{"id":3381,"date":"2013-01-17T16:35:00","date_gmt":"2013-01-17T15:35:00","guid":{"rendered":"https:\/\/www.zerodonto.com\/en\/2013\/01\/lingual-orthodontics-without-brackets-for-the-treatment-of-angle-ii-class-malocclusions\/"},"modified":"2017-10-19T16:01:23","modified_gmt":"2017-10-19T14:01:23","slug":"bracketless-lingual-orthodontics-angle-ii-class-malocclusions","status":"publish","type":"post","link":"https:\/\/www.zerodonto.com\/en\/2013\/01\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\/","title":{"rendered":"Lingual Orthodontics without brackets for the treatment of Angle II Class malocclusions"},"content":{"rendered":"<p>Fixed orthodontics is the elected treatment in any age permanent dentition patients.<\/p>\n<p>In fact, in most of cases only with a fixed appliance is possible to achieve a precise and controlled dental movement.<\/p>\n<p>When patient needs an invisible treatment the answer is a fixed lingual treatment, that could be realized with or without brackets. The appliance is so bonded on the lingual aspect and this is why it is not visible.<\/p>\n<p>At first lingual fixed orthodontic without brackets was deviced to solve relapse of previous classic brackets treatment that didn&#8217;t want anymore a brackets therapy. Then was applied to treat malocclusion in patients never treated before because it does not produce tongue and soft tissues pains and phonetics diseases that usually occurred with a lingual brackets therapy.<\/p>\n<p>With fixed lingual orthodontic without brackets it is possible to treat every kind of malocclusions by means of orthodontic wires directly bonded on the lingual aspect of the teeth, like the active retainers, but also other devices, like the mini-screws. Mini-screws are a recent innovation in orthodontic treatment and have a large application also in conventional brackets therapy, because they allowed a maximum skeletal anchorage and a faster dental movement.<\/p>\n<p>The following clinical case is an example of dental and skeletal second class treated by means of this innovative therapy.<\/p>\n<p>The patients, a 25 years old female, presented at a clinical examination (fig. 1-6)<\/p>\n<ul>\n<li>an edge to edge molar and canine and a scissor bite between 24-34 on the left side<\/li>\n<li>an edge to edge canine and a previous extraction of tooth 46 with mesialization and inclination of tooth 47 on the right side<\/li>\n<\/ul>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/1-frontale-malocclusione-di-seconda-.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"angle II class malocclusion\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/1-frontale-malocclusione-di-seconda-.jpg\" alt=\"angle II class malocclusion\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><br \/>\n<!--more--><\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/2-overjet_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; float: none; padding-top: 0px; padding-left: 0px; margin: 0px auto 5px; display: block; padding-right: 0px; border-width: 0px;\" title=\"2 overjet\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/2-overjet_thumb.jpg\" alt=\"2 overjet\" width=\"295\" height=\"439\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/3-laterale-seconda-classe-molare-e-c.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"angle II class malocclusion\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/3-laterale-seconda-classe-molare-e-c.jpg\" alt=\"angle II class malocclusion\" width=\"590\" height=\"339\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/4-morso-a-forbice_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"scissor bite\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/4-morso-a-forbice_thumb.jpg\" alt=\"scissor bite\" width=\"590\" height=\"339\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/5-occlusale-superiore-malocclusione-25255B2-25255D.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"angle second class malocclusion\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/5-occlusale-superiore-malocclusione-25255B2-25255D.jpg\" alt=\"angle II class malocclusion\" width=\"590\" height=\"452\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/6-occlusale-inferiore-seconda-classe-25255B2-25255D.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"class second malocclusion\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/6-occlusale-inferiore-seconda-classe-25255B2-25255D.jpg\" alt=\"II class malocclusion\" width=\"590\" height=\"459\" border=\"0\" \/><\/a><\/p>\n<p>The x-ray evaluation (fig. 7-10) showed a skeletal second class with a proclination of the lower incisors on the mandibular plane of 6 degrees.