Article: Volume 6 Number 3 Page 86 - July 2013

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  Orth Update 2013; 6: 86-91

Orthodontics:  Severe Bimaxillary Dento-Alveolar Proclination with Hyperdivergent Jaw Bases Treated with Temporary Anchorage Devices: A Case Report

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Abstract: The article describes the orthodontic treatment of a 19-year-old female with severe bimaxillary dento-alveolar proclination and severely hyperdivergent jaw bases. Clinical and cephalometric analyses denoted it to be a critical anchorage case. Accordingly, with the aim of providing absolute anchorage, temporary anchorage devices (TADs) were placed in all four quadrants in the inter-radicular area of the second premolar and first molar, following extraction of all first premolars. Facial aesthetics improved considerably, fullness of the upper and lower lip reduced and incompetency of the lips was eliminated. The application of TADs not only reduced the antero-posterior discrepancy, but also addressed the vertical problem.

Clinical relevance: The treatment of critical anchorage, hyperdivergent cases with conventional orthodontics has always remained a challenge, with a greater chance of an unsatisfactory treatment outcome. The use of TADs has changed the scenario with the concept of absolute anchorage coming closer to reality.

Author notes: Narayan H Gandedkar, BDS, MDS, Clinical and Research Fellow, Department of Craniofacial Dentistry and Orthodontics, Chang Gung Memorial Hospital, Tun Hwa North Road, Taipei, Taiwan and Assistant Professor, Department of Orthodontics and Dentofacial Orthopaedics, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India and Ameet V Revankar, BDS, MDS, Reader, Department of Orthodontics and Dentofacial Orthopaedics, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India.

Objective: To demonstrate the versatility of the use of temporary devices (TADs) in the treatment of critical anchorage cases – antero-posteriorly as well as vertically.

Kavo Kerr