Esthetic pre-prosthodontic treatment opportunities by using orthodontic mini-implants.
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Benedict Wilmes
Course details
Lecturers
Details
1h 46min
English
Lesson program
The intrusion of overerupted upper molars is a difficult orthodontic treatment objective. When conventional appliances are used, the extrusion of adjacent teeth may occur. In recent years, temporary anchorage devices have been used to avoid these unwanted side effects. For this purpose, mini-implants have been primarily inserted in the alveolar process. However, due to many disadvantages of mini-implant placement between the roots of the upper molars, it is now preferred to insert mini-implants in the anterior palate ensuring a low risk of failure or mini-implant fracture. As a less bulky alternative to the “Mousetrap” appliance (with TPA) the “Mini-Mousetrap” (without TPA) was designed and comprised two mini-implants in the anterior palate and lever arms for molar intrusion. If a TPA is not used, molar movement must be monitored and the direction of the force adjusted to avoid unwanted molar tipping.
Unless a prosthetic replacement is inserted soon after extraction or loss of a first molar, the second molar may tip mesially into the edentulous space. Not only will the first-molar space contract mesiodistally, but eccentric occlusal loading will reduce the biomechanical loading capacity of the second molar. Such a situation requires preprosthetic uprighting of the second molar using appropriate mechanics. Simply tipping the molar distally will lead to extrusion and likely cause occlusal interference. Stable anchorage is critical, since simultaneous intrusion and uprighting forces create a high moment load on the anchorage unit. Otherwise, unwanted mesial tipping and extrusion of the anchorage teeth may occur. The use of an orthodontic mini-implant for direct anchorage can help avoid such dental side effects. This lecture describes a technique using mini-implants in an edentulous first-molar site as anchorage for uprighting mesially tipped molars.
Lecturers 1
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Professor and Deputy Director of the Department of Orthodontics at Heinrich Heine University Düsseldorf, Germany (Professor since 2013). Specialist in orthodontics and dentofacial orthopedics with focus on non-compliant and invisible treatment strategies including temporary anchorage devices (TADs), lingual orthodontics, and clear aligner therapy. Maintains private orthodontic practice in Düsseldorf alongside academic position.
Over 20 years of clinical and academic experience treating complex orthodontic cases using skeletal anchorage systems and digital workflows. Pioneer in developing innovative TAD applications including palatal TADs with exchangeable abutments for transverse expansion, orthopedic protraction, and molar distalization. Research focuses on digital orthodontics, CAD/CAM technologies for customized appliances, biomechanics of skeletal anchorage, and treatment efficiency in adult orthodontics. Expert in combining TADs with aligners for predictable complex tooth movements.
Active Member of the Edward H. Angle Society of Orthodontists (Eastern Component). Recipient of First Prize from the German Orthodontic Society (DGKFO, 2007), First Prize from the European Orthodontic Society (EOS, 2009), and First Prize from the German Society for Lingual Orthodontics (2018). Author of over 200 peer-reviewed publications and textbook chapters on TADs, lingual orthodontics, and digital orthodontics. Reviewer for numerous international orthodontic journals including American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, European Journal of Orthodontics, and others. International lecturer having delivered over 300 lectures and courses in 70 different countries worldwide on skeletal anchorage, digital treatment planning, and contemporary orthodontic biomechanics.
DMD from Heinrich Heine University Düsseldorf, Germany. Postgraduate degree (Dr. med. dent.) in Orthodontics and Dentofacial Orthopedics from Heinrich Heine University Düsseldorf. Professor appointment at University of Düsseldorf (2013).
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