Evaluation of the Co-Go-Me angle as a predictor in Class II patients treated with Herbst appliance and skeletal anchorage: a retrospective cohort study.

Introduction: A condylion-gonion-menton (Co-Go-Me) angle threshold of 125.5° has been introduced as a predictive parameter of cephalometric mandibular response in the orthopedic treatment of growing Class II patients with functional appliances, despite some contradictions in the literature. Considering the lack of studies evaluating the role of skeletal anchorage, this study aims to reassess the threshold of 125.5° in the Co-Go-Me angle as a useful predictor in growing skeletal Class II patients treated with acrylic splint Herbst appliance and two mini-screws in the lower arch (STM2). Methods: Thirty-five consecutively treated patients (20 males, 15 females; mean age, 11.37 years) with mandibular retrusion were classified into two groups according to their Co-Go-Me baseline values (Group 1, <125.5°; Group 2, >125.5°). The STM2 protocol involved the use of the MTH Herbst appliance with an acrylic splint in the lower arch and two interradicular mini-screws as anchorage reinforcement. Cephalometric analysis was performed by the same operator for each patient at baseline (T0) and at the end of the Herbst phase (T1). The effects of time and group on the variables were assessed by a repeated-measures analysis of variance. The primary research outcome was the difference between the groups in terms of mandibular responsiveness to treatment referred to as the relative difference (T1-T0) in Co_Gn. Results: The mean duration of the treatment was 9.5 months. No statistically significant differences between groups were detected at baseline, except from the expected SN/GoMe° (p < 0.001) and Co-Go mm (p = 0.028). No statistically significant changes between groups, which were caused by the treatment, were found considering the mandibular sagittal and vertical skeletal parameters. Similarly, no statistically significant differences were found in the dental changes between the high-angle and low-angle patients, apart from the upper molar sagittal position (p = 0.013). Discussion and conclusions: The 125.5° threshold in the Co-Go-Me value was not a reliable predictive parameter for the mandibular response in growing patients treated with the MTH Herbst appliance and lower skeletal anchorage. Due to its effective control in the sagittal and vertical planes, the STM2 technique might be an appropriate protocol to use in treating skeletal Class II patients, regardless of the growth pattern.

Tooth movement with dental anchorage vs. skeletal anchorage: A systematic review of clinical trials.

The aim of this study is to compare the time and movement of orthodontic treatment using dental anchorage and skeletal anchorage in adolescent and adult patients with dental malocclusions. A systematic search was conducted in the Embase, PubMed, Lilacs, Cochrane, Trip, and Scopus databases up to October 2022. All the articles were selected using title and abstract, applying the inclusion and exclusion criteria. Disagreements were resolved with a third author. Finally, a full-text selection took place. The data extraction was conducted by two authors who independently evaluated the risk of bias. The methodological quality of the randomized clinical trials was evaluated using the Cochrane tool for the evaluation of the randomized clinical trials. Six articles were included in the data analysis. There were four clinical trials and two randomized clinical trials. A total of 176 patients was obtained with an age range between 14 and 46 years. Four studies showed significant differences when comparing the two anchorages in retraction or distalization of tooth groups, and two showed no differences when using dental and skeletal anchorage for vertical movements; only the articles with vertical movements showed relapse. We can conclude that skeletal anchorage generates precise and stable horizontal movements without overloading or changing the position of the molar. Future studies must incorporate three-dimensional technology for greater clinical accuracy.

Upper Midline Correction Using the Mesial-Distalslider.

