Authors :
Dr. Sharath Kumar Shetty; Dr. Revanth S. Soonthodu; Dr. Aashiq Iqbal
Volume/Issue :
Volume 10 - 2025, Issue 9 - September
Google Scholar :
https://tinyurl.com/yt6mb8c7
Scribd :
https://tinyurl.com/y3mfyskr
DOI :
https://doi.org/10.38124/ijisrt/25sep1300
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Abstract :
Background:
Management of Class II malocclusion often requires maxillary distalization. Conventional methods are limited by
anchorage loss, patient compliance, or dental side effects. Infrazygomatic crest (IZC) screws provide absolute anchorage
and enable efficient full-arch distalization.
Case Presentation:
A 19-year-old female presented with a convex facial profile, Class II molar relationship, and proclined maxillary
incisors. Non-extraction management was planned using IZC screws for en-masse distalization of the maxillary arch. IZC
screws were inserted bilaterally between the maxillary first and second molars at the infrazygomatic crest region. 220 g of
force was applied per side for distalization. Over 12 months, full-arch distalization was achieved, molar relation was
corrected to Class I, and incisor proclination was reduced.
Conclusion:
IZC screws provided reliable anchorage for en-masse distalization, simplifying biomechanics, avoiding extractions,
and improving facial esthetics. They represent an effective treatment option for Class II correction when non-extraction
therapy is indicated.
Keywords :
Infrazygomatic Crest (IZC) Screws, Distalization, Temporary Anchorage Devices (TADs).
References :
- Liou EJW, Chen PH, Wang YC, Lin JC. A computed tomographic image study on the thickness of the infrazygomatic crest of the maxilla and its clinical implications for miniscrew insertion. Am J Orthod Dentofacial Orthop. 2007;131(3):352–356.
- Chang CH, Liu SSY, Roberts WE. Primary failure rate for 1,638 consecutively placed orthodontic miniscrews in Taiwan. Int J Oral Maxillofac Implants. 2007;22(6):955–962.
- Wilmes B, Ludwig B, Vasudavan S, Nienkemper M, Drescher D. The T-Zone: median paramedian insertion of palatal mini-implants and clinical results. J Clin Orthod. 2016;50(4):194–204.
- Lin JJ, Roberts WE. Guided infrazygomatic screws: reliable maxillary arch retraction. Int J Orthod Implantol. 2013; 32:4–18.
- Liou EJW. Clinical applications of orthodontic miniscrews in the infrazygomatic crest area. Prog Orthod. 2011;12(2):123–132.
- Chang CH, Lin JS, Roberts WE. Orthodontic bone screws: biomechanics and clinical application. Int J Orthod Implantol. 2012; 27:18–28.
- Yao CCJ, Lai EH, Chang JZ, Chen I, Chen YJ. Comparison of treatment outcomes between skeletal anchorage and extraoral anchorage in adults with maxillary dentoalveolar protrusion. Am J Orthod Dentofacial Orthop. 2008;134(5):615–624.
- Lin JJ, Yeh HY, Roberts WE. Distalization with extra-alveolar bone screws: biomechanics and clinical outcomes. Semin Orthod. 2018;24(1):38–50.
- Chang CH, Roberts WE. Evidence-based clinical application of IZC screws for distalization. Int J Orthod Implantol. 2017; 45:72–82.
Background:
Management of Class II malocclusion often requires maxillary distalization. Conventional methods are limited by
anchorage loss, patient compliance, or dental side effects. Infrazygomatic crest (IZC) screws provide absolute anchorage
and enable efficient full-arch distalization.
Case Presentation:
A 19-year-old female presented with a convex facial profile, Class II molar relationship, and proclined maxillary
incisors. Non-extraction management was planned using IZC screws for en-masse distalization of the maxillary arch. IZC
screws were inserted bilaterally between the maxillary first and second molars at the infrazygomatic crest region. 220 g of
force was applied per side for distalization. Over 12 months, full-arch distalization was achieved, molar relation was
corrected to Class I, and incisor proclination was reduced.
Conclusion:
IZC screws provided reliable anchorage for en-masse distalization, simplifying biomechanics, avoiding extractions,
and improving facial esthetics. They represent an effective treatment option for Class II correction when non-extraction
therapy is indicated.
Keywords :
Infrazygomatic Crest (IZC) Screws, Distalization, Temporary Anchorage Devices (TADs).