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December's Tip: A Way to Find Anchorage When Missing Molar Teeth

By: Dr. Thomas Hughes

By: Dr. Thomas Hughes

What do you do when you have no molar teeth on one side of an upper arch and need to do orthodontic treatment? This makes for an anchorage problem that you need to solve so that you can level, align and torque teeth into proper alignment (Figure 1-12).

One way might be to use a removable appliance such as a Schwarz or Hawley type appliance that can help develop the arch laterally when needed to gain arch length.  But now you have a removable appliance that the patient might or might not wear.

My solution is to band both bicuspids and use a buccal and lingual wire to tie both teeth together so that they act like a molar tooth (Figure 13-16). This way you can then use a fixed/removable lingual arch to act as anchorage and to widen the arch to make more arch length to align teeth.

Near the end of treatment you can remove the lingual arch and separate the bicuspids by cutting the buccal and lingual wires (Figures 17-18).  If you want you could also remove the bands and rebracket the bicuspids with brackets.  This way you can get the proper torque on each bicuspid (Figures 19-30).

Hopefully this will solve a problem you might have had with adult cases having missing molars in an arch.

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