Micro-implant Uprighting cantilever for the correction of a severely rotated and angulated mandibular canine during clear aligner treatment

Root movements and the rotation of a round-shaped tooth are known to be particularly challenging using clear aligners. This case report describes effective and efficient hybrid mechanics, combining aligners and a micro-implant uprighting cantilever, to correct a rotated and angulated mandibular canine. A 28-year-old male patient sought treatment for moderate crowding and presented with a severely rotated and angulated right mandibular canine, which required significant root movement to correct. Despite 12.5 months of treatment using a bracketless wire in resin slots plus clear aligners, the canine rotation and angulation remained uncorrected. Consequently, a nickel–titanium cantilever supported by a micro-implant was added to the aligner treatment. The desired mesial-out crown rotation and distal root movement of the canine occurred in 5.5 months. Adding an auxiliary cantilever when treating severely rotated and angulated teeth in clear aligner treatment is worthy of consideration.