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Abstract

Summary: An adult male (20 years old) came to our clinic with a chief complaint of lower posterior crowding. Clinical examination found mild spacing over the lower anterior teeth and lingually blocked-in lower second premolars. Because the patient didn’t want to receive extraction treatment, ISW (improved superelastic Ti-Ni alloy wire) leveling was performed to relieve lower arch crowding. Sufficient space was created by distalization with open coil spring and crimpable stopper. With ISW MEAW-like wire as reinforced anchorage over the lower arch, a satisfactory result was obtained. Meanwhile, lower left second premolar was derotated with open coil spring and elastic chain. Treatment was completed within 11 months and a stable occlusion was achieved after the active treatment.

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