Nonextraction treatment in growing patients, with emphasis on distal movement

Abstract

The following points have been mentioned: 1. 1. Considerable space can be obtained by distal tipping of tipped-forward lower buccal teeth. 2. 2. It is possible to tip lower buccal teeth distally and have them upright with roots distal to where they had previously been. 3. 3. In properly treated cases, tipped-back lower molars will be uprighted in function by the forces of occlusion, with the roots going distally more than the crown moves forward. 4. 4. When a tip-back force is exerted by an arch wire, there must be a constant distal force to avoid anterior displacement of roots. 5. 5. In many crowded cases, it is not uncommon to discover that the lower molars are tipped mesially. 6. 6. When it is anticipated that Class II elastics will be used, it is very desirable that they be preceded by Class III elastics to prevent anterior cant of the occlusal plane. 5 7. 7. In deficiency cases with low ANB angles, we must be careful not to move point A distally with lingual root torque while at the same time attempting to make room for teeth in the lower arch. 8. 8. A stable upper arch exerts a restraining influence on tipped-back lower teeth being uprighted by the forces of occlusion. 9. 9. A mesial drift of molars is not inevitable in transition from a mixed to a permanent dentition. 10. 10. Lower teeth can be mechanically moved distally through the “leeway” space with likelihood of their staying there. 11. 11. The anterior-posterior position of the lower incisors in stable cases is one of the most permanent of all tooth positions. 12. 12. Lateral expansion of the second molar position causes very little increase in arch length. The amount of increase of the inside measurement 1 is not the same as the increase at the contact point. 13. 13. The basic limitations of treatment should always be respected in treatment planning.