Midline Alignment & Overjet Reduction
Sharjah Orthodontics (12 Months)
This case features an 18‑year‑old female presenting with maxillary midline deviation and excessive overjet, who sought advanced orthodontic intervention. Treatment was completed using Temporary Anchorage Devices (TADs) and HANT NiTi coil springs, precisely realigning her smile without extractions. Under the expert care of Dr. Srinivas in Sharjah, the result is a beautifully balanced, harmonious smile achieved in just 12 months.
Quick Facts Box (at a glance):
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Patient: 18‑year‑old female
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Chief Complaint: Maxillary midline deviation and prominent overjet
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Treatment Modality: Fixed braces enhanced by Temporary Anchorage Devices (TADs) and heat-activated nickel‑titanium (HANT NiTi) coil springs for gentle, continuous force with fewer appointments.
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Duration: Completed in 12 months
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Result: Precise midline alignment, overjet reduction, and optimal occlusion achieved without extractions—under the care of Dr. Srinivas in Sharjah.
Pre‑ vs Post‑Treatment Gallery
Pre‑treatment Fontal view
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maxillary midline deviation,
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prominent overjet
Post‑treatment Fontal view
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Midline aligned
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Overjet corrected
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Optimal incisor display
Pre - Treatment Right occlusal view
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End on Canine Relationship
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End on Molar Relationship
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Improper occlusal contacts
Post - Treatment Right occlusal view
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Class I Canine Relationship
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Class I Molar Relationship
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Ideal occlusal contacts
Pre - Treatment left occlusal view
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Larger Overjet
Post - Treatment left occlusal view
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Corrected Overjet
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Ideal occlusion
Pre‑treatment maxillary arch
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Shifted upper mid line
Post‑treatment maxillary arch
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Corrected upper mid line
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Ideal arch form
Pre‑treatment mandibular arch
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Mild Crowding
Post‑treatment mandibular arch
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Corrected crowding
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Well aligned lower teeth
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Achieved ideal arch form
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Precisely Placed lower fixed retainer
Treatment Sequence & Timeline
Phase 1: Diagnosis & Planning (Weeks 0–2)
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Initial Consultation & Records: CBCT, photos, impressions, and bite assessment establish diagnostic baseline.
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Treatment Plan Finalization: Customized plan designed to correct midline shift and overjet using TADs.
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Patient Alignment: Set expectations on a 12‑month timeline, schedule, and treatment costs.
Phase 2: Appliance Placement (Weeks 3–4)
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Brackets & Archwires Fitted: Bonded to both arches and initial light wires applied.
Phase 3: Active Treatment (Months 1–12)
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Alignment & Leveling (Months 1–4): Sequential heat-activated NiTi (HANT) wires aligned and leveled arches rapidly.
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TAD Placement (Month 4): Mini-implants (IZC screws) inserted in the upper jaw for anchorage control.
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Midline & Overjet Correction (Months 4–9): TAD-supported mechanics shifted the dental midline and reduced overjet efficiently.
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Finishing & Detailing (Months 9–12): Refined occlusion, root alignment, and esthetics for optimal bite and smile balance.
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Visit Frequency: Adjustments scheduled every 4–8 weeks to maintain progress.
Phase 4: Debonding & Retention (Month 12)
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Bracket Removal: Fixed appliances were carefully removed and teeth cleaned.
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Retainer Delivery: Custom fixed or removable retainers provided, with nighttime wear emphasized.
Phase 5: Retention Monitoring (Months 12–36+)
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Follow-Up Visits: Retainer fit and stability assessed at 3, 6, and 12 months post-debond.
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Long-Term Retention Advice: Transition to nighttime-only wear, with relapse prevention and ongoing monitoring.
Challenges & Clinical Insights
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Demand for micro‑level precision – The patient required exact midline and overjet correction, necessitating meticulous biomechanical control.
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Anchorage control via TADs – Temporary Anchorage Devices provided absolute anchorage, eliminating the need for headgear or elastics and ensuring asymmetrical tooth movement without unwanted reciprocal shifts
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Efficient 12‑month treatment window – By using advanced mechanics (HANT NiTi coil springs + TAD anchorage), the case was completed in 12 months, aligning with evidence that supports faster, patient-friendly treatment .
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Continuous, gentle force application – HANT NiTi coil springs delivered steady light forces with minimal discomfort and fewer appointments, backed by studies showing continuous-force NiTi springs outperform elastomerics in efficiency with less need for adjustments
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Biomechanical precision – Strategically sequenced phases (alignment, midline shift, finishing) prevented occlusal setbacks, all within a comfortable, patient-centered protocol.
Results Summary & Patient Feedback
Key Outcomes:
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Midline Aligned & Overjet Corrected – Achieved precise dental midline and normalized overjet, restoring ideal incisor position and improving lip posture.
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Class I Canine & Improved Occlusion – Established bilateral Class I canine relationships, delivering stable posterior occlusion and optimal bite alignment.
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Efficient 12‑Month Completion – The treatment was completed in just 12 months—driven by advanced biomechanics, not compliance.
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Anchorage Precision with TADs – Temporary Anchorage Devices provided absolute skeletal anchorage, ensuring controlled midline and overjet correction without extractions or headgear
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Continuous, Gentle Force via HANT NiTi Coil Springs – Utilized heat-activated NiTi coil springs to deliver steady, light forces with minimal discomfort and fewer appointments—backed by studies showing superelastic NiTi springs maintain constant forces and reduce pain during treatment
Patient Review
⭐️⭐️⭐️⭐️⭐️
"I’m thrilled with my new smile! The midline is perfect, and after years of issues, I can finally bite confidently on both sides."
Final Clinical Insights
By combining TAD-based anchorage, HANT NiTi coil spring mechanics, and precise biomechanical sequencing, this case achieved outstanding results in record time—true innovation powered the outcome, not just patient compliance. This modern, patient-centric protocol delivered both efficiency and comfort, exemplifying the quality of contemporary orthodontic care.
FAQs
1. How long does this treatment take?
Answer: This midline and overjet correction was completed in just 12 months using TADs and HANT NiTi coil springs—no extractions required.
2. What are TADs and why are they used?
Answer: TADs (Temporary Anchorage Devices) are small titanium mini-screws placed in the jawbone to provide a stable anchorage point. They allow precise tooth movement—like shifting the midline or reducing overjet—without bulky headgear or extractions
3. Do TADs placement and removal hurt?
Answer: Most patients describe minimal discomfort—placement and removal are quick and usually feel like mild pressure under local anesthesia. The jawbone itself has no nerves, so pain is minimal .
4. Are HANT NiTi coil springs painful?
Answer: No—heat-activated NiTi coil springs deliver a gentle, continuous force. Compared to other methods like elastic chains, NiTi springs maintain more consistent pressure with less discomfort .
5. Why were HANT NiTi coil springs chosen?
Answer: These springs use shape-memory properties to apply constant, optimal force over long periods, enhancing efficiency (e.g., 0.24–0.53 mm/month faster space closure) and minimizing the need for adjustments .