Orthodontic management of missing lateral incisor by miniscrew-anchored device

Congenitally missing teeth are one of the most common tooth anomalies associated to therapeutic sets of problems. Orthodontists should consider these clinical cases because management often requires an integrated orthodontic and restorative approach. In the present study authors reported a therapy note referred to a 14-year-old male patient affected by missing maxillary lateral incisors, bilateral dental Class II and deep bite, treated in 2009 at the Department of Orthodontics of the University of Messina. An orthodontic treatment has been planned with the aim of distalize maxillary molar and the following opening of the spaces necessary for the prosthetic restoration of missing lateral incisor. For the distalization of maxillary molars has been decided to use a Distal Jet supported by miniscrew (Distal-Screw, American Orthodontics, Sheboygan, WI, USA). After seven months of treatment with distal screw, maxillary molar distalization was completed, obtaining a bilateral molar Class I. A multi-bracket orthodontic appliance was bonded in the upper and lower arch using Empower Brackets (American Orthodontics). Class II molar relationship has been over-corrected to Class I in about seven months. The orientation of the force vector resulted in a tipping and rotation of the first molars, without significant vertical changes. Distal Jet reinforced with screws seems to be effective in molar distalization without any type of side effects. The advantages of this device were the absence of patient compliance, relatively predictable outcomes, favorable esthetics, possibility of different activations in each side.