Abstract
Before the advent of skeletal anchorage distalisation of the lower arch was considered cumbersome. Individual lower molar distalisation followed by retraction into the distalised space created is very time-consuming. Therefore, to reduce the treatment duration lower arch distalisation can be attempted by using buccal shelf screws. Here we present a case of Angle's Class III malocclusion which has been treated effectively with distalisation of lower arch using 2 buccal shelf screws (2x12mm) with elastic chains following lower third molars extraction. We achieved full arch distalisation of 3.5mm bilaterally in a span of 1.5 months into a class I molar and canine relationship with normal overjet and overbite. Total treatment duration was of 17 months.
These results were stable. There were no changes in vertical facial dimensions.
INTRODUCTION
Class III malocclusion has a low incidence and thus its prevalence varies among different ethnic groups.1-3 The severity of class III malocclusion and the patient's age are the determining factors in its treatment. Orthognathic surgery is the option for very severe malocclusion on the other hand, orthodontic camouflage can be attempted in mild to moderate cases.4-5 Camouflage in the past has been attempted with various approaches such as: single lower incisor extraction, high pull headgear, molar protraction and class III elastics.4,6-10 Camouflage treatment can be attempted with two approaches: in first approach extraction of teeth is done either lower premolar or lower incisor.9,11 In the second approach mandibular molar distalisation can be attempted. [12] [13] [14] [15] Orthodontists consider mandibular molar distalisation as one of the difficult movement to be achieved due to further complexities such as distal tipping and rotation of molars.16 According to Newton's law, the backward push canines, or to anterior hooks. 21 In our treatment, we have done en masse distalisation.
Few studies have shown the counter results of placing buccal shelf screws i.e. the lateral component of the force may act to increase the intercanine width and consequently affect the stability of the treatment results. They may also cause rotation of the occlusal plane, increasing the vertical dimension, based on the relationship between the force vector and the center of resistance of the entire arch. 22 We didn't face any adverse effects of buccal shelf screws in our case. To prevent first and second order side effects rigid wire should be used for distalisation.
CONCLUSION
The Buccal shelf implants can withstand heavier loads and appear as a viable option for lower full arch distalisation.
When compared to retromolar implants there is no waiting period required for bone fill in the third molar region, thus advantageous. OJN

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