Objective: In orthodontic treatment, uprighting and mesial movement of molars while controlling anchorage can be difficult when using conventional mechanics. However, absolute anchorage can be achieved with the use of orthodontic anchor screw. We report its use in an adult case with severe mesial inclination of the molars.
Case: Our patient was a 46 year-old female whose chief complaint were anterior crossbite and poor posterior occlusion. Clinical examination showed all four first molars and the lower left second molar to be missing due to caries. Mesial inclination was seen in the remaining molars; specifically, the upper right and left second molars, the lower right second and third molars, and left third molar. The patient had anterior crossbite with overjet of -0.5mm. The lateral cephalometric analysis indicated a high angle case with skeletal Class III tendency. The treatment objectives were: (1) To upright and mesially move the upper second molars, the lower right second molar (after extraction of the adjacent third molar), and the lower left third molar using a sectional arch connected to an anchor screw, and (2) Expansion of the upper arch and labial inclination of the maxillary incisors to correct anterior crossbite. The post-treatment panoramic radiograph showed that uprighting and mesial movement of the molars were achieved, and lateral cephalometric superimposition showed no significant skeletal changes.
Discussion and Summary: It can be considered that three-dimensional control of molars using anchor screw provided the predictable treatment result in this case.