A simplified approach to true molar intrusion

Three female patients aged 14, 18 and 19 years who decided against a surgical correction were treated with a device consisting of mini implants in the palatal slope, a palatal bar and intrusion cantilevers.In all three patients, an open bite reduction of more than a millimeter occurred within four months. An anterior overbite of 2 mm or more could be established within 6 to 9 months.The method presented in this article enables the practitioner to use mini implants in an easily accessible insertion site. A lab-side procedure is optional but not required.The management of anterior open bites is considered one of the most difficult tasks in orthodontics.In growing patients, functional or orthopedic approaches can be applicable [1-3]. Without growth, only orthognathic surgery and orthodontic tooth movement remain as means of therapeutic intervention.Orthodontic solutions may involve an unfavorable extrusion of the incisors and may result in an increased display of gingiva [4]. In many cases, posterior intrusion is favorable but it requires appropriate anchorage. A high-pull headgear can provide for an adequately directed force but depends on patient cooperation. Furthermore, it is usually not an option in adults. Skeletal anchorage using mini plates has been proven efficient in the management of open bites [5]. However, this approach requires incision and suture.Various mini implant insertion sites are available for the purpose of molar intrusion. Interradicular insertion bears the risk of root damage. Even after correct implant insertion, root contact may still occur later due to the progress of the intrusion, which may impair implant stability. Insertion beyond the attached gingiva may also lead to an increased failure rate [6]. The palate as a skeletal anchorage site has been described by several authors and for different treatment tasks [7,8]. It offers good bone support [9-11].The aim of this work is to present an approach that does not require incision, interradic