Intermaxillary Traction

This 15 year old boy presented with a Class II division 2 malocclusion, absent lower right 1st premolar and significant displacement of the lower centreline to the right side. Extraction of the upper right 1st premolar was then required to achieve a Class I buccal occlusion and incisor relationship. Initial fixed appliance treatment involved re-opening the lower right premolar space as the labial segment was advanced in order to normalise the lower centreline and reduce the deep overbite. Full anchorage support was then required for mesialisation of the lower molar teeth and subsequent use of class III traction (to preserve the upper centreline).

A 1.5mm diameter 9mm body length Infinitas mini-implant was inserted mesial to the lower right canine (once this tooth was in the correct position) following  simple manual perforation of the mandibular cortex using the Infinitas bone punch. Direct traction was applied to the 1st molar attachment hook using elastomeric modules until the 1st premolar space was closed. An inter-maxillary elastic was then worn full-time from the mini-implant to the upper right 1st molar hook. Hence, full control was achieved over space closure in relation to preserving the lower, and then the  upper centreline corrections.