Premolar Extraction Research Articles

Recovery bone formation on radiographic palatal bone dehiscences after incisor retraction with microimplants.

To investigate the difference in labial and palatal alveolar bone thickness and height during the retention period after incisor retraction treatment with microimplant. A sample of 21 patients (mean age: 17.80 ± 4.38 years) who underwent incisor retraction treatment using microimplants after premolar extraction was investigated. The cone-beam computed tomography images at pretreatment, posttreatment, and retention were used to measure anterior alveolar bone thickness (labial, palatal, and total; at three vertical levels) and height (labial and palatal) and differences in the incisor position during treatment or retention. Repeated-measures analysis of variance with Bonferroni correction was performed to compare the variables at T0, T1, and T2. The maxillary central incisor moved posteriorly by approximately 8.0 mm along with intrusive movement of 1.8 mm after treatment. The alveolar bone thickness significantly decreased on the palatal side and increased on the labial side after treatment. Thereafter, the palatal bone thickness significantly increased and labial bone thickness decreased during the retention period. The palatal interdental bone depressed by incisor retraction showed substantial bone deposition after retention. Radiographic palatal bone dehiscences on the incisor root and palatal bone depression between the incisor roots were apparent after treatment. This palatal bone loss around the incisor roots noticeably recovered with newly formed bone during retention.

Nasal profile changes after orthodontic tooth extraction in Class II, Division 1 malocclusion patients: A retrospective study

IntroductionThis study aimed to investigate changes in the facial soft-tissue profile, especially the nose, following fixed orthodontic treatment, with or without tooth extraction, in individuals diagnosed with dental Class II malocclusion. Materials and methodsCephalometric images of 81 individuals with dental Class II malocclusion who underwent fixed orthodontic treatment were assessed before and after treatment. The participants were categorized into three groups: non-extraction; upper first premolar extraction; and four first premolar extractions. The parameters measured were: upper lip height, upper lip to E-plane, lower lip to E-plane, lower lip height, nasolabial angle, nasomental angle, facial convexity, lower anterior face height, soft-tissue facial convexity, nasal tip angle, nasal bridge length, N′-nasal bridge point, nasal bone length, nasal bone angle, nasal depth, columella convexity, and nose height. ResultsWithin the upper two extraction group, there were significant increases at the start and end periods in nasolabial angle (P = 0.023), nasal depth Pr to Ac (P = 0.027), and nasal depth Pr to N-Prn (P = 0.040); and decreases in columella convexity (P = 0.010), upper lip to E-plane (P = 0.009), and nasomental angle (P = 0.009). There were significant results in comparisons between measurements based on the extraction status in the mean nasolabial angle (P = 0.011), mean columella convexity (P = 0.028), and mean lower lip to E-plane (P = 0.045). ConclusionOrthodontic treatment involving tooth extraction may potentially affect the nasolabial angle and nasal depth. During treatment planning, it is crucial to consider the potential changes that may occur to the nose and any alterations that may be needed to achieve the desired esthetic outcome.

Impact of orthodontic-induced facial morphology changes on aesthetic evaluation: a retrospective study

BackgroundThe profound influence of orthodontic treatments on facial aesthetics has been a topic of increasing interest. This study delves into the intricate interplay between orthodontic treatments, facial feature alterations, and aesthetic perceptions.MethodsA total of 73 patients who had undergone orthodontic treatment were included in this study. Facial photographs were taken before and after treatment. Ten orthodontists provided facial aesthetic ratings (FAR) for each patient's frontal, profile, and overall views. 48 facial landmarks were manually placed by the orthodontists and normalized using Generalized Procrustes analysis (GPA). Two types of phenotypes were derived from facial landmarks. Global facial phenotypes were then extracted using principal component analysis (PCA). Additionally, 37 clinical features related to aesthetics and orthodontics were extracted. The association between facial features and changes in FAR after orthodontic treatment was determined using these two types of phenotypes.ResultsThe FAR exhibited a high correlation among orthodontic experts, particularly in the profile view. The FAR increased after orthodontic treatment, especially in profile views. Extraction of premolars and orthognathic surgery were found to result in higher FAR change. For global facial phenotypes, the most noticeable changes in the frontal and profile views associated with FAR occurred in the lip area, characterized by inward retraction of the lips and slight chin protrusion in the profile view, as well as a decrease in lip height in the frontal view. The changes observed in the profile view were statistically more significant than those in the frontal view. These facial changes were consistent with the changes from orthodontic treatment. For clinical features, two profile features, namely pg.sm.hori and pg.n.ls, were found to be associated with FAR following orthodontic treatment. The highest FAR scores were achieved when pg.sm.hori was at 80° and pg.n.ls was at 8°. On the other hand, frontal clinical features had a subtle effect on FAR during orthodontic treatment.ConclusionsThis study demonstrated that orthodontic treatment improves facial aesthetics, particularly at lip aera in the profile view. Profile clinical features, such as pg.sm.hori and pg.n.ls, are essential in orthodontic treatment which could increase facial aesthetics.

