09/07/2026
This 23 y.o.(then 20 y.o) male patient reported with a chief complaint that he felt his upper front teeth were crooked and had a few teeth missing. He also did not want any prosthesis like dental implants or a bridge to rehabilitate his missing teeth.
A problem list was devised for him as follows:-
- Mild maxillary and mandibular anterior crowding
- Congenitally was missing a lower permanent incisor
- Narrow maxillary dental arch in the premolar segment bilaterally
- Missing 36,46
- Mesially tipped 37,47.
A non extraction treatment plan was formulated with TAD supported protraction of 37,38 and 47,48 planned for later. 0.022” MBT slot fixed appliances were used and 1.5x8 mm miniscrews were placed in the 1st and 2nd premolar interradicular region after 1 year and protraction began.
Treatment duration was roughly 40 months at the end of which a Class I molar and canine relationship was achieved. The patient was extremely happy with both the final result and that he didn’t need any prosthetic work done!😃
P.S.:- Tried a hook from the tube of 37,47 but since it kept hurting the patient’s mucosa, shifted to directly placing the Echain from the TADs onto the tube hook but used gable bends to counter tipping of the 7’s.
