Closing mandibular first molar spaces in adults

Adult orthodontic patients with missing mandibular first molars and large spaces to close have challenged orthodontists for many decades. Most of the techniques previously used to close such spaces have rendered equivocal results that typically result in compromised treatment. The mandibular protraction appliance offers orthodontic clinicians a method to close those spaces by bringing the mandibular second molars forward without retracting the mandibular incisors. This presents a method for managing large mandibular spaces without resorting to prosthetic replacements.