Changes in the arch width and buccal corridor after fixed orthodontic treatment with Damon self-ligating system: premolar extraction vs. non-extraction.

Extraction vs. non-extraction is a crucial decision in orthodontic therapy. The aim of the present study was to investigate the changes in the dental arch width and buccal corridor after orthodontic treatment using extraction and non-extraction therapy with Damon self-ligating system. This retrospective study consisted of 35 patients (20 female and 15 male patients with median age of 12.5 years), treated by extracting 4 or 2 premolars, and 37 patients (16 female and 21 male patients with the median age of 12.8 years), treated without premolar extraction. Both groups were treated with Damon self-ligating system. Plaster models before (T0) and after (T1) treatment were measured, and the arch width values were determined at the level of the first molars, second premolars, canines and palatal rugae. Buccal corridor width was measured using the extraoral images at T0 and T1. Paired t-test was used for the analysis of the normally distributed data, and Wilcoxon Mann-Whitney U test was used for the data with non-normal distribution. Values of p<0.05 were set as statistically significant. The upper intercanine width increased significantly in both groups (p<0.01). In the non-extraction group, the arch width increased significantly in the maxillary second premolar and first molar region (p<0.01) as well as in the region of the canines (p=0.04), second premolars (p=0.01) and first molars (p<0.01) of the mandible. The buccal corridor decreased significantly in the non-extraction group (p<0.01). Premolar extraction in combination with Damon self-ligating system did not lead to reduction of the dental arch width in the maxilla, nor did it increase the size of the buccal corridors.

Cephalometric Evaluation of Soft-tissue Profile Changes in Class-II Division 1 Patients with Varied Growth Patterns Treated with all First Premolar Extractions: A Cross-sectional Study

Introduction: Knowledge of the facial skeleton and its overlying soft-tissue is essential in determining facial harmony. Additionally, an individual’s growth pattern may influence posttreatment facial profiles and needs to be considered during treatment planning. Aim: To evaluate the soft-tissue profile changes in treated Class-II malocclusion patients with varied mandibular growth patterns and to compare these changes with patients having a skeletal Class-I relationship and a balanced facial profile. Materials and Methods: The present cross-sectional cephalometric study was conducted in the Department of Orthodontics, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India, from June 2021 to December 2022. The study included 210 lateral cephalograms of 120 patients. The cephalograms were divided into four groups based on the Frankfort horizontal Mandibular plane Angle (FMA): Group-1 (control, n=30): skeletal Class-I (FMA=22°-28°); Group-2 (n=30): skeletal Class-II with a horizontal growth pattern (FMA&lt;22°); Group-3 (n=30): skeletal Class-II with an average growth pattern (FMA=22°-28°); and group-4 (n=30): skeletal Class-II with a vertical growth pattern (FMA&gt;28°). All patients in the groups2,3, and 4 were treated with all first premolar extractions using a 0.022˝ McLaughlin, Bennett and Trevisi (MBT) appliance. The student’s t-test and post-hoc test was used to analyse skeletal, dental and soft-tissue parameters using Statistical Package for the Social Sciences (SPSS) software (version 22.00 for Windows; SPSS Inc., Chicago, USA). Results: Of the total, 120 patients, 52 were males and 68 females with an age range of 18-28 years. On intergroup analysis, significant changes (p-value&lt;0.05) in the Sella, Nasion and A point (SNA) and Sella, Nasion and B point (SNB) angles were observed in group-3. Clinically insignificant changes were found in the A point, Nasion and B point (ANB) angle across all experimental groups. However, a significant change (p-value&lt;0.001) in the post-treatment ANB angle was observed in group-2, followed by group-3 and 4 when compared with group-1. The soft-tissue profile angle showed a significant change in Group-2 when compared with Group-1 (p-value=0.012). Conclusion: The post-treatment soft-tissue profiles of the experimental groups were comparable to the balanced profile of the control group patients.

