Combined use of miniscrews and clear appliances for the treatment of bialveolar protrusion without conventional brackets

The increasing demand for esthetic orthodontic treatment has led to the development of tooth-colored and even "invisible" appliances. Although sequential removable clear aligners have several advantages over conventional bracket systems, they have some limitations in extraction treatment. This case report presents the esthetic extraction treatment of a patient with bialveolar protrusion; conventional brackets were not used. The treatment was completed in 2 steps. The first step involved segmental retraction of the anterior teeth by using miniscrews and an anterior lingual splint with a clear lever arm. The second step involved alignment and finishing by using sequential removable clear aligners. The patient's esthetic demands were fulfilled successfully during treatment, and satisfactory facial profile and occlusion were achieved after treatment.