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Non-extraction camouflage treatment using extra-alveolar skeletal anchorage

Young-Jun Lee
Young-Jun Lee
, 
Jae Hyun Park
Jae Hyun Park
, 
Na-Young Chang
Na-Young Chang
, 
Kang-Gyu Lee
Kang-Gyu Lee
 y 
Jong-Moon Chae
Jong-Moon Chae
   | 27 ene 2022
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Publicado en línea: 27 ene 2022
Páginas: 63 - 73
Recibido: 01 nov 2021
Aceptado: 01 ene 2022
DOI: https://doi.org/10.21307/aoj-2022.007
© 2022 Young-Jun Lee et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Pre-treatment photographs, dental casts and radiographs.
Pre-treatment photographs, dental casts and radiographs.

Figure 2

Pre-treatment cone-beam computed tomography. Top: (A) Frontal view, (B) Submentovertical view. The lower images are coronal section views showing the molar scissor-bite: (C) Severe buccal tipping of the maxillary right second molar, (D) Severe lingual tipping of the mandibular right second molar, (E) Normal buccolingual angulation of the maxillary left first molar and severe lingual tipping of the mandibular left first molar, (F) Normal buccolingual angulation of the maxillary left second molar and severe lingual tipping of the mandibular left second molar.
Pre-treatment cone-beam computed tomography. Top: (A) Frontal view, (B) Submentovertical view. The lower images are coronal section views showing the molar scissor-bite: (C) Severe buccal tipping of the maxillary right second molar, (D) Severe lingual tipping of the mandibular right second molar, (E) Normal buccolingual angulation of the maxillary left first molar and severe lingual tipping of the mandibular left first molar, (F) Normal buccolingual angulation of the maxillary left second molar and severe lingual tipping of the mandibular left second molar.

Figure 3

Treatment progress intraoral photographs and cone-beam computed tomographic images. (A, B) Three-dimensional key plate (3DKP) with transpalatal WAVE wire and extension arms for distalisation and palatal uprighting of the maxillary molars, fixed orthodontic appliance for levelling of the mandibular dentition, and miniscrews in the buccal shelf for distalisation, buccal uprighting and intrusion of the mandibular molars. (C) Finishing.
Treatment progress intraoral photographs and cone-beam computed tomographic images. (A, B) Three-dimensional key plate (3DKP) with transpalatal WAVE wire and extension arms for distalisation and palatal uprighting of the maxillary molars, fixed orthodontic appliance for levelling of the mandibular dentition, and miniscrews in the buccal shelf for distalisation, buccal uprighting and intrusion of the mandibular molars. (C) Finishing.

Figure 4

Post-treatment photographs, dental casts and radiographs.
Post-treatment photographs, dental casts and radiographs.

Figure 5

Superimposition of the lateral cephalograms at pre-treatment (black), post-treatment (red), 1 year post-treatment (green).
Superimposition of the lateral cephalograms at pre-treatment (black), post-treatment (red), 1 year post-treatment (green).

Figure 6

Superimposition. Cone-beam computed tomography (CBCT) images at pre-treatment (red) and post-treatment (green): (A) Sagittal and coronal views of the right side (a, first molars; b, second molars); (B) Sagittal and coronal views of the left side (c, first molars; b, second molars). Dental casts at pre-treatment (yellow) and post-treatment (blue): (C) Maxilla; (D) Mandible.
Superimposition. Cone-beam computed tomography (CBCT) images at pre-treatment (red) and post-treatment (green): (A) Sagittal and coronal views of the right side (a, first molars; b, second molars); (B) Sagittal and coronal views of the left side (c, first molars; b, second molars). Dental casts at pre-treatment (yellow) and post-treatment (blue): (C) Maxilla; (D) Mandible.

Figure 7

Posterior available space: (A) Pre-treatment of the manxilla (presence of the maxillary right third molar); (B) Post-treatment of the maxilla; (C) Pre-treatment of the mandible; (D) Post-treatment of the mandible.
Posterior available space: (A) Pre-treatment of the manxilla (presence of the maxillary right third molar); (B) Post-treatment of the maxilla; (C) Pre-treatment of the mandible; (D) Post-treatment of the mandible.

Figure 8

Post-treatment photographs and radiographs at 12 months.
Post-treatment photographs and radiographs at 12 months.

Figure 9

3-dimensional key plate (3DKP) and various types of transpalatal WAVE wire with extension arms. (A) Molar distalisation using the WAVE wire. (B) Molar mesialisation using the transpalatal WAVE wire (T-WAVE). (C) Asymmetric molar movement with modified WAVE wire (M-WAVE). Schematic diagram of two different lines of action for total distalisation of the maxillary dentition using the three-dimensional key plate (3DKP): (D) For bodily movement (yellow elastomers); (E) For intrusive movement (green elastomers).
3-dimensional key plate (3DKP) and various types of transpalatal WAVE wire with extension arms. (A) Molar distalisation using the WAVE wire. (B) Molar mesialisation using the transpalatal WAVE wire (T-WAVE). (C) Asymmetric molar movement with modified WAVE wire (M-WAVE). Schematic diagram of two different lines of action for total distalisation of the maxillary dentition using the three-dimensional key plate (3DKP): (D) For bodily movement (yellow elastomers); (E) For intrusive movement (green elastomers).

Figure 10

Digital set-up model.
Digital set-up model.

Figure 11

Cone-beam computed tomographic images to identify the labial alveolar bone thickness: (A) Pre-treatment; (B) Post-treatment.
Cone-beam computed tomographic images to identify the labial alveolar bone thickness: (A) Pre-treatment; (B) Post-treatment.

Cephalometric measurements.

Measurement Norm Pretreatment Posttreatment 1 year posttreatment
SNA (°) 81.6 80.1 80.1 80.1
SNB (°) 79.1 75.4 74.8 74.8
ANB (°) 2.4 4.7 5.3 5.3
Wits (mm) −2.7 −1.7 −1.5 −2.2
SN-MP (°) 33.3 38.9 39.0 39.0
FH-MP (°) 24.2 31.0 31.2 31.3
U1-SN (°) 107.0 100.8 101.6 100.8
U1-FH (°) 116.0 110.6 111.7 110.6
OPA (°) 14.0 16.5 17.9 18.9
U1-NA (°) 25.2 21.7 23.1 21.4
IMPA (°) 95.9 93.3 102.8 102.9
L1-NB (°) 28.4 27.5 36.5 36.7
U1/L1 (°) 124.0 130.6 117.5 117.0
Overbite (mm) 2.3 3.6 1.7 1.8
Overjet (mm) 3.2 4.2 2.8 2.9
NLA (°) 100.0 93.6 91.1 95.3
UL/EL (mm) −1.0 0.4 1.7 1.2
LL/EL (mm) 2.0 1.8 3.4 2.0

Dental arch width changes (mm).

Pretreatment Posttreatment Difference
Intercanine width
  Maxilla 36.5 34.8 −1.7
  Mandible 23.5 26.8 +3.3
Interpremolar width (at first premolar)
  Maxilla 39.0 42.3 +3.3
  Mandible 30.7 35.4 +4.7
Intermolar width (at first molar)
  Maxilla 44.4 45.7 +1.3
  Mandible 39.0 46.7 +7.7
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