Multipurpose orthodontic system using palatal implants for solving extremely complex orthodontic problems

Asymmetrical treatment mechanics are one of the most complex treatment options. Three dimensional force analysis must be completed, then approaches that can produce a three dimensional force system, such as palatal implants, are beneficial. A 37-year-old female with skeletal Class III required very complex mechanics because the maxillary right side showed a transpositioned second premolar, ectopic eruption of the second molar, large periapical lesion of the lateral incisor and the left side showed a high canine. The treatment plan involved extraction of the maxillary right lateral incisor, right first molar, left second premolar and third molar, as well as right quadrant mesialization and left quadrant distalization from a maxillary palatal implant. Consequently, the transpositioned maxillary right second premolar and ectopically erupted second molar were mesialised 14mm and 8mm respectively. Satisfactory improvement of the overjet and overbite, and good intercuspation were obtained. Active treatment was completed in 2 years 9 months. Complex treatment mechanics, such as asymmetric force systems, can be created using this palatal implant.