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Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
Molar distalization /certified fixed orthodontic courses by Indian dental academy
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Molar distalization /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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  • 1. MOLAR DISTALIZATION INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2.  Class II Malocclusion  Non-Extraction treatment  Non-Compliance therapies  Treatment - Molar Distalization  Space regaining procedure -Mesial migration of first permanent molars www.indiandentalacademy.com
  • 3. Indications for Molar distalization 1. In a growing child - to relieve mild crowding - causes permanent increase in arch length of about 2mm on each side. 2. Late mixed dentition - When lower E space –utilized for relief of anterior crowding, - Upper molars distalized to get a class I relation www.indiandentalacademy.com
  • 4. Indications for Molar distalization 3. Non-growing patient - To regain lost arch length - Blocking out of canines 4. Upper second molar extraction - Lower arch normal www.indiandentalacademy.com
  • 5. Indications for Molar distalization  Class I malocclusion- with highly placed canine/impacted canine  Lack of space for eruption of premolars due to mesial migration of permanent first molars www.indiandentalacademy.com
  • 6. Indications for Molar distalization  End on molar relationship with mild to moderate space requirement  Cases with less than a full cusp class II molar relationship www.indiandentalacademy.com
  • 7. Indications for Molar distalization  Good soft tissue profile  Borderline cases  Mild to moderate space discrepancy with missing 3rd molars/2nd molars not yet erupted www.indiandentalacademy.com
  • 8. Indications for Molar distalization  Axial inclination : Mesially angulated upper molars  Normal or Hypodivergant growth pattern  Late mixed dentition with mild crowding of anteriors www.indiandentalacademy.com
  • 9. Case selection 1. Normal or near normal mandibular arch 2. Late mixed dentition-ideal - Early permanent dentition-growth still left in maxillary tuberosity area.- 16-17 yrs-males 14-15 yrs-females 3. Molars placed normally- buccolingually 4. 3rd molars-absent –stacking of upper molars – unsuitable 5. Profile considerations- well developed nose & chin 6. High MPA- contraindicated-wedging effect 7. Space discrepancy- not very severe www.indiandentalacademy.com
  • 10. Classification 1. Location of appliance  Extra-oral  Intra-oral 2. Position of appliance in mouth  Buccal  Palatal 3. Type of tooth movement  Bodily movement  Tipping movement www.indiandentalacademy.com
  • 11. Classification 4. Compliance needed from patient  Maximum compliance  Minimum or No compliance 5. Type of appliance  Removable  Fixed 6. Arches involved Intra-arch Inter-arch www.indiandentalacademy.com
  • 12. Various appliances used for Molar Distalization :          Headgears Wilson Bimetric arch design ACCO Crozat appliance Crickett appliance Modified Nance Lingual appliance Non-extraction treatment Schmuth and muller double plates Molar distalization with magnets www.indiandentalacademy.com
  • 13. Various appliances used for Molar Distalization           Use of Super elastic NiTi Jones Jig The Pendulum appliance Claspring Removable molar distalization splint Fixed piston appliance The K-loop appliance The distal jet Using Implants Fixed functional appliances www.indiandentalacademy.com
  • 14. Distalization using Headgears  Very efficient  Reciprocal forces are not transmitted to other teeth  Molar movements depends on direction of force in relation to the C Res of the molar & magnitude of force www.indiandentalacademy.com
  • 15. Biomechanics of Headgears:  C Res  Moments www.indiandentalacademy.com
  • 16. Straight pull headgear  Class II Malocclusion with no vertical problems  Prevent anterior migration of maxillary teeth, translate them posteriorly  Buccal force to molar Expansion of inner bow www.indiandentalacademy.com
