Abstract
Objective: When a first molar is lost, orthodontic replacement with second and third molars would be an excellent treatment option. There are some side effects that tend to occur during molar protraction, such as mesial tipping of molar that could increase the time required to correct. These side effects can be avoided by understanding the biomechanical variables affecting molar protraction. The author tries to present the modification of sliding jigs, instead of the power arm function, with additional of lingual force, for molar protraction.Methods: This case report describes the management of a 23-years-old woman who was missing left mandibular first molar, had class III skeletal profile, and anterior crossbite. After anterior crossbite correction, the left mandibular first molar extraction spaces were closed by protraction of the second and third molars. Mesial tipping was detected in the early protraction phase when using conventional method. Consequently, uprighting procedure was done and protraction was continued using reciprocal force generated by two sliding jigs and lingual buttons to achieve bodily movement of tooth.Results: The result was excellent, the space was closed without tipping and rotation.Conclusion: The presented article provides an alternative mechanic for molar protraction using sliding jigs and how it can be designed to achieve predictable result.
Highlights
The mandibular first molar is the most frequently damaged tooth due to caries.[1]
The space closure of the post extraction space of mandibular left molar was performed by protraction of the second molar using conventional method, that uses elastic chain placed on the buccal tube hook of the second molar to the anterior anchorage
The reciprocal forces generated by sliding jigs and lingual buttons in this case provide an alternative mechanics for molar protraction
Summary
The mandibular first molar is the most frequently damaged tooth due to caries.[1]. Some treatment options that are available after extraction of molar include implant, prosthese, and space closure using orthodontic devices.[2]. In the case of molar protraction, placing the power arm on the buccal tube can help to place a force close to the Cres so that a bodily movement can be obtained.[2,8]. Anterior retraction of the mandibular teeth was continued using elastic chain to cover the remaining extraction space of the mandibular right first premolar. The space closure of the post extraction space of mandibular left molar was performed by protraction of the second molar using conventional method, that uses elastic chain placed on the buccal tube hook of the second molar to the anterior anchorage. After the 6 months of treatment, the remaining space appeared to close, but tipping movement of second molar was detected figure 2. The progress was good and the treatment was still continued to correct the lower left third molar and left posterior cross bite figure 5A and figure 5B
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