<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/7-ortopantomagrafia_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"opt\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/7-ortopantomagrafia_thumb.jpg\" alt=\"opt\" width=\"590\" height=\"443\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/9-cefalometria_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"cephalometry\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/9-cefalometria_thumb.jpg\" alt=\"cephalometry\" width=\"590\" height=\"443\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/8-teleradiografia_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"teleradiography\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/8-teleradiografia_thumb.jpg\" alt=\"teleradiography\" width=\"590\" height=\"443\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/10-esame-cefalometrico_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"cephalometric exam\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/10-esame-cefalometrico_thumb.jpg\" alt=\"cephalometric exam\" width=\"590\" height=\"768\" border=\"0\" \/><\/a><\/p>\n<p>The second class treatment with inter-maxillary elastics was not advised because of the excessive lower incisors proclination (+6 on the mandibular plane).<\/p>\n<p>To avoid the upper first bicuspids extraction we decided to distalize the upper lateral sector from canine to the second molars on both sides.<\/p>\n<p>The upper third molars were extracted few weeks later the orthodontic appliance positioning. The space generated by the distalization was used to level the frontal teeth. In the lower arch it was necessary teeth levelling, uprighting and mesialization of tooth 47.<\/p>\n<p>The distalization was accomplished by using 2 mini-screws as anchorage, applied between lateral incisor and canine on both sides. To simplify and better explain the procedure, after the mini-screws insertion it was taken a silicon impression of the upper arch and the system was reproduced on the model cast.<\/p>\n<p>The applied mini-screws had a cylindrical shape, 8 mm length and 1,5 mm wide. Screws head has two holes crossed to each other that allows the sliding of the wires. In the holes given into the impression by the mini-screws head, we placed the same two mini-screws applied into the mouth so to reproduce the identical position (fig.11-16).<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/11-impronta-dentale_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"dental impression\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/11-impronta-dentale_thumb.jpg\" alt=\"dental impression\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/12-impronta-miniviti_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"mini-screws impression\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/12-impronta-miniviti_thumb.jpg\" alt=\"mini-screws impression\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/13-miniviti-nellimpronta_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"mini-screws impression\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/13-miniviti-nellimpronta_thumb.jpg\" alt=\"mini-screws impression\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/14microviti-nellimpronta_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"mini-screws impression\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/14microviti-nellimpronta_thumb.jpg\" alt=\"mini-screws impression\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/15-miniviti-nel-modello-in-gesso_thu.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"mini-screws in the model cast\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/15-miniviti-nel-modello-in-gesso_thu.jpg\" alt=\"mini-screws in the model cast\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/16-miniscrews-nel-modello-in-gesso_t.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"mini-screws in the model cast\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/16-miniscrews-nel-modello-in-gesso_t.jpg\" alt=\"mini-screws in the model cast\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><\/p>\n<p>Two .016-.016 inches stainless steel sectional were modelled to slide on one side in the hole of the mini-screws and to be bonded on the other side on the palatal surface of the first molar (fig. 17-18).<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/17-miniviti-con-foro_thumb1.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"mini-screws and wire\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/17-miniviti-con-foro_thumb1.jpg\" alt=\"mini-screws and wire\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/18-microviti-con-foro_thumb1.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"mini-screws head and bar\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/18-microviti-con-foro_thumb1.jpg\" alt=\"mini-screws head and bar\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><\/p>\n<p>The distalization force was realized by means of a coil spring compressed between the mini-screws and the gingival handle of the sectional (fig.19).<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/19-coil-per-distalizzare_thumb1.