  • 17. Cervical Headgear   Short face Class II maxillary protrusive cases with low MPA & Deepbites Extrusive & distalizing effect www.indiandentalacademy.com
  • 18. High pull Headgear     Produces intrusive & Posterior direction of pull Long face class II patients with high MPA Force through c res – Intrusion & distal movement of molar 6-8 months – class IIclassI Adv-effective, no reciprocal forces Disadv- Patient compliance www.indiandentalacademy.com
  • 19. Bimetric system for Molar Distalization      Dr.Wilson-Tandem yoke with bimetric arches for molar distalization Tandem yoke-.045” round tube – slides on .040” end section of the bimetric loop. .018 retractor .045” coil spring for distalizing Intermaxillary traction www.indiandentalacademy.com
  • 20.  Coil spring- between molar tube & the yoke  Elastics- 12 hours a day  Headgear – at night  The Omega adjustable stop –to modify & control arch length  Crimpable .040”tube  .061 Omega loop  Coil springs & intermaxillary hooks. www.indiandentalacademy.com
  • 21. Bimetric arch modified by Dr. Jayade  Class II correction- Distalization + expands caninepremolar area- unlocks the occlusion  A mild-moderate class II div 2 with normal mandibular arch-easily corrected www.indiandentalacademy.com
  • 22. Bimetric arch modified by Dr. Jayade Archwire design:  .016”premium wire  Premolars bonded if expansion is required  Teardrop shaped loop  Bite opening bend  Mild toe-in  2mm activation www.indiandentalacademy.com
  • 23. Elastic load reduction principle:  Class II elastics – used sequentially T.P Green – 1st week Pink - 2nd week Yellow – next 2-3 weeks  Initial heavy force- to resist forward pushing force of new wire- force transferred distally  Later Molar uprights-mesially directed archwire force decreases- support with light forces.  Extrusive component of class II- kept to a minimum Borderline cases –Non extraction www.indiandentalacademy.com
  • 24. ACCO Appliance  Removable appliance with headgear  Distal mass movement of buccal segments  Dr.Leonard Margolis – harness growthlater springs added for distal tooth movement www.indiandentalacademy.com JCO1969
  • 25.  Northwest Headgear12hrs/day, counteracts anterior component of force Appliance design:  Labial bow: .022 x .028 wire  Loops to receive NWHG between the central and lateral on each side  Wire covered with acrylic for good retention www.indiandentalacademy.com
  • 26. Appliance design: Clasps :.030 or .031 wire Modified ring clasp Finger springs : .021 X .025 Acrylic :3-4 mm away from lingual surfaces of teeth distal to lever arm of finger springs Enough bite plane in anterior segment, so that the posterior occlusion is just cleared when the lower anteriors are in contact with the bite plane www.indiandentalacademy.com
  • 27. Treatment progression : A. Placement of finger springs for first appliance  If 7,6,5,4 present, 2 finger springs engaged B. Second appliance  After distalization on one side  Leave first appliance as retainer C. Cuspid retraction  Third appliance to retract both cuspids www.indiandentalacademy.com
  • 28. Nonextraction treatment Cetlin & Ten Hoeve, JCO 1983 Space Gaining in the Mandibular Arch With the Lip Bumper  .045 SS wire covered with tubing  U-shaped loops – adjustment areas And stops mesial to the molar tubes.  Placed on most distal molar  Recent studies- Ram Nanda etal - AJO 1991 Jun Posterior movement of mandibular incisors are very minimal www.indiandentalacademy.com
  • 29. Nonextraction treatment Cetlin & Ten Hoeve, JCO 1983 Space gaining in the maxillary arch  Combination of extraoral force and an intraoral force Inraoral     Anchorage – adaptation to palate & acrylic shield around incisors Bite plane Adams clasp on premolars Springs on molars activated by 1-1.5 mm – force -30 gms Exraoral  Cervical or high pull headgear 150 gms / side ; 12 -14 hrs/day www.indiandentalacademy.com
  • 30. Nonextraction treatment Cetlin & Ten Hoeve, JCO 1983 Palatal bar as an adjunct in space gaining in the maxillary arch  Unilateral distalization www.indiandentalacademy.com
