[Multiple uses of skeletal anchorages: taking advantage of mini-screws to improve aesthetics with active and passive appliances].

INTRODUCTION

The main causes of failures in canine traction are anchorage defects, incorrect direction of force, uncontrolled forces. An adolescent female (10 years, 9 months) presents with two included canines on the maxillary arch, in a palatal position and her lateral incisors (12 and 22) are microdontic. Two mini-screws are inserted on the palate, in a mesial position to 16 and 26 to secure the traction of 13 and 23; in general, braces are bonded after this first step. After debonding, mini-screws remain to help stabilize the palatal plate during the retention period and to avoid unaesthetic metallic wires and hooks which sometimes cause occlusal interferences.

DISCUSSION

The alternatives are discussed: Ballista spring, mini-screw inserted in the palatal suture, Nance appliance… Conclusion: The multi-use of temporary anchorage devices during traction of palatally impacted canine(s) (especially in the case of bilateral inclusions) offer new alternatives by securing the canine displacement, eliminating almost all of the patient's compliance (no loss of sagittal anchorage). This type of small appliance increases the patient's comfort and decreases the complexity of activations. The global duration of treatment with braces can be decreased if no braces are needed during the first steps, and then retention can be more effective and more aesthetic, especially during smiling.