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"dental coil to distalize\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/19-coil-per-distalizzare_thumb1.jpg\" alt=\"dental coil to distalize\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><\/p>\n<p>This system, that was not based on patient&#8217;s collaboration and that avoid the proclination of the lower incisor because of the skeletal anchorage, produced a controlled force of quite 400gr on both sides.<\/p>\n<p>For the mini-screws insertion procedure it is important to control that one of the two hole is parallel to the occlusal plane so allowing the sectional sliding during teeth distalization.<\/p>\n<p>The sectional gingival handle was modelled to applied the force near the occlusal third of the first molars roots and more near as possible to the resistance center to have a body movement.<\/p>\n<p>The connection realized by a fiberglass from canine to the second molar on both sides contributed to move occlusally the resistance center increasing the body movement.<\/p>\n<p>After a first step this fiber connection was removed, to continue only the molar distalization (fig. 20-21-21a-21b).<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/20-mini-screws-palatali_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"palatal mini-screws\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/20-mini-screws-palatali_thumb.jpg\" alt=\"palatal mini-screws\" width=\"590\" height=\"433\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/21-distalizzazione-nella-seconda-cla-25255B2-25255D.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"palatal mini-screws and coils\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/21-distalizzazione-nella-seconda-cla-25255B2-25255D.jpg\" alt=\"palatal mini-screws and coils\" width=\"590\" height=\"449\" border=\"0\" \/><\/a><br \/>\n<a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/21a_thumb3.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"activated coil and mini-screws\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/21a_thumb3.jpg\" alt=\"activated coil and mini-screws\" width=\"590\" height=\"406\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/21b-_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\" activated coil and mini-screws\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/21b-_thumb.jpg\" alt=\"activated coil and mini-screws\" width=\"590\" height=\"401\" border=\"0\" \/><\/a><\/p>\n<p>Further coil activations were realized applying flowable resin on the sectional handle and light-cured it in the meanwile an utility probe activated the coil in contraction by reducing its length.<\/p>\n<p>After molar distalization (fig.22-26) it take place the bicuspids distalization, connected to each other.<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/22-distalizzazione-dei-molari_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"activated coil and mini-screws\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/22-distalizzazione-dei-molari_thumb.jpg\" alt=\"activated coil and mini-screws\" width=\"590\" height=\"394\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/23-sistema-per-distalizzare-i-molari.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"activated coil and mini-screws\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/23-sistema-per-distalizzare-i-molari.jpg\" alt=\"activated coil and mini-screws\" width=\"590\" height=\"326\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/24-miniviti-di-ancoraggio_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"anchorage and coil\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/24-miniviti-di-ancoraggio_thumb.jpg\" alt=\"anchorage and coil\" width=\"590\" height=\"301\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/25-seconda-classe-distalizzazione-mo-25255B1-25255D.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"molars distalization\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/25-seconda-classe-distalizzazione-mo-25255B1-25255D.jpg\" alt=\"molars distalization\" width=\"590\" height=\"326\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/26-correzione-rapporto-di-classe-mol.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"molars distalization\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/26-correzione-rapporto-di-classe-mol.jpg\" alt=\"molars distalization\" width=\"590\" height=\"363\" border=\"0\" \/><\/a><\/p>\n<p>Two bands and a trans-palatal bar were applied to anchorage the molars in the achieved position. The trans-palatal bar was activated in de-rotation an in slight contraction, to correct the buccal movement produced by the lingual-buccal force vector of the distalization system (fig. 27-31).<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/27-bande-molari-superiori_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"upper molars bands\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/27-bande-molari-superiori_thumb.jpg\" alt=\"upper molars bands\" width=\"590\" height=\"322\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/28-bande-per-ancoraggio-dentario_thu.