Efficacy of 4% articaine with 1:100000 epinephrine versus 2% lignocaine with 1:100000 epinephrine in infiltration for extraction of maxillary premolars for orthodontic correction – A prospective, randomized, double-blind, crossover study

Background: Unlike other amide local anesthetics (LAs), articaine has better lipid solubility and potency. Very few studies have been done on comparing articaine with other LAs as buccal infiltration among the participants requiring paired extraction of maxillary premolars but limitations of those studies include smaller sample size, lack of washout periods, and diversity in study designs. Aims and Objectives: This study compares the anesthetic efficacy of 4% articaine (1:100,000 epinephrine) with 2% lidocaine (1:100,000 epinephrine) as buccal infiltration. Materials and Methods: This is a randomized double-blinded crossover study conducted at the Department of Oral and Maxillofacial Surgery in collaboration with the Department of Pharmacology, SRIHER, Chennai. This study was done on 59 participants on an outpatient basis. The selected participants received 4% articaine or lignocaine with epinephrine (1:100000) in the mucobuccal fold at the maxillary area during their first visit and the same individual received the other local anesthetic drug on the other side in the same area during the second visit, i.e., 1 week from the date of the first visit. All the statistics were calculated using the software Statistical Package for the Social Sciences 16 version. For all primary and secondary outcomes in the study, the Mann–Whitney U-test was employed to compute the mean and standard deviation. Results: The total mean age of the participants included was 21.69. The volume of drug required was 1.578 ± 0.2760 mL for articaine and 2.2068 ± 0.0984 ml for lignocaine. The onset time was 30–45 s with articaine and 75–90 s with lignocaine. A decrease in pain scores was seen in the articaine group compared to the lignocaine group. Conclusion: This study showed better efficacy of articaine in comparison to lignocaine. Articaine may replace lignocaine in orthodontic corrections with its higher efficacy, faster action, and longer duration.

Effect of Four I. Premolar and Upper Two I. Premolar Extraction on Hard and Soft Tissues in Skeletal Class II Camouflage Treatment

Effect of Four I. Premolar and Upper Two I. Premolar Extraction on Hard and Soft Tissues in Skeletal Class II Camouflage Treatment

Early implant placement in sites with ridge preservation or spontaneous healing: histologic, profilometric, and CBCT analyses of an exploratory RCT.

The aim of this study was to compare changes in soft and hard tissue and the histologic composition following early implant placement in sites with alveolar ridge preservation or spontaneous healing (SH), as well as implant performance up to 1 year after crown insertion. Thirty-five patients with either intact buccal bone plates or dehiscence of up to 50% following single-tooth extraction of incisors, canines, or premolars were included in the study. They were randomly assigned to undergo one of three procedures: deproteinized bovine bone mineral with 10% collagen (DBBM-C) covered by a collagen matrix (DBBM-C/CM), DBBM-C alone, or SH. At 8 weeks, implant placement was carried out, and cone-beam computed tomography scans and impressions were obtained for profilometric analysis. Patients were followed up after the final crown insertion and again at 1 year post-procedure. Within the first 8 weeks following tooth extraction, the median height of the buccal soft tissue contour changed by -2.11 mm for the DBBM-C/CM group, -1.62 mm for the DBBM-C group, and -1.93 mm for the SH group. The corresponding height of the buccal mineralized tissue changed by -0.27 mm for the DBBM-C/CM group, -2.73 mm for the DBBM-C group, and -1.48 mm for the SH group. The median contour changes between crown insertion and 1 year were -0.19 mm in the DBBM-C/CM group, -0.09 mm in the DBBM-C group, and -0.29 mm in the SH group. Major vertical and horizontal ridge contour changes occurred, irrespective of the treatment modality, up to 8 weeks following tooth extraction. The DBBM-C/CM preserved more mineralized tissue throughout this period, despite a substantial reduction in the overall contour. All 3 protocols led to stable tissues for up to 1 year.

Micro-osteoperforation for enhancement of orthodontic movement: A mechanical analysis using the finite element method.

