To achieve pure molar distalization without the expense of anterior teeth proclination is always a challenging job for orthodontist. In the past, headgear was the most common way to achieve this task, but this relied on patient's compliance. Besides, headgear normally produces symmetrical molar distalization on both sides, but this may not be a desired effect on dental asymmetry cases. Nowadays, temporary anchorage device (TAD) has been used popularly to assist with orthodontic anchorage and active tooth movement. Molar distalization, therefore, can also be accomplished by incorporating the TAD into the orthodontic treatment.
Here presents a case with class I incisor on mild skeletal class II base with average FMA and mild crowding on both arches. The upper centerline is 2 mm deviated to the right and the lower centerline is coincident. Molar relationships are right side class I and left side half-unit class II. In order to correct upper centerline deviation and to achieve class I buccal segments on both sides, TAD was inserted on the upper left quadrant and utilized for unilateral molar distalization. Buccal segment teeth were shuffled one by one until achieving class I relationship. By applying this method, This patient avoided the need of extraction, and class I buccal segments and coincident centerlines were also achieved.