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"upper molars bands for anchorage\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/28-bande-per-ancoraggio-dentario_thu.jpg\" alt=\"upper molars bands for anchorage\" width=\"590\" height=\"351\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/29-barra-palatale_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"trans-palatal bar\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/29-barra-palatale_thumb.jpg\" alt=\"trans-palatal bar\" width=\"590\" height=\"385\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/30-ancoraggio-barra-palatale_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"trans-palatal bar\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/30-ancoraggio-barra-palatale_thumb.jpg\" alt=\"trans-palatal bar\" width=\"590\" height=\"401\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/31-distalizzazione-canino_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"canine distalization lingual orthodontics\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/31-distalizzazione-canino_thumb.jpg\" alt=\"canine distalization lingual orthodontics\" width=\"590\" height=\"318\" border=\"0\" \/><\/a><\/p>\n<p>In the lower arch was bonded a .014 inches stainless steel arch from 36 to 45, and a .016-.016 stabilization sectional on 44 e 45, as 47 up-righting anchorage. The up-righting was realized positioning a buccal tube on the molar and a sectional, first in Ni-Ti and then in stainless steel, that moved from the occlusal slot of the tube and directly bonded on the 45 buccal surface. The mesialization was accomplished with a sliding mechanic by means an elastic chain and a lingual chain was applied to control the molar rotation (fig. 32-34).<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/32-uprighting-molare_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"molar uprighting \" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/32-uprighting-molare_thumb.jpg\" alt=\"molar uprighting \" width=\"590\" height=\"397\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/33-mesializzazione-molare_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"molar mesialization\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/33-mesializzazione-molare_thumb.jpg\" alt=\"molar mesialization\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/34-uprighting-e-mesializzazione_thum.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"mesialization and uprighting\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/34-uprighting-e-mesializzazione_thum.jpg\" alt=\"mesialization and uprighting\" width=\"590\" height=\"397\" border=\"0\" \/><\/a><\/p>\n<p>Then it was applied on the lingual surfaces from 33 to 35 an active retainer to move buccally and intrude the 34, to solve the scissor bite, meanwhile a stainless steel stabilization sectional connected 35 to 36.<\/p>\n<p>After lateral sectors distalization in the upper arch was applied an active retainer to level the frontal teeth (fig 34b). The retainer was modelled and activated as <a href=\"https:\/\/www.zerodonto.com\/en\/2010\/10\/active-retainers-clinical-procedure\/\">previously explained in the article.<\/a><\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/34b-retainer-attivo_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"active retainers lingual orthodontics without brackets\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/34b-retainer-attivo_thumb.jpg\" alt=\"active retainers lingual orthodontics without brackets\" width=\"590\" height=\"425\" border=\"0\" \/><\/a><\/p>\n<p>The following pictures showed the first class closure reached at the end of the therapy (fig. 35-39).<a name=\"_GoBack\"><\/a><\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/35-frontale-finale_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"active retainers lingual orthodontics without brackets\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/35-frontale-finale_thumb.jpg\" alt=\"active retainers lingual orthodontics without brackets\" width=\"590\" height=\"311\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/36-distalizzazione-settori-laterali-25255B1-25255D.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"active retainers lingual orthodontics without brackets\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/36-distalizzazione-settori-laterali-25255B1-25255D.jpg\" alt=\"active retainers lingual orthodontics without brackets\" width=\"590\" height=\"443\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/37-occlusale-inferiore-finale_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"active retainers lingual orthodontics without brackets\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/37-occlusale-inferiore-finale_thumb.jpg\" alt=\"active retainers lingual orthodontics without brackets\" width=\"590\" height=\"405\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/38-prima-classe-dentaria_thumb.