AIM: The purpose of the present study is the three-dimensional (3D) analysis of molar and incisor movements that occur during the correction of the upper midline deviation by using the Mesial-Distalslider appliance. MATERIALS AND METHODS: A total of 20 consecutive patients (12 women and 8 men; mean age 19.6 ± 11.1 years) were selected from the Orthodontic Department of Heinrich-Heine University of Düsseldorf. To correct the upper midline deviation (>2 mm), the patients were treated with asymmetric mechanics (mesialization on one side and distalization on the contralateral side) with the aid of Mesial-Distalslider. Dental casts were taken for each patient before (T0) and after the treatment (T1). The casts were 3D digitized and the models were superimposed on the palatal anterior region. Three-dimensional molar movements and sagittal incisor movements (proclination and retroclination) were assessed for T0 and T1. RESULTS: At the end of the treatment, the total movements of the molars resulted in 4.5 ± 2.2 mm (antero-posterior direction), -0.4 ± 2.4 mm (transverse direction) and 0.3 ± 0.9 mm (vertical direction) on the mesialization side, and -2.4 ± 1.7 mm (antero-posterior direction), -0.5 ± 1.5 mm (transverse direction) and 0.2 ± 1.4 mm (vertical direction) on the distalization side. Incisor displacement was 0.9 mm ± 1.7 (mesialization side) and 0.6 mm ± 0.7 (distalization side). CONCLUSION: The Mesial-Distalslider appliance could be considered a valuable tool in orthodontic treatment for upper midline correction. Within the limits of a retrospective study, asymmetric molar movements appeared possible without clinically relevant anchorage loss.

Bilateral distalization of maxillary first molars in a group of adult patients after extraction of maxillary second molars using infra-zygomatic mini-implants: A prospective clinical trial.

BACKGROUND: It is now possible to predictably distalize maxillary first molars in nongrowing patients with the infra-zygomatic gear distalizer and to improve malocclusions without having to extract the premolars and regardless of the patient's compliance. The purpose of this study was to investigate the amount and rate of distal movement of the maxillary first molars using our proposed appliance after extraction of maxillary second molars. METHODS: Ten nongrowing female patients successfully treated with our proposed appliance were the subjects of this study. The amount, rate, and type of distalization, were analyzed through upper jaw cone beam computed tomography (pre- and post-treatment) and scanned casts taken on a monthly interval. RESULTS: The average amount of distalization of the maxillary first molars was 4.03 mm at the crown level and 2.88 mm at the root level. The rate of distalization had an average of 0.61 mm per month with a maximum of 0.79 mm in the first month because of the regional acceleratory phenomena after extracting the maxillary second molar. CONCLUSIONS: The maxillary first molars were distalized in a significant manner and all patients reached a Class I relation within an average duration of 6.4 months. The proposed appliance proved to be a viable noncompliance modality to distalize maxillary first molars correcting maxillary Class II malocclusions characterized by maxillary protrusion or maxillary incisor crowding.

Surface Treatment of Dental Mini-Sized Implants and Screws: A Systematic Review with Meta-Analysis.

Miniscrews are devices that allow for absolute skeletal anchorage. However, their use has a higher failure rate (10-30%) than dental implants (10%). To overcome these flaws, chemical and/or mechanical treatment of the surface of miniscrews has been suggested. There is no consensus in the current literature about which of these methods is the gold standard; thus, our objective was to carry out a systematic review and meta-analysis of the literature on surface treatments of miniscrews. The review protocol was registered (PROSPERO CRD42023408011) and is in accordance with the PRISMA guidelines. A bibliographic search was carried out on PubMed via MEDLINE, Cochrane Library, Embase and Web of Science. The initial search of the databases yielded 1684 results, with 98 studies included in the review, with one article originating from the search in the bibliographic references of the included studies. The results of this systematic review show that the protocols of miniscrew surface treatments, such as acid-etching; sandblasting, large-grit and acid-etching; photofunctionalization with ultraviolet light; and photobiomodulation, can increase stability and the success of orthodontic treatment. The meta-analysis revealed that the treatment with the highest removal torque is SLA, followed by acid-etching. On the other hand, techniques such as oxidative anodization, anodization with pre-calcification and heat treatment, as well as deposition of chemical compounds, require further investigation to confirm their effectiveness.

