Titanium screw anchorage for protraction of mandibular second molars into first molar extraction sites

This report describes the orthodontic treatment of a 20-year-old woman with missing mandibular first molars. Titanium screws were placed in the buccal alveolar bone between the roots of the first and second premolars to provide absolute anchorage for protraction of the second molars into the atrophic edentulous areas. More than 8 mm of protraction was done in 15 months without significant lingual tipping of the incisors. Increases in alveolar ridge width and vertical bone height were noted mesial to the second molar. Good posterior occlusion was achieved and has been maintained for 1 year after active treatment.