Incorporation of “Power Arm System” (PAS)
27 years old, female patient, came to the clinic for orthodontic treatment. Patient’s main concern was her shifted midline
CLINICAL PRESENTATION
–Class 1 malocclusion with upper and lower arch crowding and centreline shift
CLINICAL FINDINGS
- Class 1 molar relation
- Upper and lower centreline shifted to right hand side
- Missing UR3 and LR5
- Moderate upper arch crowding
- Mild lower arch crowding
TREATMENT GOALS
- To align both arches
- To correct upper and lower midline shift
TREATMENT APPROACH
Extraction of UL4, LL5 done. Power arms placed on LL4 and LL6 for root control. Power arms need to be cemented along the long axis of the tooth, the hook is bent away from the gingiva to prevent trauma to soft tissues.
Stage 1
- 35 sets of aligners
- Power arms on LL4 and LL6 to close LL5 space. Power arms activated monthly with power chain
Stage 2 (Refinement)
- Early refinement due to loss of 2nd order control of LL6
- 18 sets of aligners
Stage 3 (Refinement)
- Power arms removed
- 23 sets of aligners for finishing adjustments and closing posterior open bites
CONCLUSION
-The power arm system helps in the root control during space closure of second premolar extraction to prevent mesial tipping of the first molar and distal tipping of the first premolar into the extraction space.