic Miniscrews

Abstract

Loss of the mandibular first molar often leads to the overeruption of the opposing maxillary first molar, resulting in occlusal interference, loss of periodontal bony support, and inadequate room to restore the mandibular edentulous space. Without orthodontic molar intrusion or segmental surgical impaction, restoring the posterior occlusion often entails the need for significant reduction of maxillary molar crown height, with the potential need for costly iatrogenic root canal therapy and restoration. The literature has cited successful maxillary molar intrusion with minor prosthodontic reduction using palatal orthodontic miniscrews and buccal zygomatic miniplates. In this report, the authors present successful maxillary molar intrusion with two orthodontic miniscrews in a patient with extreme dental anxiety and significant dental erosion due to gastric reflux. Using two orthodontic miniscrews for skeletal anchorage to intrude the maxillary molar simplified the orthodontic treatment by eliminating the need for extensive surgery, headgear, and intraoral multiunit anchorage and preserved indispensable tooth enamel. The clinical results showed significant intrusion through the maxillary sinus cortical floor while maintaining periodontal health, tooth vitality, and root length.