Use of miniscrews in the buccal shelf for mandibular molar mesialization - Part 2

Henrique Mascarenhas VILLELA e Anastácio Barbosa BRAGA

Introduction: Bodily mesialization of the mandib- ular molar is frequently performed in the orthodontic clinic, due to agenesis and premature loss of molars or premolars. However, this orthodontic movement is difficult to perform due to the need to control rotation, angulation and the torque on these teeth during their translation. This difficulty also results from the type of bone found in the mandible, which has high density cortical bone, and the quality of medullary bone is frequently low. The introduction of skeletal anchorage with miniscrews has brought about many benefits to this difficult task, simplifying the orthodontic mechanics, minimizing the undesirable side effects, reducing the need for patient cooperation and making treatments increasingly predictable. Nevertheless, in order to perform this movement more efficiently, it is necessary to understand and master the biomechanics applied to these devices. With the introduction of extra-alveolar miniscrews, new strategies have appeared to enable maximum advantage to be taken of these devices, which must be localized in the mandibular buccal shelf. This localization allowed free sagittal movement of the teeth, due to the fact that the body of the screw will be positioned in the most cortical region, and away from the roots of the teeth. Objective: The present article shows a treatment strategy capable of performing mandibular molar mesialization in cases of loss of a second premolar, by using skeletal anchorage with an extra-alveolar miniscrew placed in the buccal shelf region. Conclusion: By means of this strategy, mandibular molars are bodily mesialized more efficiently, with- out undesirable side effects, with preservation of the periodontal structures, and obtaining a good final dental relationship.

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

How to cite: Villela HM, Braga AB. Use of miniscrews in the buccal shelf for mandibular molar mesialization - Part 2. Clin Orthod. 2021 Feb-Mar;20(1):66-81.

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