“Keles transpalatal arch for molar derotation”- Clinical discussion

Aim: The aim of the article is to describe the effect of Keles Trans Palatal Arch (TPA) on unilateral and bilateral molar rotation illustrated with two case reports. Method: Unilateral and bilateral maxillary first permanent molars de-rotation were performed in two cases using Keles appliance system which consists of the precision lingual hinge cap and TPA made of TMA wire. (0.032 × 0.032") (Ormco, Orange, CA). A 20 degree activation is given to the rotating part/terminal end(s) of the TPA every fourth week until rotation is completely corrected. The de-rotation achieved and change in the intermolar width are assessed using digital cast analysis performed by Ilexis FACAD (AB-2014 version 3.8.00) software and by comparing the pre and post maxillary occlusal radiographs with marker wires. Result: Pre and post values showed that the de-rotation is achieved in both cases. Inter-molar width showed no significant changes in both cases, suggestive of minimal/no expansion. Conclusion: The Keles TPA resulted in better transverse molar control during molar de-rotation owing to its superior precision self-locking design. When Keles TPA is used in correction of unilateral molar rotation, it causes successful de-rotation on the affected side and minimum or no changes on the unaffected side