  • 31. Modified Nance and Lingual appliances for unilateral tooth movement Ghafari JCO 1985 Nance holding arch :  Palatal arch attached to first molar bands , embedded in an acrylic "button"  space maintainer in the maxillary arch,  support maxillary posterior anchorage during tooth movement Modified Nance holding arch and modified lingual arch:  Anchorage for unilateral distalization of posterior teeth  No patient compliance required www.indiandentalacademy.com
  • 32. Modified Nance and Lingual appliances for unilateral tooth movement Modified Nance holding arch          12 yrs/M Skeletal & Dental class I Right side- distoocclusion 2nd premolar- 3.5 mm space R – 1st PM & molars banded Segmental .019 x .025 NiTi Open coil spring 4 months No labial movement of incisors www.indiandentalacademy.com
  • 33. Modified Nance and Lingual appliances for unilateral tooth movement Modified Lingual arch  13 yr /F  Skeletal class I  Lingually positioned R 5  3.2 mm space  Lingual arch from L6 to R4  Coil spring from R 4-6 on a segmental .019 x .025 NiTi www.indiandentalacademy.com
  • 34. K-Loop Molar Distalizing Appliance Valrun Kalra – JCO 1995  K-loop – forces - .017 x .025 TMA  Nance button – anchorage  8mm long , 1.5 mm wide  Legs- 20 degree bend  Inserted into molar and first premolar tube, marked  Stops bent 1mm distal , 1mm mesial  Stops- 1.5mm long www.indiandentalacademy.com
  • 35. K-Loop Molar Distalizing Appliance  Reactivated 2mm 6-8 weeks later  Molars move by 4mm, premolars by 1mm  Valrun Kalra – JCO 1995 Anchorage can be reinforced by headgear www.indiandentalacademy.com
  • 36. K- loop Appliance www.indiandentalacademy.com
  • 37. Removable molar distalization splint Dr. Karrodi Ritto JCO 1995  Splint – 1.5mm Biocryl-Biostar machine  More esthetic & comfortable  Bilateral- 1st premolar- 1st premolar  Unilateral – Premolar – Opposite Molar  Two internal clasps – retention  NiTi open coil spring- 220 gm force  1.5mm-2mm/month www.indiandentalacademy.com
  • 38. Distalization of Molars with Repelling Magnets Gianelley etal JCO 1988  Anchorage – Modified Nance appliance  Wire extending from 1st premolars  Acrylic button anteriorly contacting the incisors  Auxillary wire with a loop at its end soldered - premolars bands www.indiandentalacademy.com
  • 39. Distalization of Molars with Repelling Magnets  Incisor brackets – passive sectional wire- maintain incisor alignment  Repelling surfaces of magnets brought into contact by passing an .014 ligature through the loop, then tying back a washer anterior to the magnets  Force- 200-225 gms , dropped as space opened  3mm in 7 weeks  Anchor loss – 1mm www.indiandentalacademy.com
  • 40. Japanese NiTi coils used to move molars distally -Gianelly AJO 1991      100 gm superelastic coils Nance appliance with bite plate in anterior region .016 x .022 wire with stops abutting distal wings of premolar and molars Coil – between 1st premolar and the molars .018 “ uprighting spring placed in vertical slot of premolars,directing crowns distally www.indiandentalacademy.com
  • 41. Japanese NiTi coils used to move molars distally  2nd molars erupted- Class II elastics  Rectangular wire – 10 degree lingual root torque  Once distalized, Coils &Nance appliance are removed, insert .016 x .022 “ wire with stops + High pull headgear to upright roots of molars www.indiandentalacademy.com
  • 42. Molar distalization with Superelastic NiTi wire Gianelly JCO 1992  100gm Neosentalloy upper archwire  3 markings  Stops crimped, hook added  Insert wire such that posterior stop abuts mesial end of molar tube, anterior stop abuts distal of premolar  Anchorage reinforced by class II, or Nance appliance www.indiandentalacademy.com
  • 43. Molar distalization with Superelastic NiTi wire Case report :  12 yr / F  Unilateral class II  Class II against upper 1st premolar  Overcorrected- 4 months www.indiandentalacademy.com
  • 44. NiTi Double Loop system for simultaneous distalization of first and second molars Giancotti JCO 1998  Mandibular molars and 2nd premolars banded, other teeth bonded  Lip bumper- prevent extrusion  Maxillary molars and bicuspids – banded, aligned  80 gm Neosentalloy – maxillary archwire placed – marked 1. Distal to 1st premolar 2. 5mm distal to 1st molar tube  Stops crimped on markings www.indiandentalacademy.com
