Use of miniscrews in the buccal shelf for mandibular molar mesialization - Part 1

Henrique Mascarenhas Villela

INTRODUCTION: Bodily mesialization of the mandibular molar is very common in orthodontic practice, due to agenesis and early loss of molars or premolars. However, this orthodontic movement is difficult to perform due to the need to control the rotation, angulation and torque of these teeth during their translation. This difficulty is also due to the type of bone found in the mandible, which presents a high-density cortical and often with little amount of bone marrow. The introduction of skeletal anchorage using miniscrews brought many benefits to this difficult task, simplifying orthodontic mechanics, minimizing unwanted side effects, reducing the need for patient collaboration and making treatments more predictable. However, in order to carry out this movement more efficiently, it is necessary to understand and master the biomechanics applied to these devices. After the introduction of the extra-alveolar miniscrews, new strategies have emerged to get the most out of this device, which is located in the mandibular buccal shelf. This location allows free sagittal movement of the teeth, due to the fact that the screw body is positioned in a more cortical region and away from teeth roots. OBJECTIVE: This article presents a treatment strategy capable of performing the mesialization of the mandibular molars before the loss of a second premolar, using skeletal anchorage with extra-alveolar miniscrew in the buccal shelf region. CONCLUSION: By means of this treatment strategy, the three mandibular molars can be efficiently bodily mesialized, with no undesired side effects, preserving the periodontal structures and obtaining a good final dental relationship.

Keywords: Molar mesialization. Buccal shelf. Miniscrew. Mini-implants.

How to cite: Villela HM. Use of miniscrews in the buccal shelf for mandibular molar mesialization - Part 1. Clin Orthod. 2020 Dez-2021 Jan;19(6):66-79.

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