The 6th Japan Academy of Aligner Orthodontics Annual Congress 2019

Case report of Premolar extraction with Anterior ankylosis

The prognosis for tooth movement in orthodontic treatments for teeth with ankylosis is poor, and it is often difficult to move teeth with ankylosis to the desired position. This presentation examines a 4 premolar extraction case with upper anterior ankylosis. It reports on the current condition of treatment finished with a mouthpiece. [Case] Female patient was a 25yr 10mo old at initial visit [Chief Complaint] Desired improvement of protruding mouth [Examination] Examination of the facial configuration revealed slight mandibular rotation to the right. Convex type facial profile with upper and lower labial protrusion. Retrognathia of the mandible also confirmed. Angle II Class molar relation, with a +5.1mm overate and 0mm overbite. Cephalo examination showed SNA+83.3°、SNB+75.9°、ANB+7.5°(+2SD)、Gonial.a139.0°(+3SD)、Cd-Go（-3SD）、Pog’-Go(-2SD)、mandibular hypergrowth、progressive condylar resorption due to retrognathia、and respiratory stenosis. [Diagnosis] Retrognathia with Anterior Maxillary Protrusion. [Treatment Plan] upper anterior lingual braces, upper p / a impression tray, 2 upper #4 premolar extraction, installation of ⏊TAD in maxillary palate for maximum upper molar anchorage and upper molar intrusion from mandibular autorotation. Installation of lower labial brackets. Upper and lower #4 premolar extraction. [Treatment progress] Following upper and lower leveling with wires, 4 #4 premolar extraction. 1 year after beginning treatment no observable reaction in upper anterior teeth. Changed to mouthpiece, performed piezosurgery on the upper anterior teeth with favorable results.