ABSTRACT
A missing first molar is a common issue in adult orthodontic patients. The missing molar can lead to the tilt of the second molar and the extrusion of the opposing tooth. One of the orthodontic treatment techniques for intrusion and uprighting of molars is TADs. This study aims to describe orthodontic treatment using TADs to correct extrusion in the maxilla premolar using two TADs. Whilst, the tilting molars were treated via one TADs and an uprighting spring for each molar to upright them, to achieve normal occlusion, and improve functional occlusion. A 26-year-old male arrived with a chief complaint of functional problems. Four first molars were missing. Examination of the patient revealed a convex facial profile and mild crowding of lower anterior teeth. Class II skeletal relationship was diagnosed with the retrognathic mandible (SNA 80°, SNB 74°, ANB 6°), lower incisors inclination (U1 – L1 116°, U1 – SN 104°, L1 – MP 100°), extrusion of the first premolar left and severe tilting first lower molar. TADs were used to intrude the first premolar left maxilla and to upright the second molar mandible. Patient was using four TADs in that case. Progress showed premolar maxillary intruded 4 mm, confirmed by superimposition in cephalometric before and after treatment and second slightly upright within 2 months confirm with panoramic before and after treatment. The treatment for this patient remains ongoing using fixed orthodontics. Intrusion and uprighting problems were effectively corrected by TADs.
