Orthodontics provided by Dr Peter Vaughan, specialist orthodontist, and surgery provided by Dr Paul Coceancig, specialist oral & maxillofacial surgeon.

This 18 year old girl had never developed her left lower second premolar tooth. The orthodontist wanted to have the deciduous molar removed, and to move the permanent first molar into the tooth space, but the length of movement was considerable, and the forces were more likely to move her front teeth backwards, than her back teeth forwards. A traction screw was employed to provide a stable anchorage, and gradually the first molar was moved into ideal position.

X-ray shows retained lower second deciduous molar, and developing wisdom tooth, (which remains buried). The intention is to remove the baby tooth, and to orthodontically pull the first permanent molar forward. To maintain 7 teeth in the dental arch quadrant, the wisdom tooth will remain as the 7th tooth.

Traction screw placed between the canine and first premolar, allows for a stable traction point to provide pull on the first molar, and which is guided by the orthodontic wire. Placement of a simple elastic between the first premolar and first molar, will pull the premolar backwards more than it will pull the molar forward.

Gradual movement of lower left first molar occurs along orthodontic wire, with traction point provided by screw, and with fresh elastics providing constant sustained uni-directional force.

Final x-ray image showing repositioned first molar, and with developing wisdom teeth providing final 7th tooth position for quadrant.

Orthodontic closure demonstrated in final treatment photo, and just prior to traction screw removal. Traction screw insertion and removal takes approximately 30 seconds, and is covered under Medicare when provided by Oral & Maxillofacial Surgeons.

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