This patient had previous surgical exposure of the U1s and removal of very hypoplastic 7s. The treatment plan was not finalized until the U1s aligned, when it became clear that she needed over-jet reduction (without use of class II traction) and correction of ¼ and ½ unit class II buccal segment relationships. Therefore, 1.5mm screws were inserted at the age of 14 years, palatally and mesial to U6 palatal roots, for (asymmetrical) distalisation of buccal segments (via hooks on U4s) and then, indirectly, the incisors. This demonstrates the benefit of a stent for accurate insertion of palatal implants, and flexibility of this approach for distalisation of up to ½ unit.
