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Abstract

A case report was presented with a female patient of class II malocclusion,bimaxillary dentoalveolar protrusion with space deficiency. Bilateral lower left second molars were mesially inclined impactions with large caries. The lower left second molar was diagnosed with acute apical periodontitis. Treatment planning was described as below: (1) asymmetric extraction of upper bilateral first premolar , lower right first premolar and lower left second molar, (2) A bone screw was placed in the lower left region for distalization of lower left dentition and midline control. The treatment results were satisfied and stable, including great improvement of facial profile , coincident dental midline and Angle Class I canine relationship. Other possible treatment options, mechanics of lower molar distalization, and factors associated with miniscrew failure were discussed comprehensively.

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