G-Spring-TAD: A bondable uprighting spring for root control during aligner treatment in a patient with dental transposition

One of the most frequent types of transposition affects maxillary canines and first premolars, and in cases of both transposition correction and consolidation, root control is particularly crucial when delivering aligner treatment. The purpose of the present study is to outline an alternative method to optimise root control during aligner treatment of dental transposition. A 25-year-old woman presented with a skeletal Class III and dental Class I malocclusion, a normodivergent facial pattern, moderate maxillary crowding with proclined maxillary incisors, mild mandibular crowding with proclined mandibular incisors, and complete transposition of the maxillary right canine and first premolar. The orthodontic treatment was approached in two phases. In the first phase, transposition was consolidated by moving the maxillary right first premolar into the maxillary right canine position, and an additional aligner stage was performed after provisional aesthetic restoration on the maxillary right first premolar to improve the overall alignment and occlusion. The second phase was planned to combine aligners with an auxiliary made from an 0.18-mm stainless steel wire bonded directly on the tooth and a miniscrew placed distal to the lateral incisor. A G-Spring-TAD was bonded on the maxillary right canine to control root tipping and connected to a temporary anchorage device to cope with the reaction forces. The G-Spring-TAD is essentially a bondable uprighting spring but, instead of using a vertical slotted bracket and a wire as anchorage, it is bonded on the enamel and connected to a temporary anchorage device in order to have a stable anchorage point. The device described can be considered a valid and effective auxiliary for root control during aligner treatment. Keywords: aligners, sectional wires, transposition