Distal movement of upper incisors in cases with upper anterior spacing

Some Class II/l cases have upper incisors which are demonstrably too far forward in the face. If this is associated with anterior spacing, it is a relatively routine procedure to gather up the upper incisors and retract them into the available space. (The mechanics have been likened to using a piece of rope to gather up a group of marbles on a tablecloth!)

Sliding mechanics are used, on a normal working steel rectangular wire, and active tiebacks achieve the necessary retraction and space closure, sometimes augmented by a light four-link anterior elastic chain. It is necessary to ensure that good lower arch leveling has been achieved beforehand. Appropriate anchorage support from an upper palatal bar, a sleeping headgear, or Class II elastics may be needed. Typical treatment mechanics are shown diagrammatically (figs 7.17 & 7.18) and may be seen in Case DO, page 209.

Occlusal Contact

Figs 7.17 and 7.18 If there is anterior spacing, sliding mechanics on a .019/.025 steel rectangular wire may be used to retract incisors and close spaces. Archwire hooks should be close to upper lateral incisor brackets, to avoid impingement onto canine brackets as the space closes. Anchorage support can be provided from a palatal bar, headgear, or Class II elastics.

Fig. 7.19 Lateral view of sliding mechanics after upper first premolar extractions. Without anchorage support (A), reciprocal space closure normally occurs. With anchorage support (B), it is possible to retract the six anterior teeth into the space available and maintain A/P position of molars.

Fig. 7.19 Lateral view of sliding mechanics after upper first premolar extractions. Without anchorage support (A), reciprocal space closure normally occurs. With anchorage support (B), it is possible to retract the six anterior teeth into the space available and maintain A/P position of molars.

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