Protocolo BAMP: Reporte de Caso Clínico

El presente reporte tiene como objetivo presentar de manera secuencial y visual la protracción maxilar de un paciente clase III esqueletal, utilizando el protocolo BAMP. Una vez realizado el análisis clínico del caso se decidió realiza un tratamiento ortopédico a través del uso de miniplacas de titanio con elásticos intermaxilares de clase III siguiendo el protocolo BAMP, junto a un tratamiento ortodóncico dento alveolar con aparatología fija bimaxilar prescripción Roth 0.22" Mini sprint forestadent. Se observa el éxito del enfoque interceptivo utilizando el protocolo BAMP. Este enfoque logró reducir tanto el tiempo como la complejidad del tratamiento ortodóncico, y también disminuyó la necesidad de someterse a una cirugía ortognática en la edad adulta. El tratamiento BAMP, diseñado para ciertas edades y crecimiento, se demostró exitoso en un paciente de 12 años sin potencial de crecimiento. Las miniplacas como anclaje son efectivas para protracción maxilar en varios casos, aunque se necesita seguimiento y educación postquirúrgica. Se recomienda retirar las miniplacas cuando no sean necesarias, adaptando el protocolo a cada paciente. En resumen, el tratamiento con miniplacas es eficaz para corregir anomalías Clase III esqueléticas.

The present report aims to sequentially and visually present the maxillary protraction of a Class III skeletal patient using the BAMP protocol. After conducting a clinical analysis of the case, it was decided to perform orthopedic treatment using titanium miniplates with Class III intermaxillary elastics following the BAMP protocol, in conjunction with dentoalveolar orthodontic treatment using fixed bimaxillary appliances with Roth prescription 0.022" Mini Sprint Forestadent. The success of the interceptive approach using the BAMP protocol is observed. This approach managed to reduce both the time and complexity of orthodontic treatment and also decreased the need for orthognathic surgery in adulthood. The BAMP treatment, designed for specific ages and growth stages, proved successful in a 12-year-old patient without growth potential. Miniplates as anchorage are effective for maxillary protraction in various cases, although post-surgical follow-up and education are required. It is recommended to remove the miniplates when they are no longer necessary, adapting the protocol to each patient. In summary, miniplate treatment is effective in correcting Class III skeletal anomalies.

Is significant mandibular advancement possible after the peak of puberty? Dento-osseous palatal expansion and the STM4 technique (Skeletal Therapy Manni Telescopic Herbst 4 miniscrews): A case report.

INTRODUCTION: Treatment of skeletal class II growing patients often requires the use of functional appliances, aimed at promoting mandibular advancement. Among these, Herbst appliance is recommended for its effectiveness, efficiency, and reduced need for compliance. Despite its skeletal favourable effects, well-known dental compensations can occur, especially when the appliance is not used close to the pubertal peak: upper incisors retroclination, lower incisors proclination, upper molars distalization and lower molars mesialization could reduce the overjet needed for a proper mandibular advancement. To counteract these unfavourable effects skeletal anchorage could be crucial. AIM: The aim of this case report is to describe and evaluate the effects of using a skeletally anchored Herbst appliance in an 18-year-old (CVM5) male patient with skeletal Class II malocclusion and a convex profile. TREATMENT PROTOCOL: The treatment started with a tooth-bone-borne palatal expansion, then the upper arch was bonded with pre-adjusted ceramic brackets. After 2months, a Manni Telescopic Herbst (MTH) supported by 4 miniscrews (two in the maxilla and two in the mandible) was applied. To avoid anchorage loss, TADs were connected with elastic chains to the arches. Nine months later, the Herbst was removed, the lower teeth were bonded and the patient wore class 2 elastics to stabilise the occlusion. RESULTS AND CONCLUSIONS: After 24months the treatment goal was achieved with a considerable improvement of the profile and a clinically significant mandibular advancement (Pogonion moved forward 7mm). A one-year follow-up lateral X-rays showed a good stability of the result.

