TAD Assisted Retraction in A Lingual Appliance for Correction of Dentoalveolar Class II Malocclusion

ABSTRACT Orthodontics, in today’s contemporary world, is focused mainly on aesthetics. Most of the adult patients are reluctant to orthodontic treatment due to their un-aesthetic appearance. To answer such problems several options are available, ranging from aesthetic brackets, made from tooth-coloured plastic or ceramic, another option is Invisalign, which is restricted to the treatment of only certain kinds of simple malocclusions. Hence, the lingual appliance selected for this case is by far the best option available from the aesthetic outlook and mechanical aspect however torque control of anterior teeth in lingual orthodontic appliance has always been considered a major problem. For maintaining the torque value of anterior teeth either we have to apply direct moment and force to the lingual brackets or by using a different combination of lever-arm and mini-screws mechanics to deliver force in a line that passes through or near to the center of resistance. In the present case, we utilized the combination of long lever-arm and palatal mini-implant system to produce a controlled en-masse retraction of the anterior teeth. This customised long lever arm created by soldering one power to others such that the point of force application is close the center of resistance.