I have class three malocclusion. Can micro-implants and elastics give the best results in distalizing mandibular posterior teeth?

Q. What is the outcome of treating class three malocclusion with micro-implants and elastics?

Answered by
Dr. Mayank Khandelwal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 17, 2022 and last reviewed on: Jul 28, 2023

Hi doctor,

I want your advice on a case that can be found online, and I have attached that case link. The girl has a class three malocclusion, and I have the same. She proposed a treatment of distalizing the mandibular posterior dentition with a micro implant combined with intra-arch elastics, but she refused, so they fixed it otherwise. Would the outcome have been different (more straight teeth instead of tilted) if she had chosen the implants?



Welcome to icliniq.com.

I understand your concern. I have seen the case link that you have posted along. I want to mention initially that the treatment protocols might be the same, but the end results may vary to some extent based on patient-to-patient biological responses. If you carefully go through the treatment alternative, they have mentioned that the patient chose the third alternative, which involves micro-implants and elastics. However, implants are an invasive procedure, and the patient was not willing for it. The role of the micro implant here is to serve as an anchorage unit that remains stable, and forces can be put against this unit to make the teeth react and distalize. Micro implants are placed in the bone with its head exposed; to it, elastics are connected, and the other end of elastics to the teeth. Since the implants are inserted into the bone, the chances of implants moving are almost nil, and an absolute anchorage is reinforced (meaning, no movement of the anchorage unit and only the reactive unit, that is, teeth moves). On the other side, if you do not put implants and take anchorage from the upper dentition to distalize the lower dentition, anchorage reinforced is not absolute and the chances of the upper dentition moving as a reaction to lower distalization is more. Hence, it would result in both the dentition moving (upper moving forward and lower moving backward). The patient will see a change in overjet and lower teeth moving backward, but it would be a camouflaged result. Hence, the anterior (front teeth) are not straightened completely and look flared. Some inclination (flaring) and overjet (horizontal distance between upper and lower teeth) are required, but it is a compromised result here. Yes, results could have been different if a micro implant had been used. To note this point, implants reinforce the anchorage, but the amount of space available in the jaws, bone conditions, and oral hygiene play a role in successful orthodontic treatment. What might be a success in someone else case might not be the same in others. I would like to have a look at your photos as well to assess and guide you better. Please share the photographs and X-ray as you have seen in the article for assessment. Feel free to reach out for further information or clarifications. Do rate the response and drop feedback to enable us to enhance the quality of answers. I hope this helps. Kind regards.

Regarding follow up:

Please share the pictures as requested for further assessment and precise solutions for your consideration

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