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En-masse Distalisation of Mandibular Dentition with Ramal Miniplate for Correction of Class III Malocclusion: A Case Report

Mandibular arch distalisation is a non extraction camouflage treatment modality for class III malocclusion, and the introduction of skeletal anchorage devices has enabled its use with minimal patient compliance and reciprocal side effects. The aim of this case report was to show the efficacy of the retromolar fossa as a suitable skeletal anchorage site for mandibular dentition distalisation. Inter-radicular miniscrews are the most commonly used forms of skeletal anchorage; however, they are often problematic in the mandible because of their high failure rate in the posterior region. In order to avoid these issues, some clinicians place miniscrews extraradicularly in the buccal shelf area or in the retromolar area. This approach is demonstrated through a case report of an 18- years-old male patient with a chief complaint of extra teeth and spacing in the upper front teeth. The diagnosis formulated was a Class III skeletal pattern, anterior divergence, Angle’s Class III malocclusion with an edge-to-edge bite and presence of mesiodens in the premaxillary region. The treatment approach was to use skeletal anchorage to distalize the mandibular arch with ramal plates after extraction of the mandibular third molars, since the patient refused the surgical treatment. At the 1 year follow-up appointment, there was no noticeable relapse or signs or symptoms of adverse effects like gingival recession, mobility and bone loss.