Molar distalisation with skeletal anchorage.

BACKGROUND Distalisation of the upper molars can be used to treat a dental Class II deep bite malocclusion with a flat facial profile. It is a useful procedure when extraction treatment has been refused and providing distalisation is an appropriate solution to the patient's problem. AIMS To describe distalisation of the upper buccal segments using a modified distal jet appliance and miniscrew. METHODS Two case reports are presented. The first case was treated with a distal screw appliance: a modified distal jet appliance with a palatal miniscrew and without the premolar arms. The Nance button was anchored to the palatal bone by a miniscrew inserted through a posterior locating plate. Locating holes in the plate ensured that the miniscrew was inserted into a site with optimal bone in the posterior part of the palate. The second case was treated with a similar distal screw appliance, but in this case the locating plate was embedded in the acrylic button. The miniscrew was inserted through a prepared hole in the button and plate. The locating hole(s) ensured that a screw could be inserted into an optimal site to one side of the median palatal suture. CONCLUSIONS The distal screw appliance can be used to distalise upper teeth with minimal or no anchorage loss.