“In 4 months, note the complete intrusion with only the force of the adjacent molar as anchorage. Restorative space was created and the opposing prosthetic used.” Case 2: Unilateral Class Two Distalization Pt preop. Brackets bands and a palatal Gonzalez appliance had been placed with almost no move-ment after two months, so sectional wilkodontics were discussed after patient’s impatience was expressed for adult treatment (Fig. 4). Corticotomies created with surgi-cal 957 bur. Slow speed round burs are recommended if you are begin-ning or feel you may slip. Light luxation of the teeth is accom-plished with an elevator or molt to ensure the corticotomies have decreased the bone density enough(Fig. 5). Corticotomies created and graft placed on buccal aspect only with CaSO4 (Dentogen) bone graft prior Fig. 4 Fig. 2 Fig. 3 to suture (Fig. 6). Initial presenta-tion at suturing with prf (platelet rich fibrin) graft used at tissue inter-face (Fig. 7). Appearance at seven days of healing (Fig. 8). Molar posi-tion before we began (Fig. 9). Six weeks movement of the molar to super class 1. It is distal-ized more than it appears due to the spring being on the lingual only which rotated the tooth slightly buccal as it distalized. See next photo (Fig. 10). Rapid movement in 1 week (Fig. 11). 6 weeks tension in spring is gone and second premolar is migrating on it’s own distally to follow the molar (Fig. 12). Fig. 6 Fig. 5 www.orthodontics.com Winter 2016 9
Journal of the American Orthodontic Society Winter 2016: Page 9
