Korean J Orthod.  2019 May;49(3):194-201. 10.4041/kjod.2019.49.3.194.

Total arch distalization with interproximal stripping in a patient with severe crowding

• Jung MH

• KMID: 2450229
• DOI: http://doi.org/10.4041/kjod.2019.49.3.194

Abstract

When a patient shows severe crowding, premolar extraction should be considered to provide required available space for alignment. If the third molars have already erupted and demonstrate a poor prognosis, third molar extraction and distalization of the posterior dentition can be used instead of premolar extraction to obtain space. Interproximal stripping (IPS) may also be used to gain space in cases of crowding. This case report describes the treatment of a 25-year-old man with severe crowding and mild lip protrusion. Although the crowding in the lower arch was severe enough to require first premolar extraction, distalization of the entire lower dentition with orthodontic mini-implants, extraction of the lower third molars, and IPS could successfully resolve the crowding and lip protrusion.

Keyword

Interproximal stripping; Orthodontic mini-implant; Distalization

MeSH Terms

Adult
Bicuspid
Crowding*
Dentition
Humans
Lip
Molar, Third
Prognosis

Figure

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  Figure 1 Pretreatment facial and intraoral photographs.

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  Figure 2 Pretreatment radiographs and tracing. The numbers in the tracing indicate FDI tooth number.

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  Figure 3 Schematics of space gaining in the lower arch. Bracket bonding on the lower second premolars was postponed until sufficient space was obtained using interproximal stripping and molar distalization. Double sided arrows indicate the pushing force of the spring.

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  Figure 4 Posttreatment facial and intraoral photographs.

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  Figure 5 Posttreatment radiographs.

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  Figure 6 Facial and intraoral photographs acquired 20 months after debonding.

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  Figure 7 Radiographs (A, B) acquired 20 months after debonding and superimposition tracing (C–E); pretreatment (black), posttreatment (red), and retention (blue) lateral cephalograms. C, mandibular superimposition; D, maxillary superimposition; E, cranial base superimposition. The numbers in D and E indicate FDI tooth number.

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