Distalisation of the dental arches using clear aligners and miniscrews

Purpose and methods: The distalisation of molars using clear aligners has been found to be achievable; however, the distalisation of an entire arch is still an orthodontic challenge and reported as only clinically possible using fixed appliances. To date, there has been no study on the distalisation of both dental arches using a clear aligner system. In the present report, a case is described in which the entire maxillary and mandibular arches were successfully distalised using clear aligners and miniscrews for the treatment of a bimaxillary protrusion malocclusion in a 22-year-old female patient. Pre- and post-treatment records as well as 1.5-year follow-up records are presented.

Results: The distalisation of both dental arches was achieved using a V-pattern staging process by moving the second molars, then the first molars, followed by the premolars and the anterior teeth, as well as by elastics applied between precision cutouts in the aligners and the miniscrews. The dental arches were efficiently distalised by approximately 3 millimeters in the first molar areas after 13 months of treatment. A review 1.5 years post-treatment showed that the outcome was stable without significant relapse observed in the facial profile and occlusion.

Conclusion: The distalisation of both dental arches is achievable using clear aligner systems by applying elastics between miniscrews and precision aligner cutouts in the treatment of a bimaxillary protrusion malocclusion.