Dentoskeletal effects of mini-screw assisted, non-surgical palatal expansion in adults using a modified force-controlled polycyclic protocol: a single-centre retrospective study.

OBJECTIVES: This study assessed the dental and skeletal effects of pure bone-borne, non-surgical maxillary expansion, using a modified force-controlled polycyclic protocol. METHODS: Records of 17 adult patients, mean age 24.1 years; range 18-39 years, who had undergone maxillary expansion using a bone-borne Quad-expander (with 4 mini-screws), were analysed. In all patients, 0.17 mm/day of expansion was completed for 1 week, followed by a cyclic protocol of expansion of forward and backward turns until the force needed to turn the expander was below 400 cN, assessed weekly. After this, expansion continued at a rate of 0.17 mm/day until the desired amount of expansion was achieved. Cone beam computer tomography scans were taken pre- and post-expansion. RESULTS: The mid-palatal suture was successfully opened in 100% of patients included in this study. Axially, the amount of skeletal opening at the posterior nasal spine was 61% of the anterior nasal spine. Expansion was pyramidal in the coronal plane. Significant increases at the dental and skeletal levels were achieved, with changes at the skeletal level reaching 73%. The alveolar bone angle increased more than the angular changes at the molars and premolars. LIMITATIONS: This is a retrospective study with short-term results. CONCLUSION: The Quad-expander, with a force-controlled polycyclic expansion protocol, effectively produced a significant increase in maxillary width in skeletally mature subjects in the short term.

Cephalometric and digital model analysis of dentoskeletal effects of infrazygomatic miniscrew vs. Essix- anchored Carriere Motion appliance for distalization of maxillary buccal segment: a randomized clinical trial.

TRIAL DESIGN: Parallel. OBJECTIVE: To compare skeletally anchored Carriere Motion appliance (CMA) for distalization of the maxillary buccal segment vs. Essix anchored CMA. METHODS: Thirty-two class II malocclusion patients were randomly allocated into two equal groups. One group was treated with infrazygomatic (IZC) miniscrew- anchored CMA (IZCG) and the other group treated with Essix retainer- anchored CMA (EXG). Two lateral cephalograms and two digital models for upper and lower arches were taken for each patient: immediately before intervention and after distalization had been completed. RESULTS: Distalization period was not significantly different between the two groups. In contrast to EXG, IZCG showed insignificant difference in ANB, lower incisor proclination, and mesial movement of the lower first molar. There was significant rotation with distal movement of maxillary canine and first molar in both groups. CONCLUSION: IZC anchored CMA could eliminate the side effects of class II elastics regarding lower incisor proclination, mesial movement lower molars with a more significant amount of distalization of the maxillary buccal segment but with significant molar rotation. TRIAL REGISTRATION: The ClinicalTrials.gov Protocol Registration and Results System (PRS) has this RCT registered as (NCT05499221) on 12/08/2022.

Orthodontic considerations in hypodivergent craniofacial patterns.

This article examines the characteristics of hypodivergent craniofacial patterns and explores treatment modalities in response to these features. It discusses the impact of robust masticatory muscles, which produce heavy occlusal forces. In addition, it examines the use of Botox or splints to reduce gonial angles in individuals with a square face. A nonextraction treatment approach supported by temporary skeletal anchorage devices is recommended; however, if anatomical limitations persist, extraction may be necessary when arch expansion, molar distalization, incisor proclination, or interproximal reduction cannot create the necessary space. In hypodivergent cases where a nonextraction approach is impractical, a single-arch extraction strategy may be considered to prevent a reduction in the vertical dimension. Emphasizing esthetics, particularly maxillary incisor display, a protocol of total arch extrusion of the maxillary dentition assisted with temporary skeletal anchorage device, bite raisers, and interarch elastics is suggested.

Biomechanical and clinical considerations in deep bite treatment using temporary skeletal anchorage devices.

