Buccal Intrusion

This adult patient was originally scheduled for posterior maxillary impaction to correct her anterior open bite. Instead, after initial alignment, Infinitas mini-implants were used for intrusion of the upper buccal segments. Extraction of the premolars was also undertaken, but no space closure was undertaken until incisor contact had been achieved. The patient also had extraction of the 3rd molars once the intrusion was  proceeding successfully. Prior to this a significant step had developed between the 2nd and 3rd molar crowns, as the former teeth were intruded.

A 1.5mm diameter 9mm body length, long neck mini-implant was inserted bilaterally in the palatal alveolus between the 1st and 2nd molar palatal roots (after removal of a circle of mucosa using the Infinitas mucotome). Direct elastomeric traction (to bonded cleats) on the molars produced differential elevation of their palatal cusps (as well as bodily intrusion), whilst arch constriction was counteracted by archwire expansion. Some over-correction of the anterior openbite was achieved as evidenced by posterior openbites at debond.
The pre- and post-intrusion lateral radiographs demonstrate the alteration in the maxillary occlusal plane and also the resulting favourable mandibular auto-rotation (and pogonion advancement).