Management of Bimaxillary Dentoalveolar Protrusion using the Snail Loop: A Case Report
Abstract
Bimaxillary protrusion is a prevalent malocclusion in the central Indian population, characterised by proclined upper and lower incisors, leading to lip incompetence and a convex profile. Management requires strategic treatment planning to achieve optimal functional aesthetic outcomes. The management of bimaxillary dentoalveolar protrusion presents a significant orthodontic challenge. The present case reports of a 17-year-old female patient with Angle’s class I malocclusion, Dewey’s type II modification, treated with the extraction of the first premolars in both the upper and lower arch, followed by en-masse anterior retraction using the Snail loop fabricated with 0.019”×0.025” titanium molybdenum alloy wire with preactivation alpha and beta bends of 20° and 30°, respectively. Complete space closure was achieved within six months with monthly activations, effectively demonstrating the efficiency of frictionless mechanics. Post treatment evaluation revealed significant improvement in incisor inclination {Upper Incisor to Nasion-A-Point (U1-NA) reduced from 29° to 23°, the Lower Incisor to Nasion-B Point angle (L1-NB) reduced from 36° to 27°}, enhanced facial profile (nasolabial angle improved from 93° to 108°) and achievement of lip competence (lower lip to E-line reduced from 2 mm to 0 mm). The present case demonstrates distinctive clinical significance through its achievement of en-mass anterior retraction utilising frictionless mechanics in a critical anchorage case, accomplished without skeletal anchorage while maintaining predictable force delivery, excellent torque control, and favourable dentoalveolar and soft-tissue results. Considering the limited clinical documentation available regarding the use of snail loop for bimaxillary dentoalveolar protrusion correction, the present case report represents a valuable addition to the clinical evidence base, substantiating the biomechanical efficacy and practical applicability of this technique.