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Appliance with ALF Appliance
Mid-arch extractions are frequently the treatment of choice for severe arch length loss in the permanent. The same patients usually have underdeveloped arches as a component of their malocclusion. The major mechanical problem the clinician faces in a mid-arch extraction case is not losing the extraction sights until the cuspids have been fully retracted and the incisors are correctly aligned. The ALF appliance used in conjunction with fixed appliance therapy is the perfect solution to both of these situations.
The following case is an excellent example of how the ALF appliance can be used to both develop the arches and prevent the loss of anchorage with the molars moving forward.
Severe arch length loss in all four quadrants.