Deep bite is usually treated by intrusion of the anterior teeth, extrusion of the posterior teeth, or a combination thereof. Various traditional methods have been used to correct deep bites, but they can cause negative side effects. Recently, temporary skeletal anchorage devices (TSADs) have been used to intrude the anterior teeth simply and efficiently without side effects. The amount of incisal exposure at rest should be considered as the first factor in determining which tooth segment should be intruded to correct a deep bite. The center of resistance of the anterior teeth should be considered to achieve the proper biomechanics when intruding them. The location of TSADs should be determined to ensure sufficient interradicular bone to achieve the desired tooth movement. Therefore, clinicians should understand the biomechanical and clinical considerations to correct a deep bite using TSADs.

Anterior open bite correction via molar intrusion: Diagnosis, advantages, and complications.

Anterior open bite can be effectively treated nonsurgically via molar intrusion. This technique, involving the intrusion of posterior teeth using temporary skeletal anchorage devices, prompts counterclockwise rotation of the mandible. This rotation not only corrects anterior open bite but also contributes to a decrease in anterior facial height, improvements in lip incompetency, and forward movement of the chin. For successful outcomes, temporary skeletal anchorage devices, installed on both the buccal and palatal sides, must deliver equivalent intrusion force to the maxillary teeth. Treatment planning should consider factors such as skeletal discrepancies, vertical excess, incisor exposure, and configuration of the occlusal plane. Clinicians are advised to closely monitor periodontal changes and consider overcorrection to ensure lasting stability and maintenance of incisal overlap post-treatment.

Mini-Implant Insertion Using a Guide Manufactured with Computer-Aided Design and Computer-Aided Manufacturing in an Adolescent Patient Suffering from Tooth Eruption Disturbance.

Due to dental diseases, anatomical restrictions, and mixed dentition, the reduction in the number of teeth and the displacement of tooth germs pose challenges in orthodontic treatment, limiting anchorage options. The presented case demonstrates an advanced treatment solution using digital CAD/CAM-technologies and medical imaging for the creation of a mini-implant template. A 12-year-old male patient experiencing delayed tooth eruption, multiple impacted germs, and maxillary constriction underwent intraoral scanning and CBCT. Utilizing coDiagnostiXTM Version 10.2 software, the acquired data were merged to determine the mini-implant placement and to design the template. The template was then manufactured through stereolithography using surgical-guide material. Mini-implants were inserted using the produced appliance, enabling safe insertion by avoiding vital structures. Surgically exposed displaced teeth were aligned using a Hyrax screw appliance anchored on the mini-implants for rapid palatal expansion (RPE) and subsequently used as fixed orthodontics to align impacted teeth. The screw was activated daily for 10 weeks, resulting in a 7 mm posterior and 5 mm anterior maxillary transversal increase. Skeletal anchorage facilitated simultaneous RPE and tooth alignment, ensuring accuracy, patient safety, and appliance stability. The presented case shows a scenario in which computer-aided navigation for mini-implant positioning can enhance precision and versatility in challenging anatomical cases.

Comparative assessment of facemask therapy with and without skeletal anchorage in growing Class III patients with unilateral cleft lip and palate (UCLP): A single-center, prospective randomized clinical trial.

