Tooth Movements and Fixation Without the Use of Fixed Appliances

Both of these adult patients required orthognathic surgery, but inter-maxillary fixation (IMF) from fixed appliances was contra-indicated because of insufficiet root lengths and periodontal support. Consequently, multiple mini-implants were inserted intra-operatively in both arches for immediate bone-supported IMF (shown here using powerchain fixation). These remained in situ post-operatively until it was clear that no remedial traction was required.

The first patient then required intrusion of an over-erupted upper canine so that the lower arch could be levelled post-operatively. Two 1.5mm diameter, 6mm body length mini-implants were inserted mesial and distal to this canine, and powerchain  intrusive traction utilised. Subsequently an inter-maxillary elastic was used to extrude the lower buccal teeth, whilst the canine intrusion was allowed to relapse slightly.