{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T07:06:31Z","timestamp":1777359991922,"version":"3.51.4"},"reference-count":13,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The correction of a severe maxillary protrusion in an adult by distal movement of the maxillary molars has been one of the most difficult biomechanical problems in orthodontics. This article reports on the treatment of an adult case of severe maxillary protrusion and a large overjet treated with a skeletal anchorage system. A female patient, age 22 years and 3 months, complained of the difficulty of lip closure due to severe maxillary protrusion with a gummy smile. Overjet and overbite were +7.6 mm and \u22120.9 mm, respectively. She had a history of orthodontic treatment in which her maxillary first premolars were extracted. In order to conduct distal movement of the maxillary molars, anchor plates were placed in the zygomatic process. After achieving a Class I molar relationship, retraction and intrusion of the maxillary incisors were performed. After a 2-year treatment, an acceptable occlusion was achieved with a Class I molar relationship. Her convex facial profile with upper lip protrusion was considerably improved, and the lips showed less tension in lip closure. After a 2-year retention period, an acceptable occlusion was maintained without recurrence of maxillary protrusion, indicating a stability of the occlusion. The result of this treatment indicated that skeletal anchorage is of great importance as a remedy for achieving intrusion and retraction of the maxillary incisors in cases of severe maxillary protrusion with a patient who had previous orthodontic treatment.<\/jats:p>","DOI":"10.2319\/010307-3.1","type":"journal-article","created":{"date-parts":[[2007,8,15]],"date-time":"2007-08-15T16:52:19Z","timestamp":1187196739000},"page":"181-188","source":"Crossref","is-referenced-by-count":10,"title":["Skeletal Anchorage for Orthodontic Correction of Severe Maxillary Protrusion after Previous Orthodontic Treatment"],"prefix":"10.2319","volume":"78","author":[{"given":"Eiji","family":"Tanaka","sequence":"first","affiliation":[{"name":"a Associate Professor, Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiko","family":"Nishi-Sasaki","sequence":"first","affiliation":[{"name":"b Research Assistant, Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuro","family":"Hasegawa","sequence":"first","affiliation":[{"name":"c Graduate student (PhD), Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clarice","family":"Nishio","sequence":"first","affiliation":[{"name":"d Research Fellow, Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiko","family":"Kawai","sequence":"first","affiliation":[{"name":"e Resident, Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuo","family":"Tanne","sequence":"first","affiliation":[{"name":"f Professor and Department Chair, Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1164","reference":[{"key":"2020042120400321800_i0003-3219-078-01-0181-b1","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1034\/j.1600-0501.1996.070416.x","article-title":"The use of palatal implants for orthodontic anchorage. Design and clinical application of the orthosystem.","volume":"7","author":"Wehrbein","year":"1996","journal-title":"Clin Oral Implants Res"},{"key":"2020042120400321800_i0003-3219-078-01-0181-b2","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/0002-9416(93)90002-O","article-title":"Quantitative analysis of the orthodontic and orthopedic effects of maxillary traction.","volume":"84","author":"Baumrind","year":"1983","journal-title":"Am J Orthod"},{"key":"2020042120400321800_i0003-3219-078-01-0181-b3","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1093\/ejo\/14.4.264","article-title":"Distalization of maxillary first and second molars simultaneously with repelling magnets.","volume":"14","author":"Bondemark","year":"1992","journal-title":"Eur J Orthod"},{"key":"2020042120400321800_i0003-3219-078-01-0181-b4","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/S0889-5406(05)80439-1","article-title":"Molar and incisor changes with Wilson rapid molar distalization.","volume":"104","author":"Muse","year":"1993","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2020042120400321800_i0003-3219-078-01-0181-b5","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/S0889-5406(00)70238-1","article-title":"Dentoalveolar and skeletal changes associated with the pendulum appliance.","volume":"117","author":"Bussick","year":"2000","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2020042120400321800_i0003-3219-078-01-0181-b6","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1067\/mod.2000.110332","article-title":"Evaluation of the Jones jig appliance for distal molar movement.","volume":"118","author":"Brickman","year":"2000","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2020042120400321800_i0003-3219-078-01-0181-b7","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/j.ajodo.2005.08.036","article-title":"Distal movement of maxillary molars in nongrowing patients with the skeletal anchorage system.","volume":"129","author":"Sugawara","year":"2006","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2020042120400321800_i0003-3219-078-01-0181-b8","article-title":"Morphometric analysis in maxillary protrusion [in Japanese].","author":"Wada"},{"key":"2020042120400321800_i0003-3219-078-01-0181-b9","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/S0889-5406(99)70345-8","article-title":"Skeletal anchorage system for open-bite correction.","volume":"115","author":"Umemori","year":"1999","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"2020042120400321800_i0003-3219-078-01-0181-b10","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1007\/BF01579165","article-title":"Root resorptions in upper first premolars after application of continuous intrusive forces. 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