Mandibular molar uprighting using mini-implants: different approaches for different clinical cases--two case reports.

Aim: To detail two different clinical protocols and case studies using mini-implant anchorage developed to respond to certain clinical conditions.

Methods: Two clinical protocols are described to upright mesially tilted mandibular molars. In the first protocol, a single mini-implant is inserted distally to the molar to be uprighted, and an elastic traction chain is applied to the tooth. In the second clinical approach, two mini-implants are inserted mesially. A screw-suspended TMA sectional archwire is applied (Derton-Perini technique). Two cases, descriptive of the two different treatment protocols, are described. In the first case, the mandibular right second premolar was missing and the adjacent first molar needed to be uprighted. A single screw was inserted distally to the first molar, and an elastic chain was applied. In the second case, the mandibular left second molar was missing and the third molar needed to be uprighted. Two mini-implants were inserted mesially and a fully screw-supported sectional archwire was used to upright and bodily mesialize the third molar.

Results: Both uprighting approaches uprighted the molar axis without loss of anchorage.

Conclusion: The two approaches to mandibular molar uprighting, developed as rational responses to different clinical cases, were both found to be effective.