Management of missing second premolars using miniscrews: an elective solution for critical anchorage conditions

Growing patients with congenital missing second premolars should be accurately evaluated in order to establish an appropriate treatment plan. The decision whether to close or maintain spaces in dental arches caused by missing teeth should be based on the consideration of biomechanical factors and the aesthetic traits of individual patients. Accordingly, the choice of closing spaces requires an adequate consideration of biomechanical principles in order to avoid detrimental effects on the occlusion and profile. The effective use of titanium miniscrews for immediate loading, combined with efficient sliding mechanics, represents an elective way of successfully treating such cases. The aim of this article is to describe the procedure and highlight its advantages by giving details of a clinical case coupled with the results of a long-term follow-up.