This case report presents successful orthodontic management of unilateral retained deciduous second molars and congenitally missing second premolars using an additional anchorage in conjunction with the segmented arch approach. A 21-year-old female patient presented as skeletal Class I malocclusion, mild crowding, straight facial profile, and orthodivergent facial pattern. The treatment plan was established to extract deciduous teeth and close the extraction space by molar protraction. A Nance appliance and lingual holding arch were used as an additional anchorage to maintain the facial profile and dental midline, with pure molar protraction performed using a segmented arch and sliding mechanics. After 1 year of molar protraction with well-controlled molar angulation and rotation, a continuous arch was performed for full mouth refinement. The total treatment duration was 34 months achieving unilateral molar protraction and bilateral Class I molar and canine relationships with satisfactory facial esthetics and functional occlusion.

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.