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Mini-implants have been successfully incorporated into orthodontic practice all over the world. One of the most popular applications of mini-implant anchorage is to facilitate retraction of the anterior teeth. This article reviews the mechanics involved in anterior tooth retraction with mini-implant supported anchorage. An attempt has been made to synthesize information available in the literature and present it in a manner that is easily understandable from a clinical perspective. We discuss the fundamental differences mini-implant based incisor retraction has when compared to conventional techniques, mechanical factors affecting this process and provide a step-by-step analysis of incisor retraction. In addition, various models of space closure are discussed that have evolved through careful evaluation of in vitro and in vivo experiments., (© 2014 British Orthodontic Society.)

Treatment of an impacted maxillary central incisor poses a unique challenge to the orthodontist because of its position within the esthetic zone, requiring careful management of the soft tissues and an effective biomechanical setup for alignment. This article describes a novel method of extending an extrusion wire from cross tubes attached on the base archwire for forced eruption of impacted central incisors. The effectiveness and versatility of this method are demonstrated with 2 patients., (Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Multiple treatment options are available for patients who have impacted canines in addition to congenitally missing lateral incisors. This article describes the treatment of a 13-year-old postpubertal girl with bilaterally impacted permanent maxillary canines, missing lateral incisors, retained deciduous canines, and a midline diastema. The orthodontic treatment plan included extraction of the deciduous canines. A lingual and labial approach (1-couple force system) was used to move the permanent canines into the arch. Through a collaborative team effort, including an orthodontist and a periodontist, the outcome was excellent esthetically and functionally., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Aim: To determine the efficacy of mini-implants as intraoral anchorage during en masse intrusion of the six maxillary anterior teeth., Methods: Ten patients from the Department of Orthodontics, KLE University, Belgaum, India, who required intrusion of their anterior teeth were selected for this study. After initial alignment and leveling, the maxillary arch was divided into one anterior segment and two posterior segments. A 0.021 3 0.025-inch stainless steel wire was placed in all three segments. In all patients, one mini-implant was placed bilaterally between the lateral incisor and canine. An elastic chain was used to deliver an intrusive force of 45 cN; it was supplemented by a distal force of about 20 cN per side. Patient records were taken at the beginning and end of intrusion., Results: The amount of intrusion was statistically and clinically significant. The canines were more intruded (3.5 ± 0.9 mm) than the incisors (2.9 ± 1.0 mm). The axial inclination of the incisors did not significantly change. The average duration to accomplish this intrusion was 4.0 ± 1.5 months, with a mean rate of 0.9 mm per month for the canines and 0.7 mm per month for the incisors., Conclusion: Mini-implants are an efficient and stable source of anchorage for the en masse intrusion of the six maxillary anterior teeth., (© 2010 BY QUINTESSENCE PUBLISHING CO, INC.)

Vertical dimension control with fixed appliance mechanotherapy has always been a matter of concern in moderate to severe high-angle patients with severe proclination of the anterior teeth. Extrusion of the posterior teeth is an inevitable sequela of conventional mechanics in such patients, especially if they are adults. This article reports on 3 patients who were treated with mini-implants (diameter, 1.3 mm; length, 8 mm) placed between the roots of the second premolar and the first molar for en-masse retraction of the anterior teeth. The biomechanical force system that developed not only maintained absolute anchorage, but also provided effective control over the posterior dentoalveolar dimension so that dramatic improvement in facial esthetics could be achieved. Small but significant autorotation of the mandible was noted; this led to increased chin prominence in all 3 patients. With accurate diagnosis and treatment planning, mini-implant anchorage can be a possible alternative to orthognathic surgery in similar borderline patients., (Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

This report describes the orthodontic treatment of a 14-year-old boy who had 3 impacted maxillary teeth (right canine, left central incisor, and left second molar), 2 supernumerary teeth, and an odontoma. The treatment protocol involved surgical intervention followed by sequential traction of the 3 impacted teeth. The patient's smile dramatically improved after orthodontic treatment. Good posterior occlusion was achieved. However, long-term monitoring of the stability and periodontal health is critical.

Introduction: This study was conducted to determine the efficiency of mini-implants as intraoral anchorage units for en-masse retraction of the 6 maxillary anterior teeth when the first premolars are extracted compared with conventional methods of anchorage reinforcement., Methods: Thirty patients requiring high anchorage after extraction of the maxillary first premolars were selected for this study. They were divided into 2 groups of 15 each. In the first group (G1), mini-implants were used for en-masse retraction; in the second group (G2), conventional methods of anchorage preservation were followed. Horizontal, vertical, and angular positions of the maxillary first molar and central incisor were evaluated cephalometrically before and after orthodontic retraction., Results: The maxillary first molars in the G1 patients showed net distal movement of 0.55 mm, and mesial movement of 1.95 mm was found in G2. The differences were statistically significant. Distal tipping of the first molar of -0.13 degrees+/-3.63 degrees was seen in G1, and mesial tipping of 3.7 degrees+/-3.9 degrees was observed in G2. No significant differences were found in the rates of incisor retraction between the 2 groups. However, G1 showed more than 2 mm of incisor intrusion; this was statistically significant., Conclusions: Mini-implants are efficient for intraoral anchorage reinforcement for en-masse retraction and intrusion of maxillary anterior teeth. No anchorage loss was seen in either the horizontal or the vertical direction in G1 when compared with G2. However, a statistically significant decrease in intermolar width was noted in G1.

This case report describes the treatment of a 16-year-old post pubertal male patient with a severe Class II division 2 malocclusion and 100% deep bite. In the first phase of treatment, a 'Jones-Jig' molar distalization appliance was used to distalize the maxillary molars by more than 6 mm, to achieve a Class I molar relation. In the second phase of treatment, mini-implants were inserted between the roots of the maxillary lateral incisor and canine to intrude all the maxillary anterior teeth en masse in a single step. Four millimetres of intrusion was achieved. The implants remained stable throughout treatment. In the mandibular arch the incisors were proclined to alleviate the severe crowding. Good overjet and overbite was achieved and has been maintained one year after completion of active orthodontic treatment.

This case report describes the treatment of an adult female with a severe Class II malocclusion and congenitally missing mandibular incisors. It was decided to extract the maxillary first premolars and use mini-implants for en masse retraction of the maxillary anterior teeth. More than 13 mm of maxillary incisor retraction was obtained, with little change in the mandibular incisor inclination. The patient's facial esthetics showed dramatic improvement. The upper and lower lips were retracted by 6 mm and 7 mm, respectively. This helped reduce the mentalis strain and improve chin projection. In the mandibular arch, the canines were reshaped to substitute for lateral incisors and the first premolars were used as canines. After 25 months of retention, the results have been maintained. In this report, mini-implants proved to be an effective alternative to orthognathic surgery.