OBJECTIVE: The purpose of this study was to evaluate the maxillary protraction effect of facemask therapy with and without skeletal anchorage in growing Class III patients with unilateral cleft lip and palate (UCLP). MATERIALS AND METHODS: Thirty patients (aged 9-13 years) with UCLP having a GOSLON score 3 were selected for this prospective clinical study. The patients were allocated into two groups using computer generated random number table. Group I (facemask therapy along with two I shaped miniplates, FM + MP) and Group II (facemask mask along with tooth-anchored appliance, FM). Skeletal and dental parameters were evaluated on pre- and post-treatment lateral cephalograms and pharyngeal airway on cone-beam computed tomography systems (CBCT) for assessment of the treatment changes. RESULTS: Both methods proved to be effective with statistically significant improvements in skeletal and dental parameters (p < .05). Skeletal parameters (e.g., SNA, convexity-point A, ANB) with the FM + MP group showed greater change compared to those with FM group (SNA, 2.56°; convexity-point A, 1.22°; ANB, 0.35°). Significant proclination of maxillary incisors was observed in the FM group as compared to FM + MP group (U1 to NA, 5.4°; 3.37 mm). A statistically significant increase in pharyngeal airway volume was noted in both groups (p < .05). CONCLUSION: While both therapies are effective in protracting the maxilla in growing patients with UCLP, the FM + MP allows for a greater skeletal correction, minimizing the dental side effects seen with FM therapy alone. Thus, FM + MP appears to be a promising adjunct in reducing the severity of Class III skeletal correction needed in patients with cleft lip and palate (CLP).

A comparison of maxillary posterior changes following facemask therapy: Skeletal anchorage versus tooth-borne anchorage.

OBJECTIVE: To compare changes in the maxillary posterior structure as seen in cone-beam computed tomography (CBCT) images resulting from facemask therapy using skeletal (miniplate/FM) anchorage versus tooth-borne anchorage (RME/FM). MATERIALS AND METHODS: A retrospective study was conducted on 20 patients divided into the miniplate/FM group (nine patients aged 9.5 ± 1.4 years) and the RME/FM group (11 patients aged 9.2 ± 1.4 years). CBCT images before and after facemask therapy were evaluated to assess changes in the maxillary posterior structure. RESULTS: The miniplate/FM group had greater advancement of the maxilla and midface compared to the RME/FM group (p < .05). Specifically, there was about three times more advancement of the pterygomaxillary suture in the miniplate/FM group than in the RME/FM group (p < .05). Moreover, the advancement of the pterygomaxillary suture was about half the advancement of A point in the miniplate/FM group, while only about 25% in the RME/FM group. Finally, the miniplate/FM group showed an increase in the transverse dimension of the posterior and superior parts of the maxilla (p < .05). CONCLUSION: There was greater forward movement of the pterygomaxillary suture with facemask therapy using the skeletal anchorage compared to tooth-borne anchorage, leading to a more significant advancement of the maxilla and midface.

Total arch extrusion with skeletal anchorage to improve inadequate maxillary incisor display in a case of vertical maxillary deficiency.

Inadequate maxillary incisor display can negatively impact facial esthetics. Various treatment options exist depending on the underlying cause and severity of the condition. Skeletal anchorage was used to extrude the maxillary dentition and rotate the mandible backward, enhancing visibility of the maxillary incisors. An extrusion assembly was introduced to achieve orthodontic extrusion. Use of bite raisers and interarch elastics was also discussed. Treatment results demonstrated successful achievement of the treatment goals. In addition to optimal occlusion, the patient's facial profile improved with increased lip fullness. There was an increase in vertical facial height, and maxillary incisor display was significantly improved, resulting in a more pleasant smile. Two-year postretention records evidenced the stability of total arch extrusion to improve maxillary incisor display.

Interdisciplinary treatment of mutilated dentition and transverse maxillary deficiency with microimplant-assisted rapid palatal expansion, microimplants, and dental implants.

OBJECTIVE: This case report demonstrates an interdisciplinary approach to treat a 26-year-old male patient with hyperdivergent Class II skeletal pattern, maxillary transverse deficiency, slight anterior open bite, and multiple hopeless teeth with root rests. CLINICAL CONSIDERATIONS: An interdisciplinary treatment was required for oral hygiene improvement, caries treatment, extraction of residual roots and hopeless teeth, maxillary expansion using microimplant-assisted rapid palatal expansion, improvement of skeletal and dental relationship using orthodontic microimplants, and prosthetic restorations with the aid of dental implants. CONCLUSION: Consequently, esthetic and functional occlusal rehabilitation was achieved. CLINICAL SIGNIFICANCE: Hyperdivergent Class II facial and skeletal patterns with multiple missing teeth can be effectively treated using orthodontic skeletal anchorage. In young adults, the transverse discrepancy can be resolved using MARPE, which is also useful for improving the sagittal and vertical relationships. In the case of multiple missing teeth, orthodontic treatment can provide the proper space to facilitate dental implants to achieve optimal esthetics and function.

