Midline Alignment & Overjet Reduction Orthodontics (12 Months)

Fixed braces, temporary anchorage devices (TADs) and nickel-titanium coil-spring mechanics were used to correct the tooth positions without extractions. The published active-treatment duration was 12 months; this is an individual case outcome, not a standard treatment promise.

• Patient: 18‑year‑old female

• Chief Complaint: Maxillary midline deviation and prominent overjet

• Treatment: Fixed braces with temporary anchorage devices (TADs) and heat-activated nickel-titanium (HANT NiTi) coil-spring mechanics, selected to control the required tooth movements.

• Duration: Completed in 12 months

• Result: Precise midline alignment, overjet reduction, and optimal occlusion achieved without extractions—under the care of Dr. Sree.

Pre-treatment frontal view

• maxillary midline deviation,

• prominent overjet

Post-treatment frontal view

• Midline aligned

• Overjet corrected

• Optimal incisor display

Pre - Treatment Right occlusal view

• End on Canine Relationship

• End on Molar Relationship

• Improper occlusal contacts

Post - Treatment Right occlusal view

• Class I Canine Relationship

• Class I Molar Relationship

• Ideal occlusal contacts

Pre - Treatment left occlusal view

• Larger Overjet

Post - Treatment left occlusal view

• Corrected Overjet

• Ideal occlusion

Pre‑treatment maxillary arch

• Shifted upper mid line

Post‑treatment maxillary arch

• Corrected upper mid line

• Ideal arch form

Pre‑treatment mandibular arch

• Mild Crowding

Post‑treatment mandibular arch

• Corrected crowding

• Well aligned lower teeth

• Achieved ideal arch form

• Precisely Placed lower fixed retainer

Phase 1: Diagnosis & Planning (Weeks 0–2)

• Initial Consultation & Records: CBCT, photos, impressions, and bite assessment establish diagnostic baseline.

• Treatment Plan Finalization: Customized plan designed to correct midline shift and overjet using TADs.

• Patient Alignment: Set expectations on a 12‑month timeline, schedule, and treatment costs.

Phase 2: Appliance Placement (Weeks 3–4)

• Brackets & Archwires Fitted: Bonded to both arches and initial light wires applied.

Phase 3: Active Treatment (Months 1–12)

• Alignment & leveling (months 1–4): sequential nickel-titanium archwires were used to align and level the arches.

• TAD Placement (Month 4): M ini-implants (IZC screws) inserted in the upper jaw for anchorage control.

• Midline & Overjet Correction (Months 4–9): TAD-supported mechanics shifted the dental midline and reduced overjet efficiently.

• Finishing & Detailing (Months 9–12): Refined occlusion, root alignment, and esthetics for optimal bite and smile balance.

• Visit Frequency : Adjustments scheduled every 4–8 weeks to maintain progress.

Phase 4: Debonding & Retention (Month 12)

• Bracket Removal: Fixed appliances were carefully removed and teeth cleaned.

• Retainer Delivery: Custom fixed or removable retainers provided, with nighttime wear emphasized.

Phase 5: Retention Monitoring (Months 12–36+)

• Follow-Up Visits: Retainer fit and stability assessed at 3, 6, and 12 months post-debond.

• Long-Term Retention Advice: Transition to nighttime-only wear, with relapse prevention and ongoing monitoring.

• Demand for micro‑level precision – The patient required exact midline and overjet correction, necessitating meticulous biomechanical control.

• TAD anchorage: temporary anchorage devices provided a planned anchor point for asymmetric tooth movement. Anchorage and tooth response still required clinical monitoring.

• Recorded treatment time: active treatment was completed in 12 months in this case. Appliance choice alone does not determine speed; movement complexity, biological response and patient cooperation also matter.

• Coil-spring mechanics: nickel-titanium springs applied a planned force between reviews. The force, activation and response needed monitoring; comfort and appointment frequency vary.

• Sequenced treatment: alignment, midline correction and finishing were reviewed in stages to coordinate tooth movement and the final bite.

Key Outcomes:

• Midline Aligned & Overjet Corrected – Achieved precise dental midline and normalized overjet, restoring ideal incisor position and improving lip posture.

• Class I Canine & Improved Occlusion – Established bilateral Class I canine relationships, delivering stable posterior occlusion and optimal bite alignment.

• Recorded 12-month completion: the active phase finished in 12 months. Attendance, hygiene, appliance care and any prescribed elastics remained important.

• TAD-supported control: skeletal anchorage assisted the planned midline and overjet correction. No extractions or headgear were used in this published case.

• Nickel-titanium coil springs: the springs were selected to support the planned tooth movement. This case does not establish that springs cause less pain or require fewer visits than another method.

What This Case Shows

A dental midline and overjet problem may be managed with controlled asymmetric mechanics in a suitable case. Your starting bite, supporting tissues and goals must be assessed separately.

TAD anchorage and coil-spring mechanics helped deliver the planned midline and overjet correction in this case. The useful lesson is the coordination of diagnosis, movement control, review and retention; a single result cannot establish a faster or more comfortable outcome for every patient.

1. How long does this treatment take?
This case was completed in 12 months without extractions. Your likely duration depends on the starting bite, required movements, biology and cooperation, and is estimated after assessment.

2. What are TADs and why are they used?
Temporary anchorage devices are small mini-screws used as anchor points for selected orthodontic movements, such as midline or overjet correction. They do not automatically eliminate extractions or other appliances.

3. Does TAD placement or removal hurt?
Local anaesthetic is used for placement. Pressure during insertion and soreness afterward can occur; removal is usually straightforward. Discuss pain control, care and what to do if the device becomes loose or uncomfortable.

4. Are HANT NiTi coil springs painful?
Tooth movement can cause temporary tenderness after fitting or adjustment, including when nickel-titanium coil springs are used. Discomfort varies; persistent pain, rubbing or a loose component should be reviewed.

5. Why were HANT NiTi coil springs chosen?
Nickel-titanium coil springs were selected to apply a planned force for the required movements. Their force characteristics are one part of treatment; this case does not prove a particular monthly speed advantage or guarantee fewer adjustments.