  • 45. NiTi Double Loop system for simultaneous distalization of first and second molars Giancotti JCO 1998  Mandibular molars and 2nd premolars banded, other teeth bonded  Lip bumper- prevent extrusion  Maxillary molars and bicuspids – banded, aligned  80 gm Neosentalloy – maxillary archwire placed – marked 1. Distal to 1st premolar 2. 5mm distal to 1st molar tube  Stops crimped on markings www.indiandentalacademy.com
  • 46. NiTi Double Loop system for simultaneous distalization of first and second molars  Sectional NiTi archwires – crimp stops 1. Mesial and distal to 2nd premolar 2. 5mm distal to 2nd molar tube  Uprighting springs on 1st bicuspids  Class II elastics 24yr/f, class II div I  Simultaneous, bodily movement 5months- overcorrected www.indiandentalacademy.com
  • 47. NiTi Double Loop system for simultaneous distalization of first and second molars  Minimal patient co-operation  Ideal for simultaneous distalization  Anchorage easily controlled , without need for TPA/Nance  Due to streching of transeptal fibres, 1st molars can be distalized using lighter 80 gm force www.indiandentalacademy.com
  • 48. Pendulum Appliance for class II non-compliance therapy JAMES J. HILGERS,JCO 1992  Nance button  .032 TMA springs  Broad swinging arc (Pendulum) of force from midline of palate to upper molars www.indiandentalacademy.com
  • 49. Pendulum Appliance Fabrication : Pendulum springs consist of 1. Recurved molar insertion wire 2. Horizontal adjustment loop 3. Closed helix 4. Loop for retention in acrylic button  Springs- close to center of Nance button  Anterior portion- retentionocclusally bonded rests - Band upper 1st premolars, solder retaining wire to the bands www.indiandentalacademy.com
  • 50. Pendulum Appliance  Nance button- extend to about 5mm from teeth  Anterior retention loops fixed on model, later soldered to bicuspid bands  Acrylic pressed against the palatal vault  Pendulum springs inserted www.indiandentalacademy.com
  • 51. Pendulum Appliance Pend-X Jack-screw-One-quarter turn every 3 days www.indiandentalacademy.com
  • 52. Pendulum Appliance Preactivation and placement:  Springs bent parallel to midline of the palate  Molar bands cemented  Anterior portion of appliance later cemented  Pendulum spring brought forward & engaged in lingual sheath  As molar distalizes, moves on an arc towards midline- counteracted – opening horizontal loop www.indiandentalacademy.com
  • 53. Pendulum Appliance  Reactivate if required  Reavtivated by pushing it distally towards the midline  Stabilize after correction  Nance appliance  Full arch bonding – continous wire with omega loop  Headgear for few months www.indiandentalacademy.com
  • 54. Pendulum Appliance  Unilateral correction www.indiandentalacademy.com
  • 55. Pendulum Appliance Conclusion :  Excellent patient tolerance  Upto 5mm distalization in 4 months  Distalization + Expansion  Patient compliance not needed  Modified Pendulum Appliance- Scuzzo- 2000 April Removable arms www.indiandentalacademy.com
  • 56. Removable pendulum www.indiandentalacademy.com
  • 57. Franzulum appliance Friedrich Byloff et al  Anterior anchorage : acrylic button-5mm wide  Rests on canine and premolars - .032 wire  Tube from acrylic button to receive active component  NiTi coil springs-100200g/side  J-shaped wireinserted into tube www.indiandentalacademy.com JCO2000 sep
  • 58. Franzulum appliance Anchor unit bonded with composite  J-shaped distalizing unit ligated to lingual sheath  Active component close to C Res Case report  11yrs 10mts / M  end on molar relationship  Space deficiency in both the arches  Premolars blocked out  Upper pendulum and lower Franzulum  Nance holding arch  Fixed appliance with cervical headgear and Cl II elastics  End of treatment; Class I molar relation, no signficant. Change in facial profile  www.indiandentalacademy.com
  • 59. Open Coil Jig Jones, White –JCO 1992 Oct  Richard D. Jones  American Orthodontics  Open coil NiTi spring  Nance appliance www.indiandentalacademy.com
