Protraction of a second molar and a mesially-impacted third molar into the adjacent first-molar extraction site through mini-implant anchored Albert protraction loop with the aid of alveolar ridge augmentation.

Abstract

Protraction of a mandibular second molar to substitute the adjacent missing first molar is challenging in clinical practice. In this case report, we demonstrated a 21-year-old patient with an untreatable periapical lesion of the mandibular right first molar. The adjacent mandibular second molar had normal root length and the third molar was mesially-impacted. Two treatment alternatives were available: implant restoration of the first molar with poor prognosis or mesialization of the second and third molars to substitute the first and second molars. The patient finally chose the second treatment option. Ridge augmentation with bone grafting was performed to deal with alveolar atrophy at the first-molar extraction site. Molar protraction was accomplished with a novel protraction loop appliance (Albert loop) that was anchored onto an interradicular mini-implant. At the end of the treatment, excellent buccal interdigitations and good root parallelism were achieved. Molar protraction into the atrophic alveolar site can be efficiently accomplished through Albert protraction loop anchored on a mini-implant and ridge augmentation.