Management of Midline Deviation with Unilateral Extraction and Mesialization with Delta Loop - A Case Report

Midline deviation in younger ones is one of the unaesthetic orthodontic problems which does not go away on its own and needs orthodontist’s attention, often resulting from factors such as premature loss of primary teeth and insufficient arch length. Various treatment strategies, including midline elastics, unilateral extractions, and dental expansion, are employed to correct these deviations. This article presents a case of 22-year-old female with dental midline shift in upper arch towards the left side. Both upper and lower arches were moderately crowded on the same side with palatally blocked out upper left lateral incisor. Lower left canines were positioned lingually, with the presence of an over-retained primary canine (73). The treatment plan followed was unilateral premolar extraction on the left side in both the arches and to mesialize the posterior segment so as to not make the shift worse. The closure of the space was achieved through the use of delta loop mechanics, which allowed for regulated tooth movement and effective anchorage control. Key words: Midline deviation, unilateral extractions, unilateral mesialization, delta loop, palatally placed incisor, crowded arches.