  • 60. Open Coil Jig 3 1. Heavy round wire 2. Light wire 3. Fixed Sheath 4. Hook 5. Sliding Sheath 6. 4 Open coil spring 6 5 1 2 www.indiandentalacademy.com
  • 61. Open Coil Jig  Reactivation  4-5 mm distalization in 3-4 months  Advantages…  Disadvantages-Tipping - Cannot use with fully banded treatment - Breakage www.indiandentalacademy.com
  • 62. Lokar Molar Distalizing Appliance A- Inserts into molar attachment with a rectangular wire B- Compression spring C- Sliding sleeve D- Groove E- Flat guiding bar F- Round posterior guiding bar G- Immovable posterior sleeve www.indiandentalacademy.com
  • 63. Lokar Molar Distalizing Appliance  Nance button  Can be used in conjunction with complete edgewise appliance  With headgear  Easy insertion, activation www.indiandentalacademy.com
  • 64. Distal jet Appliance Aldo Carano, Mauro Testa JCO 1996  Fixed lingual appliance Appliance design :  Wire extending from acrylic through tube ends in a bayonet bend-inserted into lingual sheath  Coil spring  Clamp  Anchor wire to 2nd premolar www.indiandentalacademy.com
  • 65. Distal jet Applaiance Aldo Carano, Mauro Testa JCO 1996  Reactivation- sliding clamp closer to first molar  After distalization – - clamp-spring assemblyacrylic, - premolar arms cut off. www.indiandentalacademy.com
  • 66. Distal jet Appliance Case report  18/F, Class II divI  No skeletal abnormalities  Non-extraction therapy (3rd molars removed)  Distal jet  4 months- Class I ,2mm-L, 3mm-R www.indiandentalacademy.com
  • 67. Distal jet Appliance Advantages :  Bodily movement  Easy insertion  Well tolerated  Esthetic  Unilateral, Bilateral  Permits simultaneous use of full bonded appliances www.indiandentalacademy.com
  • 68. Modifications of Distal jet Appliance Andrew Quick, Angela Harris JCO 2000 Earlier :  Sliding collar-tightened- small set screw- Allen wrench Modification :  Rear entry of sliding section into the molar sheath  Sliding wire- .032 “  Stop collar soldered to wire  Activation  Retention- solid tubing www.indiandentalacademy.com
  • 69. Fixed piston appliance - Greenfield  .036 “ tubing- soldered to biccuspids  .030 “ ss wires- first molars  Nance button  NiTi coil www.indiandentalacademy.com
  • 70. Unilateral Distal Molar Distalization movement with an Implant supported Distal jet appliance Karaman et al- Angle Orthodontics-2002 Case :         11yr/M Well balanced face Straight profile Class II molar relation on left side Super class I on right side Mandibular teeth- favorable alignment Upper left 2nd premolar impacted ANB- 0 degrees www.indiandentalacademy.com
  • 71. Unilateral Distal Molar Distalization movement with an Implant supported Distal jet appliance Treatment objectives :  Class I molar relation  Eruption of impacted molar  Controlled eruption of erupting teeth Treatment alternatives  Extraction of L 1st premolar  Extraction of L 1st premolar  Distalization of upper left molar www.indiandentalacademy.com
  • 72. Unilateral Distal Molar Distalization movement with an Implant supported Distal jet appliance Appliance fabrication : Molar bands with palatal tubes Anchorage screw- 3mm dia, 14 mm long Anterior palatal suture, 2-3 mm posterior to incisive papilla Impressions for appliance construction 1mm tube adjusted to implant www.indiandentalacademy.com
  • 73. Unilateral Distal Molar Distalization movement with an Implant supported Distal jet appliance        Anchor wires .8mm-soldered to tubes for occlusal rests on premolars .9mm wire extended through each tube ending in a bayonet bendpalatal tube of molar NiTi open coil spring – active on left side only Appliance attached to premolars – composite Joint between implant & tubesecured with composite 2 months- 4.5mm distalization Space for canine-maintained www.indiandentalacademy.com
  • 74. Conclusion Borderline cases  Space gaining procedures  Simplicity  Clinical effectiveness  Patient compliance factor  www.indiandentalacademy.com
  • 75. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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