Micro-osteoperforation is a minimally invasive technique aimed at accelerating tooth movement. The goal of this novel experimental study was to assess tooth movement and stress distribution produced by the force of orthodontic movement on the tooth structure, periodontal ligament, and maxillary bone structure, with and without micro-osteoperforation, using the finite element method. Cone-beam computed tomography was used to obtain a virtual model of the maxilla and simulate the extraction of right and left first premolars. Three micro-osteoperforations (1.5 x 5 mm) were made in the hemiarch on the distal and mesial surfaces of upper canines, according to the power tip geometry of the Propel device (Propel Orthodontics, Ossining, New York, USA). An isotropic model of the maxilla was fabricated according to the finite element method by insertion of mechanical properties of the tooth structures, with orthodontic force (1.5 N) simulation in the distal movement on the upper canine of a hemiarch. Initial movement was larger when micro-osteoperforations were performed on the dental crown (24%) and on the periodontal ligament (29%). In addition, stress distribution was higher on the bone structure (31%) when micro-osteoperforations were used. Micro-osteoperforations considerably increased the movement of both the dental crown and periodontal ligament, which highlights their importance in the improvement of orthodontic movement, as well as in stress distribution across the bone structure. Important stress absorption regions were identified within micro-osteoperforations.

Effect of orthodontic premolar extraction on maxillary teeth angulation and arch dimensions in adolescent patients: A 3-D digital model analysis.

Therapeutic orthodontic premolar extraction is a common orthodontic treatment, yet the extent of its impact on the upper dental arch dimensions and teeth angulations is still under exploration. Hypothesis: We postulated that the therapeutic extraction of orthodontic premolars significantly alters the orientation of teeth and the dimensions of the dental arch. Objective: This study assessed the impact of therapeutic orthodontic premolar extraction on dental arch dimensions and tooth angulations. We conducted a retrospective cohort study involving 30 patients who underwent bilateral upper premolar extraction and fixed appliance treatment. Pre and post-treatment dental casts were scanned, and changes in tooth angulations and arch dimensions were evaluated using 3D digital maxillary models. Statistical analyses encompassed the application of paired samples t-test. Significant post-treatment changes were observed, including distal tipping in anterior teeth, minor mesial tipping in first molars, and a reduction in torque for central incisors and canines. Dental arch dimensions were also influenced, with increased width and depth between the canines and decreased width between the second premolars while inter-molar width and overall arch depth significantly reduced post-treatment. Therapeutic orthodontic premolar extraction significantly affects dental arch dimensions and tooth angulations. These findings have implications for treatment planning and predicting changes associated with orthodontic treatments involving premolar extraction. Key words:3D digital models - orthodontic premolar extraction - teeth angulation - dental arch dimensions.

Surgery combined with orthodontic treatment for bilateral horizontally impacted mandibular second molars: A case report

Abstract Surgery combined with orthodontic uprighting of impacted mandibular second molars requires sequential treatment procedures. This article presents a rare case of horizontally impacted bilateral mandibular second molars accompanied by dental crowding. The patient’s mandibular second molars were fully embedded in bone with overlying mesially-impacted mandibular third molars and the mandibular first molars were inclined distally. The treatment involved staged bilateral extraction of the second premolars and mandibular third molars, followed by the surgical implantation of micro-implants for anchorage in the mandibular ramus. At a subsequent stage, the mandibular second molars were successfully orthodontically uprighted, leading to a favourable treatment outcome.

Comparison of the Mini-plate and Mini-screw for Retraction of Anterior Teeth in Severe Bimaxillary Protrusion Cases with Extraction of First Bicuspids: A Protocol for Randomised Controlled Trial

Comparison of the Mini-plate and Mini-screw for Retraction of Anterior Teeth in Severe Bimaxillary Protrusion Cases with Extraction of First Bicuspids: A Protocol for Randomised Controlled Trial

Valuation of the Effect of Premolar Extractions in the Context of Orthodontic Treatment on Vas: A Systematic Review of the Literature

Valuation of the Effect of Premolar Extractions in the Context of Orthodontic Treatment on Vas: A Systematic Review of the Literature

COMPARISON OF OVERALL AND POSTERIOR BOLTON RATIOS OF SKELETAL CLASS II MALOCCLUSION BEFORE AND AFTER DIFFERENT COMBINATIONS OF FOUR PREMOLAR EXTRACTIONS IN A PAKISTANI POPULATION

