Vertical-dimension control during en-masse retraction with mini-implant anchorage

Vertical dimension control with fixed appliance mechanotherapy has always been a matter of concern in moderate to severe high-angle patients with severe proclination of the anterior teeth. Extrusion of the posterior teeth is an inevitable sequela of conventional mechanics in such patients, especially if they are adults. This article reports on 3 patients who were treated with mini-implants (diameter, 1.3 mm; length, 8 mm) placed between the roots of the second premolar and the first molar for en-masse retraction of the anterior teeth. The biomechanical force system that developed not only maintained absolute anchorage, but also provided effective control over the posterior dentoalveolar dimension so that dramatic improvement in facial esthetics could be achieved. Small but significant autorotation of the mandible was noted; this led to increased chin prominence in all 3 patients. With accurate diagnosis and treatment planning, mini-implant anchorage can be a possible alternative to orthognathic surgery in similar borderline patients.