Achieving correction of a posterior scissorbite with a mini-screw

From Volume 13, Issue 1, January 2020 | Pages 17-18


Jason Matharu

BDS, DDS, FDS Orth RCS(Edin), MOrth RCS(Edin), MJDF RCS(Eng), MA(Cantab), PGDip(RAM), LRAM

Consultant in Orthodontics, Department of Orthodontics and Oral and Maxillofacial Surgery, Gloucester, UK

Articles by Jason Matharu

James Dickson


Consultant in Orthodontics, Department of Orthodontics and Oral and Maxillofacial Surgery, Gloucester, UK

Articles by James Dickson

Jerry Farrier


Consultant in Oral and Maxillofacial Surgery, Department of Orthodontics and Oral and Maxillofacial Surgery, Gloucester Royal and Cheltenham General Hospitals, Gloucester, UK

Articles by Jerry Farrier


Scissorbite correction of posterior teeth can often be challenging. For adolescent patients, they may occur due to late eruption of the second permanent molar teeth after appliances are removed, or due to operator preference not to include them on the appliance. This case report describes a 17-year-old patient who had previously been treated with fixed appliances but did not originally have second permanent molars bonded. Complete correction of the scissorbite on the UR7 was effectively achieved in 14 weeks using a minimal system comprising only a palatal mini-screw, molar band and elastomeric chain.

CPD/Clinical Relevance: Mini-screws placed in a palatal position can provide an effective way to correct posterior scissorbites.


Second permanent molars can often be problematic if they are not bonded and included on a fixed orthodontic appliance. This can occur following appliance removal when there is late eruption of the second permanent molars, or when operators simply do not consider the need to bond them or check their occlusal relationship. If the occlusion is not checked before appliances are removed, or indeed retained in a suitable fashion, it can lead to a number of significant problems.

The following article describes a case in a 17-year-old adolescent patient where the upper right second permanent molar (UR7) was left in scissorbite after treatment with a fixed appliance, and the patient had noticed that both its position and the occlusion had substantially worsened since eruption of the upper right third molar (UR8). Figure 1 shows the patient at presentation, showing the UR7 in scissorbite. The patient was understandably not keen to wear further fixed appliances, so a plan was made to place a mini-screw between the palatal roots of the UR7 and UR6 to provide traction to align the UR7 and then extract the UR8 to provide the necessary space.

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