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"active retainers lingual orthodontics without brackets\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/38-prima-classe-dentaria_thumb.jpg\" alt=\"active retainers lingual orthodontics without brackets\" width=\"590\" height=\"319\" border=\"0\" \/><\/a><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/39-prima-classe-molare-e-canina_thum.jpg\"><img loading=\"lazy\" decoding=\"async\" style=\"background-image: none; padding-top: 0px; padding-left: 0px; margin: 0px 0px 5px; display: inline; padding-right: 0px; border-width: 0px;\" title=\"active retainers lingual orthodontics without brackets\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/39-prima-classe-molare-e-canina_thum.jpg\" alt=\"active retainers lingual orthodontics without brackets\" width=\"590\" height=\"388\" border=\"0\" \/><\/a><\/p>\n<p><b>Bibliography :<br \/>\n<\/b><br \/>\n1. Macchi A, Rania S, Cirulli N. Una proposta per la gestione di disallineamenti anteriori: il mantenitore attivo di contenzione (MAC)&#8221;. Mondo Ortodontico, 1999; 5: 389-393.<br \/>\n2. Macchi A, Cirulli N. Fixed active retainer for minor anterior tooth movement. Journal of Clinical Orthodontics, 2000; 34: 48-49.<br \/>\n3. Liou EJW, Chen LIJ, Huang CS. Nickel-titanium mandibular bonded lingual 3-3 retainer: for permanent retention and solving relapse of mandibular anterior crowding. American Journal of Orthodontics and Dentofacial Orthopedics 2001; 119:443-449.<br \/>\n4. <a href=\"http:\/\/www.zerodonto.it\/mariniello.pdf\">Mariniello A, Cozzolino F. Lingual active retainers to achieve teeth levelling in orthodontics: case series. International Dentistry SA Vol 10 N 5, pag. 24-29, 2008.<\/a><br \/>\n5. Kluemper et al. Biologic response to an intraoral extraosseous implant system: a pilot study. Implant Dent, 1995; 4:46-49.<br \/>\n6. Southard et al. Am J Orthod Dentofacial Orthop, 1995; 107:251-158.<br \/>\n7. Prosterman et al. The use of implants for orthodontic correction of an open bite. Am J Orthod Dentofacial Orthop, 1995; 107:245-250.<br \/>\n8. Goodacre at al. Prosthodontic considerations when using implants for orthodontic anchorage. J Prosthet Dent 1997; 77:162-170.<br \/>\n9. Huang et al. Dental implants for orthodontic anchorage. Am J Orthod Dentofacial Orthop, 2005;127:713-722<\/p>\n<p><strong>For Information:<\/strong><\/p>\n<p><a href=\"mailto:zerodonto@gmail.com\" target=\"_blank\" rel=\"noopener\">zerodonto@gmail.com<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fixed orthodontics is the elected treatment in any age permanent dentition patients. In fact, in most of cases only with a fixed appliance is possible to achieve a precise and controlled dental movement. When patient needs an invisible treatment the answer is a fixed lingual treatment, that could be realized with or without brackets. The appliance is so bonded on the lingual aspect and this is why it is not visible. At first lingual fixed orthodontic without brackets was deviced to solve relapse of previous classic brackets treatment that didn&#8217;t want anymore a brackets therapy. Then was applied to treat malocclusion in patients never treated before because it does not produce tongue and soft tissues pains and phonetics diseases that usually occurred with a lingual brackets therapy. With fixed lingual orthodontic without brackets it is possible to treat every kind of malocclusions by means of orthodontic wires directly bonded on the lingual aspect of the teeth, like the active retainers, but also other devices, like the mini-screws. Mini-screws are a recent innovation in orthodontic treatment and have a large application also in conventional brackets therapy, because they allowed a maximum skeletal anchorage and a faster dental movement. The following clinical [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":4558,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[47],"tags":[],"coauthors":[33,23],"class_list":["post-3381","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-invisible-orthodontics"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Bracketless lingual orthodontics for the treatment of class II malocclusions<\/title>\n<meta name=\"description\" content=\"An example of dental and skeletal Angle second class treated by means of this innovative bracketless fixed orthodontic therapy. 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Dr. Anna Mariniello.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.zerodonto.com\/en\/2013\/01\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\/\" \/>\n<meta property=\"og:site_name\" content=\"Zerodonto | Dentistry in Blog\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/zerodonto\" \/>\n<meta property=\"article:author\" content=\"https:\/\/www.facebook.com\/AnnaMariniello\" \/>\n<meta property=\"article:published_time\" content=\"2013-01-17T15:35:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2017-10-19T14:01:23+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2013\/01\/30-ancoraggio-barra-palatale_thumb.