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Upper Second-premolar Extraction Treatment Using SkeletalAnchorages and a Multislotted Lingual Appliance in a Class IIHigh-angle Patient

Sehong Ryu
Ryu Orthodontics, Gwangju, Korea

Purpose: This case report discusses exclusive extraction of the maxillary second premolar during treatment in a Class II high-angle patient presenting no crowding, a deep bite, and spaces between the lower four anteriors. This approached involved a lingual appliance and skeletal anchorages.

Materials & Methods: A 36-year-old female patient sought treatment to address a protruded upper lip and spaces between her lower four anteriors. A 0.018×0.025 inch multislotted lingual appliance (Anboini, BioMaterials Korea; BMK, Seoul, Korea) was selected for this treatment. Tooth-colored restorations and crowns were applied to all four upper premolars. Treatment options included the choice between exclusive upper first premolar extraction or exclusive upper second-premolar extraction, both with skeletal anchorages, with the patient choosing the latter treatment.

Results: The total orthodontic treatment duration was 30 months, employing palatal skeletal anchorages. Post-treatment records showed substantial improvement in the patient’s upper and lower lips. The spaces between the lower four anteriors were closed, and the curve of Spee of the mandibular dentition was flattened. Controlled tipping of the upper incisors, pure intrusion of the lower incisors, and upright positioning of the lower first molars were observed during superimposition. No major skeletal changes were noted, and the mandibular plane angle was well maintained.

Conclusion: Successful treatment was achieved for a Class II high-angle case with a deep bite, spacing between the lower four anteriors, and protruded upper and lower lips using a multislotted lingual appliance and skeletal anchorages


Key words: Maxillary second-premolar extraction, Multislotted lingual appliance, Skeletal anchorage


Korean J Lingual Orthod 2023;12(1): 20-27



03)KJLO (20-27)_23-101
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