Objective: To pull up the borderline during non-extraction treatment is one of the most challenging tasks facing an orthodontist. Recently, TADs have been used for perfect stable anchorage during edgewise treatment. The range of orthodontic posterior tooth movement is broadened using implant anchorage. This case report describes considered limitation of orthodontic treatment applied TADs for distal movement.
Cases: This 25.5 years old female presented with Class III molar relationship on a Class III skeletal base with increased mandibular plane angle. Severe crowding was recognized at anterior teeth on mandibular arch. The overjet was +2.0mm, and the overbite was +3.0mm. The mandibular incisors were retroclined. This patient was diagnosed with Angle Class III malocclusion with anterior crowding. TADs were placed at lower oblique line region and extraction of the mandibular third molars before treatment start, to maintain the distal movement of lower first and second molars (4.0mm of right side, 3.0mm of left side). After the treatment, Angle Class III molar relationship, severe anterior crowding of the lower incisors were improved and good profile and occlusion with anterior guidance was achieved. CBCT finding showed the distal lingual part of second molar contact to cortical bone.
Discussion and Summary: This case report suggests that consideration of limit for distal movement by TADs and examination of alveolar bone volume are effective for the management of non-extraction treatment.