Objectives: To fi nd whether diff erent premolar extraction patterns change the overall Bolton ratio from 91.30%, and the posterior Bolton ratio from 105.27% among the Pakistani population in a skeletal class II malocclusion.Materials and Methods: This Quasi Experimental study was conducted at at the Orthodontics Department of Khyber College of Dentistry, Peshawar on 30 dental models of skeletal class II patients. A Digital Vernier Caliper was used to measure the mesiodistal widths of the teeth me-sial to the second molar. Overall and posterior Bolton ratios were calculated before and after hypothetical extractions of the premolars. One-sample-t test was used to see if there was any significant diff erence between the overall and posterior Bolton ratios of the Bolton study and our study. Paired-samples-t test was used to fi nd the change in Bolton ratios before and after extractions. P value of ≤0.05 was considered signifi cant.Results: The mean overall and posterior Bolton ratios were 91.57±1.21% and 103.36±2.82%, respectively. Following premolars’ extractions in the pattern: all fi rst premolars, upper first with lower second premolars, upper second with lower fi rst premolars and all second premoalrs, the overall ratio decreased signifi cantly (p &lt;0.05) to 90.29±1.54%, 90.55±1.61%, 89.47±1.62% and 89.72±1.59%, respectively, whereas the posterior ratio for all fi rst premolars and upper fi rst with lower second premolar extractions increased signifi cantly to 105.27±3.18% and 105.88±3.71% (p &lt;0.05).Conclusion: Premolar extractions in skeletal class II malocclusion cause a signifi cant decrease in the overall Bolton ratio. The all fi rst premolars and upper fi rst with lower second premolar extractions pattern cause a signifi cant increase in the posterior Bolton ratio.

Analysis of Bolton Ratios in Skeletal Class I Malocclusion and Effects of Various Four-Premolar Extraction Combinations Before and After Treatment

This study was conducted to find whether different premolar extraction patterns lead to a change in the Overall Bolton ratio from 0.91 and the Posterior Bolton ratio from 1.05, among the Pakistani population in a skeletal class I malocclusion. This quasi-experimental study took place in Khyber College Of Dentistry, Peshawar. Dental plaster models of the patients with skeletal class 1 malocclusion were collected. A Digital Vernier Caliper was used to calculate the Bolton's ratios. The Bolton ratios were again calculated after hypothetical extractions of all the 1st premolars (4/4), all 5s, upper 4s and lower 5s, and upper 5s and lower 4s. The sample consisted of 12 males and 18 females. The change in Overall Bolton ratios was statistically significant for 4s extractions. For the Posterior Bolton ratio, the 4/4 and 4/5 extraction patterns were significant. Taking out the premolar teeth leads to a statistically significant but clinically insignificant reduction in the Posterior and Overall Bolton ratios in Skeletal class I malocclusion.

Screening for the risk of canine impaction, what are the presumptive signs and how does it affect orthodontics? A cross-sectional study in France.

The treatment of impacted canines is a challenge for orthodontists. The availability of suggestive clinical signs has become crucial for treatment before the potential for evolution ceases. The main objective was to evaluate the prevalence of the suspected displaced canine (SDC) and to highlight factors easily identifiable from the oral examination. SDC was assessed on panoramic X-rays, on the basis of the angle with the median sagittal plane and the degree of overlap with the permanent lateral incisor. Its association with mesio-distal tooth and palate widths was assessed by univariate analysis. Next, the association of SDC with temporary tooth extraction, expansion and/or premolar extraction was considered using the same modality. In this retrospective study, the records of 292 patients aged 7 to 13 years were reviewed. SDC was detected in 39% of patients i.e., 28,8% of observed canines. Reduced coronal mesio-distal diameters of permanent maxillary central incisors, 8.7 ± 0.6 mm versus 8.8 ± 0.7 mm (p < .05), and first permanent molars, 10.0 ± 0.7 mm versus 10.2 ± 0.7 mm (p < .001), as well as reduced inter-molar width, 38.7 ± 2.7 mm versus 39.4 ± 2.9 mm (p < .01), were predictive factors. SDC led orthodontists to indicate extraction of maxillary primary canines, OR = 3,32 (p < .001) or even extraction of premolars, OR = 1,66 (p < .05). This study confirmed the interest of panoramic X-rays in detected canines at risk of SDC. Dental factors can be combined to make screening more reliable and predict impaction that makes orthodontics complex. Opinion n°21.131, dated 09.21.2021, retrospectively registered.

