A New Treatment Method to Retract Anterior Teeth with the Double J Retractor System in Class III Malocclusions

The double J retractor (DJR) is a novel method to close extraction space with the aid of mini-implants. DJR is placed lingually on the incisors and has a lower profile compared with the conventional lingual bracket appliance. It consists of a newly designed lingual level arm retractor connected to the lingual of the 6 splinted anterior teeth. The anterior segment is retracted with a mini-anchor-screw as a temporary skeletal anchorage device without brackets and wires on the posterior teeth. Compared with conventional orthodontic procedures, such as leveling, space closure, and finishing, the procedures used with DJR are reduced to 2 steps: space closure and alignment/finishing. With DJR, the anterior teeth are retraced first without the leveling stages, and then the leveling and finishing procedures are performed together for individual tooth alignment and detailing with conventional fixed appliances or invisible clear thermoplastic appliances, such as Invisalign (STAR28 Dental Group, Invisalign Center, Seoul, Korea). With new and simple appliances, the anterior teeth can be retracted with proper torque control and shorten the treatment period. Patient satisfaction could be maximized by prompt anterior teeth and lip retraction at the beginning of treatment. In this article, the biomechanics in the use of DJR are discussed together with the application for treatment of Class III malocclusions.