Molar protraction using overtreatment techniques in maxillary first molar extraction: Clinical outcomes and biomechanical considerations

The present case report examines the clinical outcomes of and biomechanical considerations involved in using overtreatment techniques for molar protraction to replace an extracted maxillary first molar with the second molar. A 37-year-old woman with Class II malocclusion, anterior crowding and posterior scissor bite underwent clear aligner therapy. The treatment involved extracting the maxillary first molar and an overtreatment strategy was employed to counteract tipping during second molar protraction. After 46 months of treatment, significant improvements were attained with regard to dental alignment, occlusion and aesthetics, including corrected horizontal and vertical overlap, aligned maxillary anterior teeth, and the achievement of Class I molar and canine relationships. Cephalometric analysis showed favourable changes. This case highlights the effectiveness of clear aligners combined with overtreatment techniques for managing complex orthodontic movements, emphasising the importance of careful planning, patient compliance and regular evaluations to achieve optimal clinical outcomes. Keywords: Class II malocclusion, ClinCheck, first molar extraction, Invisalign, molar protraction, overtreatment