Occlusal Plane changes with mini-implants to solve complex cases

Controlling the occlusal plane in the three dimensions is essential for correcting complex functional imbalances and achieving proper smile aesthetics. Mini-implants have transformed modern orthodontics by providing enhanced anchorage control and improved predictability, thereby enabling novel treatment opportunities. These opportunities include the simultaneous distalization of all teeth in an arch, retraction of the anterior dental segment, non-surgical rapid palatal expansion in adults, correction of the gummy smile through entire maxillary arch intrusion, and modifications to the occlusal plane. The latter involves changes along the x-axis in the coronal plane, specifically addressing asymmetries in the frontal norm, as well as changes along the y-axis in the sagittal plane, which address inclinations of the occlusal plane such as anterior open bites. Additionally, modifications involve changes along the z-axis in the axial plane, correcting inclinations of the occlusal plane, including posterior sagittal discrepancies like Class II and III and midline corrections. This paper focuses on the latest and most accurate techniques, from diagnostic tools to detailed biomechanical execution of several treated clinical cases, with an emphasis on successful three-dimensional management of dental arches and occlusal planes.