CASE REPORT of the appliance. Observe how at least 2 mm of space gain has occurred in a two month period.(Fig. 10) Periapical X-ray image of the different Fig. 4 parts of the distalizing system in place. Observe mesial incli-nation and migration Fig. 5 of # 19, and impaction with loss of space of # 20. (Fig. 11) One month follow-ing initial placement of powerchain. Molar up righting is happening helping recover the space lost. Although much has been accomplished in one month additional movement is still required.(Fig. 12) Two months of distalization as seen on X-ray peri-apical image. There is still more inclination correction and distalization possible.(Fig. 13) Three months of treatment. The arm has been modi-fied bending towards the gingival aspect. This bend will create a more efficient distal crown movement and translation after the initial movements have been accomplished on the permanent molar. (Fig. 14) Inclination and distalization of permanent molar have been achieved and confirmed radiographically. The space for the second bicuspid eruption is now available. (Fig. 15) Panoramic image shows the restoration of space and balance of all proximal teeth such as # 18, 20 and 21. At this time the distalization appliance is changed for a band and loop retainer. The original set-up could be stabilized with ligature wire, but the authors prefer to switch to a fixed retainer such as a prefabricated band Fig. 7 Fig. 8 Fig. 9 Fig. 6 Fig. 10 www.orthodontics.com Winter 2016 31
Journal of the American Orthodontic Society Winter 2016: Page 31
