Incisor Retraction

This 16 yr old boy presented with a Class II division 1 malocclusion with an absent lower right 2nd molar, moderate anterior crowding, and both centrelines displaced to the left side. Therefore, it was ideal that both upper and lower right canines be retracted for both overjet reduction and centreline correction, but without loss of a further tooth from the lower right quadrant.

The treatment plan included extraction of the upper right 1st premolar and using a mini-implant, inserted buccal and mesial to the upper right 1st molar, for direct anchorage. Distalisation of the lower right buccal segment was undertaken using a mini-implant placed immediately mesial (and buccal) to the lower right 1st molar. One 1.5mm diameter, 9mm length Infinitas mini-implant was inserted in each right quadrant in a self-drilling manner, following initial perforation of the mandibular cortex using the Infinitas manual bone punch.

Elastic modules were used for direct retraction of the upper right canine and then the whole labial segment. In the lower arch, a laceback connected the mini-implant to the nearby canine bracket during initial alignment. Simultaneous distalisation of the posterior teeth occurred such that further active traction was not required in this quadrant.