Uprighting mesially inclined mandibular second molars with a modified Uprighter Jet.

281 P loss of the mandibular second premolars and first molars due to caries or periodontal disease can lead to mesioinclination of the second molars. Various orthodontic methods have been used to upright the lower molars for prosthetic rehabilitation,1-8 but these generally involve molar extrusion and reciprocal movement of the anchorage unit.9 Conventional flexible alloy or rectangular stainless steel archwires may not be able to control extrusive or lateral movements over such a long edentulous space.10 Dental implants have been used in extraction sites as anchorage for molar uprighting.11 Miniscrews may be more effective, however, because they can be loaded immediately with light, continuous forces from nickel titanium closed-coil springs or elastomeric thread.9,12,13 In addition, retromolar miniscrew insertion allows the force to be applied distal to the molar’s center of resistance, facilitating vertical control during the extrusion phase.14 The Uprighter Jet* developed by Carano and colleagues is an ideal appliance for space management in these cases.10 Its spring activation provides complete three-dimensional control of molar uprighting; because the center of rotation is located at the apex of the root, extrusion is minimized and the occlusal plane is preserved. The absence of brackets is helpful in deep-bite cases. The Uprighter Jet is also simple to insert, requiring no special patient cooperation, and is relatively unobtrusive and comfortable. This article describes a modified version of the Uprighter Jet that can be used with miniscrew anchorage for molar uprighting in cases with excessive edentulous spacing.