title: Combined use of miniscrews and continuous arch for intrusive root movement of incisors in Class II division 2 with gummy smile.
abstract: Adequate intrusion and torque control of the retroclined maxillary incisors are critical for the treatment of Class II division 2 (div2) malocclusion. In addition, anterior retraction via lingual root movement can be challenging. This case report demonstrates a combined use of miniscrews and continuous arch with additional torque for intrusion, retraction, and torque control of maxillary incisors in the Class II div2 with gummy smile. A 20-year-old woman presented with multiple issues, including impacted canine, lip protrusion, prolonged retained mandibular primary molar, and two missing maxillary premolars. In order to improve her facial profile and eliminate the need for prosthetic work, the mandibular primary molar and contralateral premolar were extracted. Two miniscrews were placed at the maxillary buccal alveolar bone to apply the posterosuperior force for retraction of anterior teeth, with additional labial crown torque on the arch wire. The results were the intrusion (4 mm) and lingual root movement (17°) of the maxillary incisors without anchorage loss of maxillary molars, flattening of the Curve of Spee, and Class I molar relation that were maintained after 50 months of retention period. The combined use of miniscrews and continuous arch could be a reliable and effective treatment modality for torque control and intrusion of retroclined maxillary incisors in the Class II div2 patient.
authors: a  Resident, Department of Orthodontics, School of Dentistry, Yonsei University, Seoul, South Korea.
authors: Sung-Jin
authors: SJ
authors: Kim
authors: Jin-Wook
authors: JW
authors: Kim
authors: Tae-Hyun
authors: TH
authors: Choi
authors: Kee-Joon
authors: KJ
authors: Lee
mesh_terms: D001641:Bicuspid / Q000601:surgery; D001863:Bone Screws; D003481:Cuspid / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology*; D006801:Humans; D007180:Incisor / Q000473:pathology*; D008046:Lip / Q000473:pathology; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D008437:Maxilla / Q000473:pathology; D008904:Miniaturization; D008963:Molar / Q000601:surgery; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation*; D016382:Orthodontic Appliance Design; D009969:Orthodontic Wires; D010347:Patient Care Planning; D012904:Smiling; D014087:Tooth Movement Techniques / Q000295:instrumentation*; D014092:Tooth Root / Q000473:pathology*; D014094:Tooth, Deciduous / Q000601:surgery; D014095:Tooth, Impacted / Q000628:therapy; D019415:Torque; D016896:Treatment Outcome; D055815:Young Adult
keywords: Class II division 2; Continuous arch; Gummy smile; Intrusion; Miniscrew; Torque control