Current status of the biomechanics of extra-alveolar miniscrews.

Temporary skeletal anchorage devices such as miniscrews are frequently used nowadays. Compared to miniplates, miniscrews are much less expensive and technically easier to place and remove; they are popular and can be easily placed by an orthodontist. Extra-alveolar miniscrews offer benefits compared to inter-radicular miniscrews, such as reduced risk of root damage and the lack of interference with the mesiodistal tooth movement. They are particularly useful for addressing anchorage loss issues and enabling specific tooth movements such as total arch maxillary and mandibular retraction, posterior distalization, molar protraction, molar intrusion, occlusal plane control, and midline correction. The present paper discusses the current biomechanics principles related to the use of extra-alveolar miniscrews placed in the infrazygomatic and mandibular buccal shelf.

Orthodontic treatment of an open bite after splint therapy for a patient with idiopathic condylar resorption.

In the treatment of orthodontic patients with idiopathic condylar resorption, symptoms of temporomandibular joint disorders and constantly changing occlusions caused by an instability of mandibular position make it difficult for orthodontists to confirm definitive orthodontic diagnosis and treatment plans. Therefore, these patients' temporomandibular joint (TMJ) structures need to be stabilized with splint therapy before active tooth movement to identify and maintain the true mandibular position. For some idiopathic condylar resorption patients, orthognathic surgery can cause further resorption on the vulnerable condyles of the mandible; thus, effective orthodontic camouflage treatment after joint stabilization should be considered. During the orthodontic camouflage treatment, adverse loads on the TMJ structures, which could change the position of condyles, should be avoided, and TMJ-friendly mechanics must be applied.

Miniplaca palatina versátil: um leque de possibilidades / Versatile mini palatal plate: a range of possibilities

O palato é uma região considerada ideal para a inserção de dispositivos de ancoragem temporária (DAT's). É conhecido por possuir áreas com boa quantidade e qualidade óssea, longe das raízes dos dentes, com uma gengiva de boa qualidade, e dispor de um fácil acesso para uma correta instalação. O objetivo desse artigo é apresentar uma miniplaca palatina com mecânica originada na Coréia do Sul (BOS ­ Biocreative Orthodontic Strategy) como uma alternativa de ancoragem esquelética, por meio de um caso clínico e a demonstração de um passo a passo de sua instalação. Ela se mostra muito útil e eficiente em casos de distalização de molares superiores, mesialização ou intrusão dos mesmos. Por esta versatilidade, aqui no Brasil esta miniplaca recebe o nome de miniplaca palatina versátil (MPV). A MPV representa uma alternativa bastante eficaz em casos onde é necessário ancoragem esquelética sem incisão, se destacando em pontos como: simplicidade de instalação; estética; controle biomecânico; versatilidade e valor acessível. (AU)

The palate is a region considered ideal for the insertion of temporary anchorage devices (DAT's). It is known for having areas with good bone quantity and quality, away from the roots of the teeth, with good quality gums, and having easy access for correct installation. The objective of this article is to present a mini palatal plate with mechanics originated in South Korea (BOS ­ Biocreative Orthodontic Strategy) as an alternative for skeletal anchorage, through a clinical case and a step-by-step and the installation procedure. It proves to be very useful and efficient in cases of maxillary molar distalization, mesialization or intrusion of the same. Due to this versatility, here in Brazil this miniplate is called versatile mini-palatal plate (MPV). The MPV represents a very effective alternative in cases where skeletal anchorage without incision is required, standing out in points such as: simplicity of installation; aesthetics; biomechanical control; versatility and affordable value (AU)