Three-dimensional retraction of anterior teeth with orthodontic miniplates in patients with temporomandibular disorder

Vertical dimension control is critical for adults with Class II high-angle malocclusions. If the patient has a temporomandibular disorder, this requirement is exacerbated. When extraction is planned, the treatment challenge is further increased. This article reports on a new biomechanical design (C-therapy) appropriate for anterior segment retraction with excellent control of the vertical dimension, even in a Class II high-angle patient with a temporomandibular disorder. Maximum retraction of the maxillary anterior segment can be achieved with a lingual retractor and a palatal miniplate without appliances on the maxillary posterior segments. Mandibular anterior vertical height was well controlled by a second miniplate in the mental region. This device also contributed to mandibular anchorage reinforcement. A patient with temporomandibular disorder symptoms treated with this approach is shown.