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"692\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Anna Mariniello, Fabio Cozzolino\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Anna Mariniello, Fabio Cozzolino\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/2013\\\/01\\\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/2013\\\/01\\\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\\\/\"},\"author\":{\"name\":\"Anna Mariniello\",\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/#\\\/schema\\\/person\\\/a249adce908008bfd4dc94d78a0d7523\"},\"headline\":\"Lingual Orthodontics without brackets for the treatment of Angle II Class malocclusions\",\"datePublished\":\"2013-01-17T15:35:00+00:00\",\"dateModified\":\"2017-10-19T14:01:23+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/2013\\\/01\\\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\\\/\"},\"wordCount\":1129,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/2013\\\/01\\\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/wp-content\\\/uploads\\\/2013\\\/01\\\/30-ancoraggio-barra-palatale_thumb.jpg\",\"articleSection\":[\"Invisible Orthodontics\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/2013\\\/01\\\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/2013\\\/01\\\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\\\/\",\"url\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/2013\\\/01\\\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\\\/\",\"name\":\"Bracketless lingual orthodontics for the treatment of class II malocclusions\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/2013\\\/01\\\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/2013\\\/01\\\/bracketless-lingual-orthodontics-angle-ii-class-malocclusions\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/wp-content\\\/uploads\\\/2013\\\/01\\\/30-ancoraggio-barra-palatale_thumb.jpg\",\"datePublished\":\"2013-01-17T15:35:00+00:00\",\"dateModified\":\"2017-10-19T14:01:23+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/www.zerodonto.com\\\/en\\\/#\\\/schema\\\/person\\\/a249adce908008bfd4dc94d78a0d7523\"},\"description\":\"An example of dental and skeletal Angle second class treated by means of this innovative bracketless fixed orthodontic therapy. 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She attended a Postgraduate Retraining Course in Orthodontics in 2004\\\/2005 at the University \u2018Federico II\u2019 of Naples. Then she specialized in Orthodontic in 2010 at the Catholic University of the Sacred Heart of Rome. Founder of the dental blog Zerodonto \u201chttps:\\\/\\\/www.zerodonto.com\\\/en\\\/\\\" with Dr. Fabio Cozzolino and Dr. Roberto Sorrentino. Author of a book on lingual orthodontics:\u00a0\u201cAtlas of bracketless fixed lingual orthodontics\u201d, Quintessences publishing Italia. Author of national and international orthodontic publications. Lecturer at several national and international Conferences, Courses and Master Courses in different Universities about Orthodontics and multidisciplinary approach. Her main clinical interest is bracketless invisible fixed lingual orthodontics. She works as private practitioner in Naples at Cozzolino Dental Office. 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She attended a Postgraduate Retraining Course in Orthodontics in 2004\/2005 at the University \u2018Federico II\u2019 of Naples. Then she specialized in Orthodontic in 2010 at the Catholic University of the Sacred Heart of Rome. Founder of the dental blog Zerodonto \u201chttps:\/\/www.zerodonto.com\/en\/\" with Dr. Fabio Cozzolino and Dr. Roberto Sorrentino. Author of a book on lingual orthodontics:\u00a0\u201cAtlas of bracketless fixed lingual orthodontics\u201d, Quintessences publishing Italia. Author of national and international orthodontic publications. Lecturer at several national and international Conferences, Courses and Master Courses in different Universities about Orthodontics and multidisciplinary approach. Her main clinical interest is bracketless invisible fixed lingual orthodontics. She works as private practitioner in Naples at Cozzolino Dental Office. Complete resume here.","sameAs":["https:\/\/www.zerodonto.com\/en\/author\/annamariniello\/","https:\/\/www.facebook.com\/AnnaMariniello"],"url":"https:\/\/www.zerodonto.com\/en\/author\/annamariniello\/"}]}},"_links":{"self":[{"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/posts\/3381","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/comments?post=3381"}],"version-history":[{"count":8,"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/posts\/3381\/revisions"}],"predecessor-version":[{"id":17224,"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/posts\/3381\/revisions\/17224"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/media\/4558"}],"wp:attachment":[{"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/media?parent=3381"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/categories?post=3381"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/tags?post=3381"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.zerodonto.com\/en\/wp-json\/wp\/v2\/coauthors?post=3381"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}