Bidimensional system for space closure treatment of missing lateral incisors: 10 years follow-up

INTRODUCTION: Missing lateral incisors represent a common condition that normally requires specific anchorage conditions to be treated with space closure mechanics to protract upper teeth creating a proper occlusal relationship. CASE PRESENTATION: Two cases showing Class II malocclusion with missing lateral incisors in developing age are presented, both treated with the same approach of maximum anterior anchorage applied using the Bidimensional Technique system. Long-term follow-up of 10 years is shown. MANAGEMENT AND OUTCOME: Bidimensional technique is a modified edgewise technique that uses sliding mechanics for protraction of the posterior segments by placing vertically slotted brackets of different sizes on the anterior (.018” x 0.025”) and posterior teeth (.022” x 0.028”). When a .018” x .022” wire is inserted in the .018” x .025” brackets slot on the incisors, third-order control is created in the incisor segment while the wire is undersized in the rest of the arch. Lateral brackets have been positioned on the canines, while the canine brackets have been positioned on the first premolars respecting a differential bonding height able to produce canine extrusion and first premolars intrusion and proper torque expression. Full Class II molar relationship and Class I substituted canine relationship has been reached in both cases and kept stable in the long-term follow-up (10 years). DISCUSSION: The described approach provided anterior anchorage with more simple mechanics expressing the anterior torque with a full engagement concept and adding few auxiliaries (uprighting springs) which do not require compliance.