Orthodontic Management Of Inadequate Maxillary Molar Space: A Case Report

A 32-year-old male, sought orthodontic treatment to distalize the maxillary molars to create space for prosthetic restoration. The treatment plan involved distalizing the molar using a combination of a miniscrew-supported cast framework with buccal push springs and palatal traction springs in a "dual-track" force application approach. Intraoral examination revealed a permanent dentition phase, with Class I molar and canine relationships on both sides. The anterior overjet measured 6.9mm, and the overbite was normal. The maxillary left first molar (#26) was missing, with an impant inserted, and the second molar (#27) was mesially inclined. The treatment plan involved distalizing the molar using a combination of a miniscrew-supported cast framework in a "dual-track" force application approach. The treatment duration was 4 months, achieving approximately 5mm of space expansion. Post-treatment, the occlusion of the remaining teeth remained unchanged, and the right-side molar relationship remained Class II. During treatment, a miniscrew was placed in the palatal mucosa and integrated with a maxillary cast framework. A traction hook was welded on the palatal side and extended mesially. Buccal brackets with push springs were applied, while palatal traction springs provided additional force. A "dual-track" force application system was used for molar distalization. Combined buccal-lingual force with NiTi pull springs optimized molar distalization (reduced rotation risk; sustained force delivery), while palatal implants leveraged inflammation-resistant mucosa for superior site stability.