Treatment outcome comparison of Invisalign vs fixed appliance treatment in first premolar extraction patients

In this study, we compared the dentitional changes after Invisalign and conventional orthodontic treatment with 4 first premolar extractions. This retrospective study included 57 patients whose orthodontic treatment involved the extraction of 4 first premolars because of bialveolar protrusion. A total of 27 patients were treated with Invisalign (mean age, 25.5 ± 5.2 years) and 30 patients with the fixed appliance (mean age, 24.4 ± 5.8 years). The angular and linear changes of the maxillary and mandibular central incisors, second premolars, first molars, and second molars were measured from the recordings on the basis of the lateral cephalograms taken before and after treatment. The angular changes of the canines and second premolars were measured using panoramic radiographs. The overbite and interincisal angle increased significantly in the Invisalign group compared with in the conventional fixed appliance group (P<0.05). The maxillary central incisors showed increased lingual tipping in the Invisalign group (P<0.05), whereas there was no statistically significant difference in the angular change of the mandibular incisors between groups (P>0.05). The maxillary first and second molars showed mesial tipping in the Invisalign group (P<0.05). The maxillary second premolars, first and second molars, and the mandibular second molars showed mesial movement in the Invisalign group (P<0.05). The Invisalign group showed more statistically significant lingual tipping of the maxillary central incisors, distal tipping of the maxillary canines, and mesial tipping of the maxillary first and second molars after maximum retraction of the anterior teeth compared with the fixed appliance group.

Comparative Evaluation of the Local Anesthetic Action of Tramadol Hydrochloride With Adrenaline Versus Lidocaine Hydrochloride With Adrenaline for Maxillary Exodontia: A Randomized Control Trial

Tramadol hydrochloride (T-HCl) has demonstrated to have a local anesthetic effect similar to lidocaine hydrochloride (L-HCl) when administered locally for minor oral surgical procedures. Our study aimed to compare the anesthetic effect of T-HCl versus L-HCl in maxillary premolar extraction. The study is a split-mouth, double-blind randomized clinical trial at the Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, India. The study sample was composed of patients referred for maxillary bicuspid extraction. Patients were excluded from the sample if, allergic to the study drugs, pregnant or lactating females, and smokers. The variable is an anesthetic drug administered for local anesthesia and it is grouped into 2 categories, T-HCl and L-HCl. A supraperiosteal infiltration of T-HCl with adrenaline on one side and L-HCl with adrenaline on the contralateral side was injected. The primary outcome variable was profound anesthesia of T-HCl, where the patient sensed the loss of sensation of touch, temperature, and pain. Secondary outcomes were onset and duration of anesthesia, intraoperative pain, postoperative analgesia, and adverse reactions, were recorded. Inferential statistics, the χ2 Test, the Mann-Whitney Test, and the Wilcoxon signed-rank test were used to compare the parameters. The level of significance was set at ≤ 0.05. A total of 40 patients were included, and 80 teeth were extracted. Profound anesthesia was achieved in all the cases. The mean subjective duration of anesthesia in the T-HCl and L-HCl groups was 130.80±20.01minutes and 111.40±14.87minutes, respectively, with a P value of .001. The mean Visual Analogue Scale (VAS) score for pain during the procedure in the T-HCl and L-HCl groups was 0.60±0.67 and 1.10±0.71, respectively, with a P value of .002. The mean Visual Analogue Scale score for pain postoperatively in the T-HCl and L-HCl groups was 0.70±0.72 and 1.40±0.67, respectively, with a P value of .001. Six patients in T-HCl required postoperative analgesia when compared to 18 patients in L-HCl (Pvalue < .003). T-HCl provides similar anesthetic outcomes in the extraction of maxillary bicuspids as L-HCl.

Extraction of four premolars in hyperdivergent individuals, does it help? -A case report

Treatment of any malocclusion requires careful diagnosis and treatment planning to resolve aesthetic, occlusal, and functional problems. Premolar extractions in orthodontics, over the years has been carried out to relieve dental crowding and affect incisor inclination. Clinicians’ decisions on premolar extractions and the extraction patterns have been influenced by desired anchorage control or changes to the vertical dimension. The introduction of mini-screw skeletal anchorage systems has broadened our horizons by giving us complete control over the anchorage as well as good vertical control. However, this case report shows the vertical control and the anchorage achieved using the low-lying transpalatal arch. The use of basic armamentarium along with avoiding an invasive procedure, provides an equally efficacious treatment outcome.

Class III orthodontic camouflage: A case of non-growing patient using conventional appliances

This case report details the successful orthodontic camouflage treatment of a 21-year-old female with Angle's Class III malocclusion, characterized by skeletal and dental features. The patient opted against orthognathic surgery and, instead, underwent mandibular first premolar extraction for camouflage treatment. The case highlights the careful consideration of treatment options, including the decision to maintain a Class III molar relationship. The treatment achieved satisfactory results in skeletal, dental, and soft tissue aspects, demonstrating the viability of camouflage treatment for mild to moderate Class III malocclusions. The absence of established guidelines underscores the importance of personalized treatment planning for such cases.