Abstract

Problem-Solving in Orthodontic Treatment of Bimaxillary Dentoalveolar Protrusion

by Liaw Johnny

Bimaxillary dentoalveolar protrusion is a common malocclusion in Asian population. Anterior retraction with premolar extractions is a regular way to reduce protrusion. In addition to the selection of the extraction sites, a careful mechanics plan is necessary. For maximal retraction, a reinforced anchorage setup might be considered. Temporary skeletal anchorage devices are powerful anchorage sources for stable anchorage, or even more than absolute anchorage. A variety of problems may occur during the treatment of protrusion, like a gummy smile caused by bowing effect during space closure, retroclined incisors due to torque loss during retraction, insufficient profile reduction for insufficient anchorage, difficulty of space closure hindered by the deep overbite, deficient incisor show after massive anterior retraction, root resorption in the wide range of tooth movement, encroachment of the anatomical limitations of tooth movement, periodontal sequela to the massive retraction, etc. Not every problem can be perfectly solved with patients’ satisfaction. But at least, we need to confront them with the best possible solutions.

Learning Objectives

After this lecture, you will be able to avoid complications during maximal retraction with TADs for the profile improvement
After this lecture, you will be able to know how to rescue from the complications
After this lecture, you will be able to achieve the best possible profile improvement with active vertical control