【Objectives】
In the treatment of proclined incisors, the first premolars are generally extracted to retract anterior teeth and improve facial esthetics. Considering the molar anchorage, extraction of the second premolars have a great disadvantage in the treatment for such cases. Thus, in cases with congenitally missing second premolars and proclined incisors, we have to confront with the serious problem of molar anchorage. Application of TADs could enable us to overcome this problem and a disable treatment outcome was obtained in the present case with proclined incisors and four congenitally missing second premolars.
【Case】
A 17-year-old boy with a chief complaint of the protruded incisors. The patients had four congenitally missing second premolars and persistence of three deciduous second molars. The molar relationship was Class I and Class II on the right and left sides, respectively. The ANB angle was 5.5° with a flattened mandibular plane. The incisors were proclined in both arches. To retract incisors and decrease the large overjet, all deciduous second molars were extracted and TADs were placed in the mesial sides of the both maxillary first molars to reinforce the anchorage.
【Discussion and Summary】
The proclined incisors of both arches were greatly improved, and favorable overjet with Class I molar relationship was obtained. His facial profile was also significantly improved. In this case, TADs were utilized to perform en-masse retraction of the maxillary anterior teeth and first premolars.